ORIGINAL ARTICLE  FUNCTIONAL AND PEDIATRIC UROLOGY Open access

Hellenic Urology 2025 March;37(1):1-5

DOI: 10.23736/S2241-9136.24.00035-5

Copyright © 2024 THE AUTHORS

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lingua: Inglese

TLR4 expression in testicular torsion: a comparison between neonatal and adolescent periods

Basri CAKIROGLU ¹ ✉, Ali GOZUKUCUK ², Gürkan ARIKAN ³, Ilknur B. CESUR ⁴, Bekir S. UYANIK ⁵

¹ Deparment of Urology, Hisar Hospital Intercontinental, Üsküdar University, Istanbul, Türkiye; ² Department of Pediatric Surgery, Hisar Hospital Intercontinental, Istanbul, Türkiye; ³ Deparment of Urology, Iskenderun Gelişim Hospital, Iskenderun, Hatay, Türkiye; ⁴ Deparment of Pediatric Surgery, University of Health Sciences, Adana City Teaching and Research Hospital, Adana, Türkiye; ⁵ Deparment of Biochemistry, Hisar Hospital Intercontinental, Istanbul, Türkiye

BACKGROUND: Testicular torsion is a urological emergency characterized by the twisting of the spermatic cord, leading to testicular ischemia. Toll-like receptor 4 (TLR4) is a key component of the innate immune system and has been implicated in various inflammatory processes. This study aimed to investigate TLR4 expression in testicular tissue samples from neonatal and adolescent patients with testicular torsion to understand its potential role in the pathology.
METHODS: A total of 64 patients diagnosed with testicular torsion, comprising 32 neonates and 32 adolescents, were included. Tissue samples collected during surgery underwent immunohistochemical staining for TLR4 expression. Chi-square test was used to analyze any differences in TLR4 positivity between the neonatal and adolescent groups.
RESULTS: TLR4 positivity was observed in 31.2% (20/64) of cases, with no significant difference between neonates and adolescents. However, a trend towards stronger TLR4 positivity was noted in neonates (15.6%, 5/32) compared to adolescents (3.1%, 1/32), although this difference did not reach statistical significance.
CONCLUSIONS: Our findings suggest a potential association between TLR4 expression and testicular torsion, highlighting the involvement of inflammatory processes in its etiology. Further research with larger sample sizes is needed to validate these results and elucidate the role of TLR4 in testicular torsion pathogenesis.

KEY WORDS: Spermatic cord torsion; Toll-like receptor 4; Newborn infant; Adolescent; Immunohistochemistry