Prostate Specific Antigen: Responsible Allergen In Human Seminal Plasma Allergy

Seminal plasma hypersensitivity: A systematic review of clinical presentation, diagnostics, and management options

INTRODUCTION

Seminal plasma hypersensitivity (SPH) is a rare and often misdiagnosed condition characterized by local and/or systemic reactions to seminal plasma proteins following exposure to semen. We aimed to summarize key symptomatology, diagnostic features, and management options for SPH.

METHODS

The databases PubMed, EMBASE, Web of Science, Google Scholar, and Cochrane Review were searched with key words "seminal plasma hypersensitivity" and "seminal fluid allergy" through September 2023. Exclusion criteria included non-English articles, in vitro studies, publication before 1990, duplicates, and articles with no clinical relevance to SPH in women.

RESULTS

The search yielded 53 articles for review. Of these, 60.5% described systemic SPH and 39.5% described localized.

CONCLUSION

Diagnosis of SPH relies on a thorough patient history and confirmatory skin prick testing. The use of IgE assays is controversial and less accurate for cases of localized SPH. Knowledge of disease immunopathology, systemic versus localized symptom presentation, patient preference, and desire to conceive should guide management options. Artificial insemination has the potential for severe adverse reactions in systemic SPH so necessitates extra procedural precautions. SPH does not appear to impair fertility. Additional research on specific allergens implicated in SPH can aid in the development of more targeted immunotherapy approaches with improved safety and efficacy.

Analysis of allergen profile in patients sensitized to canine allergen and potential Can f 5 cross-reactivity with human PSA

Can f 5 allergy and possible cross-reactivity with human semen in which there are significant amounts of prostate-specific antigen (PSA) are particularly interesting aspects of allergy to dog. The objective of the study was to confirm cross-reactivity between human PSA and Can f 5 in a study of canine sensitised women. A total of 100 women (aged 18-73, 41 on average) with a positive history of animal fur allergy or positive skin prick tests to canine allergens were selected. Levels of Immunoglobulin E (IgE) specific to Can f 1, Can f 2, Can f 3, Can f 5 were determined. Patients with increased concentration of sIgE Can f 5 were selected for further inhibition testing using polystyrene microplate ELISA test coated with human PSA. In the studied population, allergy to Can f 5 dominated (52.3% of patients with increased concentration of canine-specific IgE were allergic to this allergenic component). In all analyzed cases, the concentration of IgE Can f 5 decreased after incubation on the ELISA plate coated with human PSA. The minimum decrease in concentration was 10.44%, the maximum was 37.73%, the average decrease was 21.6%. No statistically significant influence of the presence or absence of allergenic sIgE Can f 5 in blood serum on the occurrence of symptoms after intercourse was found. The study confirmed the moderate ability of Can f 5 to cross-react with human PSA sIgE, which may be clinically significant in some women. At the same time, symptoms of an allergy to male semen do not constitute a typical clinical presentation of allergy to Can f 5.

Fertility and allergy: Is there a correlation?

Approximately 10% of couples have difficulties conceiving. Idiopathic infertility affects 10–15% of infertile couples. Some suspected causes of idiopathic infertility are lifestyle factors such as stress, diet, smoking, obesity, lack of physical exercise and alcohol consumption. At the same time, allergies and bronchial asthma are growing health problems in developed countries. Therefore, this study addresses the possible correlation between atopic diseases and fertility. Several interesting cases of patients presenting symptoms of HSPH (human seminal plasma hypersensitivity) have been reported to date. In the majority of cases, allergy to semen is the IgE-dependent response to proteins contained in the seminal plasma. Observations indicating that patients presenting symptoms of HSPH are primarily allergic to allergens of dogs are particularly interesting. The structure of dog allergen Can f 5 is similar to the human PSA (55–60% similarity in the sequence of amino acids). This may explain the presence of IgE-dependent reactions following contact with semen during sexual intercourse in women allergic to dog fur. This article presents the current state of knowledge on the phenomenon.