Antibodies to microbial, leukocyte and organ antigens

Male infertility and genital chlamydial infection: victim or perpetrator?

The role of Chlamydia trachomatis in the cause of male infertility is under discussion. This paper attempts to summarize data from the literature, which support the role of C. trachomatis in male infertility or oppose this suggestion. The following observations are based on a survey of the literature: 1) Chlamydia trachomatis is a frequent pathogen in male genital inflammation, the micro-organisms are rarely present in healthy men. 2) Without doubt, C. trachomatis causes inflammations of the male urethra and the epididymis. Prostatitis and glandulitis vesicalis are discussed controversially. 3) Chlamydia trachomatis antigen or DNA is not demonstrable in secretions of the male accessory glands including the semen with sufficient reproducibility. However, it is easily demonstrable in urethral swabs and the urine. 4) Determination of chlamydial antibodies in serum or semen does not conclusively indicate a current infection with C. trachomatis. 5) There are no conclusive studies showing that men infected with C. trachomatis are less fertile than uninfected men. 6) The male genital chlamydial infection is a threat to the female genital organs, because C. trachomatis infection of the female genital organs may be deleterious to female fertility.

Mycoplasma hominis expresses two variants of a cell-surface protein, one a lipoprotein, and one not

A protein similar to the previously characterized variable surface-exposed membrane protein P120 was identified (P120'), establishing that Mycoplasma hominis PG21 possesses a novel gene family. The gene, p120', was sequenced and found to have some distinctive properties including a putative start codon of GTG, rather than the common ATG codon, and a coding region with a high G + C content, characteristic of essential housekeeping genes in mycoplasmas. No sequence homology was found to known proteins. The genomic locations of the p120 and p120' genes were determined on the restriction map of five M. hominis strains by PFGE. The genes were localized in two separate regions separated by more than 6 kb. Genes as well as proteins corresponding to P120' were identified in 24/24 M. hominis isolates tested and no size variation was detected. P120' had a molecular mass of 98 kDa, 20 kDa smaller than P120 as estimated by SDS-PAGE. The protein was surface-exposed and associated with the mycoplasma membrane, but had predominantly hydrophilic characteristics upon Triton X-114 extraction. The N-terminal part of P120' had a hydrophobic leader sequence without the characteristics of a prolipoprotein. This might explain the membrane association of the protein. Unlike P120, which is frequently recognized by sera of patients seropositive for M. hominis, P120' was only rarely recognized. The conserved nature of the P120 gene family indicates that it has an essential, although currently unknown, function.

Assessment of the relevance of zona pellucida antibodies in serum and cervical mucus in patients who have fertilization failure during in vitro fertilization

OBJECTIVE

To assess whether antibodies to the zona pellucida can cause fertilization failure during in vitro fertilization (IVF).

DESIGN

Two methods for detecting zona pellucida antibodies were used to assess 20 women undergoing IVF. Nine patients had failed fertilization during the treatment cycle.

SETTING

Academic IVF department of a teaching hospital.

PATIENTS

Infertile patients previously assessed as requiring IVF.

INTERVENTIONS

Gonadotropin-releasing hormone analogue to achieve pituitary down regulation and human menopausal gonadotropin for superovulation. Transvaginal ultrasound directed oocyte recovery. Cervical mucus and serum samples were obtained.

MAIN OUTCOME MEASURES

The presence of antizona pellucida antibodies in serum or cervical mucus in relation to fertilization.

RESULTS

Seven of 20 patients had antizona antibodies in serum and 7 of 20 patients had antibodies in mucus. Only 1 patient had antibodies in both samples. No correlation between the presence of antibodies in either sample and failure of fertilization was found.

CONCLUSION

Detection of antizona pellucida antibodies by the methods described have no role in the prediction of IVF.

A comparison of sperm antibody assays

Cytotoxicity and Immunobead-binding immunoglobulin G assays agreed in 81% of sera from infertile men (n = 173), 74% of sera from their wives, 75% of seminal plasma, and 82% of cervical mucous samples (p less than 0.001; chi 2 analysis of positive and negative results) when tested against sperm from the same donors. Cytotoxic and immunofluorescent IgG antibody results agreed in 79% of sera from men and women, 76% of seminal plasma, and 76% of cervical mucus (p less than 0.001; chi 2 analysis of positive and negative results). Titers or percent binding of sperm by cytotoxicity, hemagglutination, and IgG Immunobead-binding or immunofluorescence assays in serum and secretions of husbands and wives correlated (p less than 0.001). A significantly increased number of positive results was observed in cytotoxic and Immunobead-binding IgG assays when the husbands' and donors' sperm were used rather than donors' sperm alone. On the basis of this study we conclude: (1) that cytotoxicity, Immunobead-binding IgG, and immunofluorescent IgG sperm antibody assays correlate when sperm from the same source are used, (2) that women's isoimmunity to husbands' sperm is associated with their husbands' autoimmunity to sperm irrespective of the assay, and (3) that it is desirable to use sperm from the husbands and nonautoimmune fertile men in these assays.

White cell subpopulations in autoimmune infertile men and their wives with cytotoxic sperm antibodies

Sixty six infertile men with cytotoxic sperm antibodies had fewer and lower percentages of OKT4-positive helper/inducer T lymphocytes p = 0.004 and 0.003, respectively), than the fertile (n = 14) and infertile (n = 12) antibody-negative controls. Ratio of OKT4/OKT8 was decreased (p less than 0.01), while numbers of OKDR and BD-Leu12 positive predominantly B lymphocytes were increased (p less than 0.0001) in infertile men with sperm antibodies. T lymphocytes positive for OKT3, OKT11 and OKT4 and the OKT4/OKT8 ratio were decreased in infertile women with sperm antibodies, while B lymphocytes positive for OKDR and BD-Leu12 were increased in infertile women with or without sperm antibodies (p less than 0.0001, versus fertile controls). Lymphocyte responses to phytohemagglutinin (PHA), concanavalin A (ConA) and pokeweed mitogen (PWM), however, were similar in 20 fertile and 136 infertile couples. Lymphocytes from infertile men with sperm antibodies had an enhanced stimulatory response to autologous sperm and seminal plasma. It is concluded that sperm antigens from autoimmune infertile men stimulate heightened immune responses to sperm antigens and altered distribution of white cell populations in both partners.