Chronic Infection of the Prostate by Chlamydia muridarum Is Accompanied by Local Inflammation and Pelvic Pain Development

Chronic testicular Chlamydia muridarum infection impairs mouse fertility and offspring development†

With approximately 131 million new genital tract infections occurring each year, Chlamydia is the most common sexually transmitted bacterial pathogen worldwide. Male and female infections occur at similar rates and both cause serious pathological sequelae. Despite this, the impact of chlamydial infection on male fertility has long been debated, and the effects of paternal chlamydial infection on offspring development are unknown. Using a male mouse chronic infection model, we show that chlamydial infection persists in the testes, adversely affecting the testicular environment. Infection increased leukocyte infiltration, disrupted the blood:testis barrier and reduced spermiogenic cell numbers and seminiferous tubule volume. Sperm from infected mice had decreased motility, increased abnormal morphology, decreased zona-binding capacity, and increased DNA damage. Serum anti-sperm antibodies were also increased. When both acutely and chronically infected male mice were bred with healthy female mice, 16.7% of pups displayed developmental abnormalities. Female offspring of chronically infected sires had smaller reproductive tracts than offspring of noninfected sires. The male pups of infected sires displayed delayed testicular development, with abnormalities in sperm vitality, motility, and sperm-oocyte binding evident at sexual maturity. These data suggest that chronic testicular Chlamydia infection can contribute to male infertility, which may have an intergenerational impact on sperm quality.

The occurrence and pathology of chlamydiosis in the male reproductive tract of non-human mammals: A review

Organisms belonging to the Family Chlamydiaceae are responsible for a broad range of diseases in humans, livestock, companion animals and non-domestic species. Infection of the reproductive organs can cause a range of syndromes of which sub- and infertility are the most frequently observed clinical manifestations. While the gross and histological lesions associated with the isolation of Chlamydiaceae from the non-human female reproductive tract are well documented, little attention has been given to the pathological effects of this infection in the male genital system. As such, the occurrence and importance of Chlamydia-associated disease in male non-human mammalian species is less well documented. In order to improve our understanding of the significance of chlamydiosis in domestic, laboratory and wild animals, this review provides an up-to-date summary of Chlamydia-associated male reproductive pathology, whether that infection occurs naturally or experimentally. Although most lesions in males are described as incidental and of minor significance, results of recent studies suggest that infection with Chlamydiaceae can adversely impact male fertility and/or be instrumental in disease transmission. Although in humans, bulls and mice Chlamydia infection has been associated with morphological and functional abnormalities of the spermatozoa, this review will focus on the gross and histological findings linked to the colonisation of the genital system by this pathogen. Advances in our understanding of male reproductive chlamydiosis are necessary for diagnostic and therapeutic strategies, as well as epidemiological and conservation studies.

IL-10 Producing B Cells Dampen Protective T Cell Response and Allow Chlamydia muridarum Infection of the Male Genital Tract

A significant proportion of individuals develop chronic, persistent and recurrent genital tract infections with Chlamydia trachomatis, which has been attributed to the numerous strategies that the bacterium uses to subvert host immune responses. Animal chlamydia models have demonstrated that protective immune response is mediated by CD4⁺ Th1 cytokine responses. Herein, we demonstrate that early after infecting the male genital tract, C. muridarum triggers the production of IL-10 by splenic and lymph node cells. In addition, C. muridarum triggers IL-6 and TNFα secretion. Data obtained from in vitro and in vivo experiments revealed B cells as the major IL-10 contributors. Indeed, purified B cells produced high amounts of IL-10 and also exhibited enhanced expression of inhibitory molecules such as CD39, PD-L1 and PD1 after C. muridarum stimulation. In vitro experiments performed with sorted cell subsets revealed that Marginal Zone B cells were the main IL-10 producers. In vitro and in vivo studies using TLR-deficient mice indicated that TLR4 signaling pathway was essential for IL-10 production. In addition, in vivo treatments to neutralize IL-10 or deplete B cells indicated that IL-10 and B cells played a significant role in delaying bacterial clearance ability. Moreover, the latter was confirmed by adoptive cell transfer experiments in which the absence of IL-10-producing B cells conferred the host a greater capability to induce Th1 responses and clear the infection. Interestingly, NOD mice, which were the least efficient in clearing the infection, presented much more Marginal Zone B counts and also enhanced TLR4 expression on Marginal Zone B cells when compared to B6 and BALB/c mice. Besides, treatment with antibodies that selectively deplete Marginal Zone B cells rendered mice more capable of inducing enhanced IFNγ responses and clearing the infection. Our findings suggest that B cells play a detrimental role in C. muridarum infection and that activation by innate receptors like TLR4 and IL-10 production by these cells could be used by Chlamydia spp. as a strategy to modulate the immune response establishing chronic infections in susceptible hosts.

A Classic Herbal Formula Danggui Beimu Kushen Wan for Chronic Prostatitis: From Traditional Knowledge to Scientific Exploration

Chronic prostatitis (CP) is a chronic inflammation in the prostate with unsatisfactory management. Danggui Beimu Kushen Wan (DBKW) is a classic formula developed 1800 years ago for patients with difficult urination and it has been widely utilized for CP in modern days. However, scientific understanding of DBKW on CP has not been systematically reviewed. First, we searched the Encyclopedia of Traditional Chinese Medicine for the etiologies and pathogeneses of CP-like symptoms and DBKW and compared their similarities and differences from traditional Chinese medicine and conventional medicine perspectives. Then, we searched 21 electronic databases to identify potential clinical and experimental studies. Characteristics of included studies, ingredients, herb frequency, and possible mechanisms of actions were descriptively summarized. Risk of bias of randomized controlled trials (RCTs) was evaluated using the Cochrane risk of bias assessment tool. A total of 290 studies were identified. Six clinical studies, including four RCTs and two case series, and eight experimental studies were included. Clinical studies indicated that DBKW used alone or as an adjunct therapy significantly reduced the CP symptom scores and decreased the expressed prostatic secretions-pH when compared to antibiotics or α-blocker. Most RCTs have high or unclear risk of bias. Experimental studies revealed that DBKW may have effects on anti-inflammation, antibacteria, antioxidation, sex hormone regulation, and immunoregulation. DBKW demonstrated a great potential in the treatment of CP. High-quality RCTs and network pharmacological studies should be considered for future research.

Chlamydia trachomatis neither exerts deleterious effects on spermatozoa nor impairs male fertility

Chlamydia trachomatis is the most prevalent sexually transmitted bacterial infection. However, whether Chlamydia trachomatis has a negative impact on sperm quality and male fertility is still controversial. Herein, we report the effects on sperm quality of the in vitro exposure of spermatozoa to Chlamydia trachomatis, and also the effects of male genital infection on male fertility using an animal model. Human and mouse sperm were obtained from healthy donors and cauda epididimys from C57BL/6 mice, respectively. Highly motile human or mouse spermatozoa were in vitro exposed to C. trachomatis (serovar E or LGV) or C. muridarum, respectively. Then, sperm quality parameters were analyzed. Moreover, male fertility of Chlamydia muridarum infected male C57BL/6 mice was assessed. Human or murine sperm in vitro exposed to increasing bacterial concentrations or soluble factors from C. trachomatis or C. muridarum, respectively, did not show differences in sperm motility and viability, apoptosis, mitochondrial membrane potential, DNA fragmentation, ROS production and lipid peroxidation levels, when compared with control sperm (p > 0.05). Moreover, no differences in fertility parameters (potency, fecundity, fertility index, pre- and post-implantation loss) were observed between control and infected males. In conclusion, our results indicate that Chlamydia spp. neither directly exerts deleterious effects on spermatozoa nor impairs male fertility.