[Chronic Chagas' disease: effects of treatment nn the levels of antibodies to crude and partially purified Trypanosoma cruzi antigens]

The specific therapy in Chagas' disease is useful in acute and neonatal infection and in children under three years old. The results of antiparasitic treatment during chronic infection are still controversial. It will be interesting to analyze the serological behavior in patients treated during chronic infection, to advance in the search of evolutive markers and markers of therapeutic efficacy. In the present work we have measured the antibody response by conventional serology and the response to partially purified T. cruzi antigens in chagasic patients who received nifurtimox or benznidazol 2 to 20 years before. The results showed that, by indirect immunofluorescence in 29% of treated patients the antibody levels were below the established cut off (1:32). By indirect hemagglutination 55% of treated patients showed this serological behavior. In this group a high number of discordant results was observed. By immunoenzimatic assay it was possible to detect a significative decrease of serologic reactivity to a partially purified acidic antigen (F IV) and to exoantigen of T. cruzi. It will be interesting to perform longitudinal surveys employing these antigens, to go further in the knowledge of possible immunological evolutive markers in Chagas' disease.

Notulae seminologicae. 8. Ultrastructural sperm defects in two men, carriers of autosomal inversion

The electron microscopical analysis of spermatozoa in two infertile male carriers of a pericentric inversion in one of the chromosomes 9 revealed the presence of a peculiar defect affecting the tails' fibrous sheath in both patients. This structure appeared completely disorganized and hyperplasic; sometimes the defect was associated with other usual malformations concerning the nuclear and acrosomal shape and texture and the axonemal assembly. Most spermatozoa (90-100%) of these patients were immotile. Our findings point to a definite ultrastructural sperm defect found in cases of autosomal inversion.

The effect of follicle stimulating hormone therapy on human sperm structure (Notulae seminologicae 11)

The effects of follicle stimulating hormone (FSH) treatment on the quality of human spermatozoa were assessed by examining the ultrastructure and the function of infertile human spermatozoa using a previously-defined formula. Using the spermatozoa as an andrological monitor shows that the therapeutic effect of FSH depends on the type of sperm defect. The response to FSH is, in many cases, positive and can be evaluated by examining the state of the ejaculated spermatozoa. From an initial group of 81 patients, 15 were placebo-treated controls, and 19 were non-responders (mainly with microbially infected semen). Out of 47 responders, after therapy nine achieved improved sperm quality which approached the natural fertility threshold. These responders all had spermatozoa affected by immaturity or apoptosis (n = 27). The 20 microbially-infected responders also had immature spermatozoa and never achieved the quality level of natural fertility. Thus, a natural fertility level was only achieved by nine responders out of 27 (three with immature spermatozoa, and six with apoptotic spermatozoa). Using our method of sperm analysis, these patients' spermatozoa were clearly categorized before treatment as either immature or apoptotic. In consequence, the success of the therapy was predictable. The response of individual organelles to therapy was examined. Certain qualities of the acrosome, the chromatin, the mitochondria, and the axoneme appear to be sensitive to FSH. Most of the previous conflicting results reported in the literature may be due to a lack of relevant discrimination between the different defects present in the spermatozoa of the patients, without assessing the likelihood of their response.

Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. 3. Partial zona dissection (PZD) (Notulae seminologicae 12)

This paper belongs to a series of application of the Baccetti's et al. (1995) formula to the submicroscopical mathematical examination of the human spermatozoa used for assisted reproduction. The present experiment concerns partial zona dissection, a technique requiring a careful evaluation of sperm quality in order to predict the success of the program. Our results demonstrate that the sperm submicroscopic characters introduced in the formula are clearly correlated with the result of PZD. In fact the two numbers concerning the sperm ultrastructural quality (percentage and total number of spermatozoa free from defects in the ejaculate) obtained in successful and unsuccessful PZD groups, showed a large difference (P < 0.01). The most important characteristics seem to be the quality of the acrosomal complex, the condition of the chromatin and the mitochondrial assembly. All these characteristics are expressed with largely different means in successful and unsuccessful ejaculates (from P < 0.05 to P < 0.01). A comparison with the results previously obtained in ICSI (Strehler et al., 1995) and IVF (Piomboni et al., 1996) shows that sperm quality is significantly more implicated in the success of IVF than of PZD or ICSI.

G protein-coupled receptor kinase GRK4. Molecular analysis of the four isoforms and ultrastructural localization in spermatozoa and germinal cells

G protein-coupled receptor kinase 4 (GRK4) presents some peculiar characteristics that make it a unique member within the GRK multigene family. For example, this is the only GRK for which four splice variants (GRK4alpha, -beta, -gamma, -delta) have been identified. We developed a simple assay to study kinase activity, and we found that GRK4alpha, but not GRK4beta, -gamma, and -delta, was able to phosphorylate rhodopsin in an agonist-dependent manner. GRK4alpha kinase activity was inhibited by Ca2+/calmodulin (CaM) (IC50 = 80 nM), and a direct interaction between GRK4alpha and Ca2+/CaM was revealed using CaM-conjugated Sepharose 4B. The other three GRK4 isoforms did not interact with CaM in parallel experiments. The present investigation also aimed to define cellular and ultrastructural localization of GRK4. A substantial expression of GRK4 mRNA was only found in testis and in the spermatogonia cell line GC-1 spg. Specific GRK4 immunoreactivity was only found on sperm membranes, and immunochemical and ultrastructural analyses showed that it is associated to the acrosomal membranes and to the outer mitochondrial membranes. GRK4gamma was the only detectable isoform in human sperm. We concluded that: i) only GRK4alpha can phosphorylate rhodopsin and that this activity is inhibited by CaM; ii) the other three isoforms do not phosphorylate rhodopsin and do not interact with CaM; and iii) the association of GRK4 with highly specialized sperm organelles, which are essential for fertilization, strongly indicates that this kinase is involved in this process.

Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. 2. In vitro fertilization. (Notulae seminologicae. 7)

This paper belongs to a series of applications of the Baccetti et al. formula (1) to the submicroscopical mathematical examination of human spermatozoa used for assisted reproduction. The present experiment concerns IVF, a technique requiring careful evaluation of sperm quality to predict the success of the program. Our results demonstrate that the sperm submicroscopic characters introduced in the formula are clearly correlated with the result of IVF. In fact the two numbers concerning sperm quality (percentage of spermatozoa free from structural defects and total number in the ejaculate of spermatozoa free from defects) obtained in successful and unsuccessful IVF groups, showed a large difference. The t distribution in both cases reached a significance of 0.005. The synthetic parameters obtained are therefore a good tool in the prediction of sperm power in in vitro insemination techniques. The most important characteristics seem to be the quality of the acrosomal complex, the status of the chromatin, the shape of mitochondria, the axonemal pattern, and the membrane integrity. All these characteristics are expressed with largely different means in successful and unsuccessful ejaculates (t distribution significant at 0.005). All these data confirm that submicroscopic mathematical diagnosis offers a convincing evaluation of sperm structure and function, involving all organelles, including acrosome function and cell motility. It is also demonstrated that sperm quality is a major factor in the success of IVF and that it is clearly revealed by the integrity of the majority of the sperm organelles.

Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. I. Intracytoplasmic sperm injection. (Notulae seminologicae 6)

After a large introduction concerning the influence of sperm quality in the success of in vitro fertilization, the debated problem of the importance of the sperm quality in intracytoplasmic sperm injection is investigated. The spermatozoa are studied by electron microscopy, and the results evaluated by the formula of Baccetti et al. (1995). The quality of spermatozoa has been correlated with the success of ICSI. The first conclusion has been that ejaculates which produced embryos contained higher percentages and overall higher total number of 'healthy' spermatozoa than those which obtained fertilizations arrested at the two pronuclei stage, or showed no fecundation at all. A second conclusion was that the quality of sperm organelles is mainly involved in the oocyte activation, but after the 2 pronuclei stage, segmentation usually proceeds with few influences from sperm quality. The highest involvement of spermatozoa is therefore the initiation of oocyte activation. A third conclusion confirmed the need of ultrastructural evaluation of sperm cell organization, deeply investigating the inner organelles. Moreover, we observed that the head organelles are more involved that the tail ones. Three acrosomal characteristics are concerned: the shape, the dimensions and the content. All of them are significantly better in the oocyte activating than in non activating spermatozoa. Also the nuclear shape and the status of the chromatin (frequently strictly interdependent) are significantly concerned with the oocyte activation and with the embryo segmentation. In the tail, the mitochondrial shape is significantly different in activating and not activating spermatozoa, and also in those producing embryo segmentation. Moreover, the absence of dynein arms seems to be determinant in impeding the oocyte activation.

Localisation of two classes of acetylcholine receptor-like molecules in sperms of different animal species

The distribution of different classes of acetylcholine (ACh) receptor-like molecules in sperms of different invertebrate and vertebrate species is described. ACh receptor molecules belong to one of two classes: muscarinic receptors (mAChRs), associated with signal transduction mechanisms in the inner domain of the cell, and nicotinic receptors (nAChRs), capable of opening Na+ channels when activated by the ligand. Molecules immunologically related to mAChRs and to ACh can be identified by specific antibodies, and revealed by immunofluorescent or immunogold staining; the nicotinic receptor-like molecules are localised as curare-sensitive affinity sites for alpha-bungarotoxin. In all species studied, both classes of receptors were found, with a similar distribution. Muscarinic-like molecules were found mainly in the sperm head regions of most species; such a localisation may be correlated to a function in sperm-egg interaction, for instance in the regulation of the block to polyspermy. Nicotinic-like molecules are present mainly in the tail and in the post-acrosomal region of most animals, thus confirming their function in the regulation of sperm propulsion, but are also present at the acrosomal region of most species. The distribution patterns of the different classes of molecules indicate that both may be involved in sperm-egg interactions, in addition to their known function in the regulation of sperm propulsion.

Notulae seminologicae. 5. Mathematical evaluation of interdependent submicroscopic sperm alterations

This paper concerns the mathematical evaluation of sperm quality as examined by electron microscopy. Proceeding with a Bayesian technique, we have developed a formula considering all statistical possibilities for defects of the examined sperm to be present in a sperm cell, the total number of affected spermatozoa, and, as consequence, that of sperm devoid of defects, also considering the probability of association characteristics of some of them. The formula has been studied in three applications. The first concerns the number of healthy spermatozoa present in ejaculates of fertile men. We have found an enormous variability, but we have observed that the minimal number of spermatozoa free of defects assuring a normal fertility seems to be a little higher than 2 x 10(6). The second and third examples concern varicocele and assisted fertilization. In both cases the formula allows a precise simultaneous evaluation of the totality of studied characters and a determination of the number of spermatozoa free from defects. This comparative analysis shows that the formula is sufficiently sensitive to distinguish the different degrees of the varicocele condition and the various possibilities of fertility power in cases of natural or artificial insemination. In this way we will easily control the level of improvement of sperm quality in cases of varicocele treated pharmacologically or surgically, or we will better predict the success of artificial insemination.

Focal cerebral ischemia and patent cardiac foramen ovale

By means of transthoracic contrast echocardiography, the prevalence of a patent foramen ovale (PFO) was studied, in a continuous series of 48 patients aged less than 50 years with a recent episode of acute cerebral ischemia. A PFO was found in 11 subjects (23%). In the subgroup of younger patients (aged less than 30 years), the prevalence was much higher than in those aged 30 or more (58% against 11%, p = 0.0022). In the 19 patients with clear evidence of extracardiac causal factors of cerebral ischemia, there was no PFO; of the remaining 29 subjects, a PFO was present in 11 (38%) (p = 0.0015). In conclusion, the possible presence of a PFO must be carefully investigated in subjects with cerebral ischemia aged less than 30, as well as in subjects aged between 30 and 50 in whom there is no acceptable explanation for their cerebral ischemic episode.

Notulae seminologicae. 2. The 'short tail' and 'stump' defect in human spermatozoa

In this note several cases of stunted tails involving the total sperm population in sterile humans are described. Half of the cases are classified as 'short tailed' spermatozoa, the other half as 'stump defect' previously described in bulls. Both defects are referred in details at electron microscopical level.

Notulae seminologicae. 1. New combinations of Kartagener's syndrome

In this note new consequences of the Kartagener's syndrome are described. In males the syndrome involved a diffused sperm immaturity; in one female severe skeletal defects were present probably resulting from bad organization of the renal apparatus.

Comparative experimental study of autologous adipose tissue processed by different techniques

Different techniques for processing adipose tissue were tested in 40 Swiss Albino female mice. Our study established that the use of insulin did not show any positive effect on survival of adipocytes during their transplantation. Likewise, the use of a centrifuge machine, at high or low speed, for separating the adipose tissue components, completely destroyed the adipose cells and did not allow their survival.

Evaluation of the antifertility activity of the broom Spartium junceum in the mammalian male

Male adult rabbits and rats treated with Spartium junceum showed a significant decrease in fertility, demonstrated by a lower number of pregnancies. The target of the drug seems to be the acrosomal protease system, the activity of which appears greatly reduced, while the morphology of testicular cells and epididymal spermatozoa is only partially affected. The antifertility effect is completely reversible.

Studies on varicocele. II. The inhibin secretion

In this paper a previous interpretation given by the authors concerning one of the ways varicocele can affect fertility is confirmed. Moreover, it is definitely demonstrated that the high temperature stimulates inhibin secretion (and probably the testosterone-estradiol conversion) in the Sertoli cells, while the somatomedin secretion in vitro seems to be unaffected. It means that the action of the temperature on the germinal cells seems to be mediated by the pathway: inhibin (plus estradiol)-->pituitary-->FSH. Inhibin in the Golgi complex of Sertoli and germinal cells has been detected by electron microscopical immunocytochemical techniques.

Trypanosoma cruzi induces suppression of DNA synthesis and inhibits expression of interleukin-2 receptors by stimulated human B lymphocytes

Trypanosoma cruzi, the causative agent of Chagas' disease, suppresses immune responses during the acute phase and has been shown to induce multiple cellular alterations in activated human T lymphocytes. However, no information is available regarding the effects of this parasite on human B cells. Using an in vitro culture system, in which purified T. cruzi are co-cultured with either peripheral blood mononuclear cells (PBMC) or B-cell-enriched preparations (BCE), we studied whether the organism can induce alterations in DNA synthesis after stimulation with Pansorbin (PS). This response was markedly reduced by the parasite at both suboptimal and optimal PS concentrations, and the extent of the inhibition was augmented as the parasite concentration was increased. Maximal reduction in DNA synthesis was observed when the trypanosomes were incorporated into the cultures at 0 time (i.e. together with PS); the effect was of a much lesser magnitude and undetectable when the parasites were added at 24 and 48 hr, respectively. These results imply that T. cruzi affects a relatively early event during B-cell stimulation. This inference was confirmed by the finding that the proportion of PS-stimulated B cells expressing interleukin-2 (IL-2) receptors was significantly reduced when the parasite was present in the culture. Addition of recombinant human IL-2 did not restore B-cell responsiveness to normal levels. Suppressed B-cell responses were also observed when T. cruzi was separated from the PBMC or the BCE by a cell-impermeable filter, indicating that a soluble factor(s) released by the organism mediated the effect. Accordingly, supernatants of T. cruzi suspensions were found to be suppressive. These results demonstrate for the first time that T. cruzi can affect human B-cell responses and that the mechanism involves inhibition of IL-2 receptor expression.

[Audiologic evaluation of patients with thalassemic syndromes treated with desferrioxamine B]

Following various articles in literature which have appeared in the last 3 years regarding the neurotoxicity of desferrioxamine B we studied, from the auditory functionality point of view, 95 patients affected with transfusion-dependent thalassemic syndromes, under regular chelation treatment with desferrioxamine B. Our results lead us to conclude that at standard doses, between 40 and 60 mg/Kg/day, desferrioxamine B does not demonstrate a neurotoxicity enough to cause an organic deficit in the auditory sphere, while maintaining therapeutic efficacy.