The Effect of N-Acetyl-Cysteine on NRF 2 Antioxidant Gene Expression in Asthenoteratozoospermia Men: A Clinical Trial Study

One of the important factor associated with male infertility is high production of reactive oxygen species(ROS). The main function of Nuclear factor erythroid 2-related factor 2 (NRF 2) is to activate the cellular antioxidantresponse by inducing the transcription of a wide array of genes that can combat the harmful effects of factorssuch as oxidative stress. The purpose of this study was to evaluate the effect of N-acetyl-L-cysteine (NAC), as anantioxidant drug, on NRF 2 Gene Expression in Asthenoteratozoospermia Men.

In this randomized, blinded clinical trial study, included 50 infertile men with asthenoteratozoospermia,who received NAC (600 mg, three times daily). Sperm parameters analyzed according to the world health organization(WHO; 2010). Sperm DNA fragmentation, relative NRF 2 expression, and seminal plasma level of antioxidant enzymeswere measured by TUNEL assay, reverse transcription polymerase chain reaction (RT-PCR) and ELISA test, respectively.

After NAC treatment, findings showed a significant increase in sperm concentration and motility comparedto pre-treatment status, whereas the percentage of abnormal morphology and DNA fragmentation was significantlydecreased (p <0.05). A significant improvement in expression of NRF 2 gene and antioxidant enzyme levels were observedcompared to pre-treatment by NAC (p <0.05). Significant correlations were observed between NRF 2 mRNAexpression level, specific sperm parameters and level of antioxidant enzymes (p <0.05).

The results demonstrated that NAC oral supplementation protected against oxidative stress by enhancingNRF 2 expression. This could improve semen parameters quality parameters in asthenoteratozoospermia men (Registrationnumber: IRCT20170830035998N4).