Evolution of the effectiveness of mother milk exosome in experimental testicular torsion model

Aim: In our study, it was aimed to examine the effectiveness of breast milk exosome in the treatment of testicular torsion and to reveal the importance of breast milk exosome for future studies. Materials and Methods: In our study, 8 Sprague dawley male rats, each weighing between 250-350 gr, were studied in 3 groups. A scrotal incision was made in the rats in Group 1 and closed without any other procedure. After the scrotal incision was made in the rats in Group 2, the left testis was rotated 720 degrees counterclockwise and fixed to the anterior abdominal wall with 3/0 silk sutures; Detorsion was performed after the incision was made again 4 hours after this procedure. A scrotal incision was made in the rats in group 3, and then the left testis was rotated 720 degrees counterclockwise and fixed to the anterior abdominal wall with 3/0 silk sutures; 30 minutes before the detorsion to be made 4 hours after this procedure, 1cc exosome was applied to the left testis and waited for another 2 hours. Six hours after the first operation, scrotal incision was made in all rats, their left testicles were removed, and they were divided into two for biochemical and histopathological examination and sent to the laboratory under appropriate conditions. All subjects were euthanized by anemia method. The effect of exosome on the prevention of reperfusion injury in testicular torsion was evaluated biochemically, tissue MDA, SOD, CAT levels. It was also evaluated with JTBS to show its histopathological effect. Results: It was shown that there was a statistically significant decrease in Group 3 MDA values compared to Group 2 (p<0.05). When Group 3 and Group 2 SOD and CAT values were compared, it was seen that these values were higher in Group 3. However, in the statistical analysis of these values, while the SOD value was significant, no significant difference could be found in the CAT value (p=0.012 and p=0.071). In the histopathological examination, there was a statistically significant difference in ischemia/reperfusion (I/R) injury in Group 3 compared to Group 1 and Group 2 (p<0.05). It was observed that exosome application reduced the damage in testicular tissue histopathologically significantly compared to the torsion group, but it could not reach values close to the control group. Conclusion: We have shown that low dose exosome given half an hour before detorsion in testicular torsion does not completely prevent reperfusion injury, but significantly preserves testicular tissue. Key Words: Testicular torsion, ischemia/reperfusion injury, breast milk exosome.