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Liu H, Song X, Huang M, Zhan H, Wang S, Zhu S, Pang T, Zhang X, Zeng Q. Ureaplasma urealyticum induces polymorphonuclear elastase to change semen properties and reduce sperm motility: a prospective observational study. J Int Med Res 2022; 50:3000605221106410. [PMID: 35701892 PMCID: PMC9208062 DOI: 10.1177/03000605221106410] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To elucidate the mechanism underlying how Ureaplasma urealyticum (UU) affects sperm quality and identify a therapeutic target. Methods In this prospective observational study, the differences in and relationships among semen volume, pH, viscosity, liquefaction time, sperm concentration, sperm motility [progressive motility (PR)], and seminal polymorphonuclear (PMN) elastase were analyzed in 198 normal semen samples (control group) and 198 UU-infected semen samples (observation group). The UU-infected samples were treated and the above parameters were compared between the two groups. Results The semen volume, viscosity, liquefaction time, and seminal PMN elastase were significantly higher in the observation than control group, but the pH and PR were significantly lower. In the observation group, the pH and PR were significantly higher after than before treatment, whereas the semen volume, PMN elastase, viscosity, and liquefaction time were lower. UU was closely related to semen volume, pH, viscosity, liquefaction time, sperm motility (PR), and PMN elastase. PMN elastase had significant negative effects on semen pH and sperm motility (PR) but positive effects on viscosity and liquefaction time. Conclusion UU might induce PMN elastase to increase the liquefaction time and viscosity of semen, eventually decreasing PR. PMN elastase might be a therapeutic target of UU.
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Affiliation(s)
- Huang Liu
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.,Department of Andrology, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Xiaoyan Song
- Department of Clinical Laboratory, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Mulan Huang
- Department of Clinical Laboratory, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Huashen Zhan
- Reproductive Center, Sanming Integrated Medicine Hospital, Sanming, Fujian Province, China
| | - Shiyang Wang
- Reproductive Center, The Second People's Hospital of Yunnan Province, Kunming, Yunnan Province, China
| | - Shenghui Zhu
- Department of Andrology, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Tao Pang
- Department of Andrology, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Xinzong Zhang
- Department of Andrology, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Qingqi Zeng
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.,Department of Integrated Chinese and Western Medicine, Jiangsu Health Vocational College, Nanjing, Jiangsu Province, China
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Oxidative Stress, Testicular Inflammatory Pathways, and Male Reproduction. Int J Mol Sci 2021; 22:ijms221810043. [PMID: 34576205 PMCID: PMC8471715 DOI: 10.3390/ijms221810043] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/11/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022] Open
Abstract
Inflammation is among the core causatives of male infertility. Despite male infertility being a serious global issue, "bits and pieces" of its complex etiopathology still remain missing. During inflammation, levels of proinflammatory mediators in the male reproductive tract are greater than usual. According to epidemiological research, in numerous cases of male infertility, patients suffer from acute or chronic inflammation of the genitourinary tract which typically occurs without symptoms. Inflammatory responses in the male genital system are inextricably linked to oxidative stress (OS). OS is detrimental to male fertility parameters as it causes oxidative damage to reproductive cells and intracellular components. Multifarious male infertility causative factors pave the way for impairing male reproductive functions via the common mechanisms of OS and inflammation, both of which are interlinked pathophysiological processes, and the occurrence of any one of them induces the other. Both processes may be simultaneously found in the pathogenesis of male infertility. Thus, the present article aims to explain the role of inflammation and OS in male infertility in detail, as well as to show the mechanistic pathways that link causative factors of male reproductive tract inflammation, OS induction, and oxidant-sensitive cellular cascades leading to male infertility.
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Rivera VV, Cardona Maya WD, Suárez JP. The relationship between sexually transmitted bacteria, microbiota and seminal quality in asymptomatic men. Asian J Urol 2021; 9:473-479. [PMID: 36381602 PMCID: PMC9643280 DOI: 10.1016/j.ajur.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 02/01/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To detect DNA of different microorganisms, in semen samples from apparently healthy men and correlate their presence with seminal quality. Methods Semen samples from 81 healthy volunteers were collected, and semen parameters were analyzed. DNA extraction was performed using the phenol-chloroform technique, and the microorganisms were detected by the amplification of specific primers using polymerase chain reaction. Results DNA from at least one of the microorganisms was detected in 78 samples. The most frequent microorganism found in semen were: Lactobacillus spp. (70%), Neisseria gonorrhoeae (N. gonorrhoeae) (36%), Streptococcus epidermidis (64%), Klebsiella pneumoniae (56%), Staphylococcus aureus (32%), Chlamydia trachomatis (C. trachomatis) (28%), Pseudomonas aeruginosa (27%). The seminal parameters of all semen samples were over the lower reference values for normal semen analysis. To compare with negative samples, seminal volume was higher for the Escherichia coli positive samples and lower for Pseudomonas aeruginosa positive samples. Semen samples positive for Staphylococcus aureus had worse sperm morphology. The frequency of progressive motility was higher in positive samples for N. gonorrhoeae and C. trachomatis. Positive semen samples for C. trachomatis had a higher concentration per milliliter. Conclusion It is common to find microorganisms in semen of asymptomatic men, including those responsible for sexually transmitted infections. Antimicrobial treatment is recommended only in those individuals with a sexually transmitted infection (C. trachomatis and N. gonorrhoeae) and always promote condom use.
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4
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Staphylococcal infections and infertility: mechanisms and management. Mol Cell Biochem 2020; 474:57-72. [PMID: 32691256 DOI: 10.1007/s11010-020-03833-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/11/2020] [Indexed: 12/18/2022]
Abstract
Infertility is a subject of worldwide concern as it affects approximately 15% of couples. Among the prime contributors of infertility, urogenital bacterial infections have lately gained much clinical importance. Staphylococcal species are commensal bacteria and major human pathogens mediating an array of reproductive tract infections. Emerging evidences are 'bit by bit' revealing the mechanisms by which Staphylococci strategically disrupt normal reproductive functions. Staphylococcal species can directly or through hematogenous routes can invade the reproductive tissues. In the testicular cells, epididymis as well as in various compartments of female reproductive tracts, the pathogen recognition receptors, toll-like receptors (TLRs), can recognize the pathogen-associated molecular patterns on the Staphylococci and thereby activate inflammatory signalling pathways. These elicit pro-inflammatory mediators trigger other immune cells to infiltrate and release further inflammatory agents and reactive oxygen species (ROS). Adaptive immune responses may intensify the inflammation-induced reproductive tissue damage, particularly via activation of T-helper (Th) cells, Th1 and Th17 by the innate components or by staphylococcal exotoxins. Staphylococcal surface factors binding with sperm membrane proteins can directly impair sperm functions. Although Staphylococci, being one of the most virulent bacterial species, are major contributors in infection-induced infertility in both males and females, the mechanisms of their operations remain under-discussed. The present review aims to provide a comprehensive perception of the possible mechanisms of staphylococcal infection-induced male and female infertility and aid potential interventions to address the lack of competent therapeutic measures for staphylococcal infection-induced infertility.
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Solomon M, Henkel R. Semen culture and the assessment of genitourinary tract infections. Indian J Urol 2017; 33:188-193. [PMID: 28717267 PMCID: PMC5508428 DOI: 10.4103/iju.iju_407_16] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The male factor contributes approximately 50% to infertility-related cases in couples with an estimated 12%–35% of these cases attributable to male genital tract infections. Depending on the nature of the infection, testicular sperm production, sperm transport, and sperm function can be compromised. Yet, infections are potentially treatable causes of infertility. Male genital tract infections are increasingly difficult to detect. Moreover, they often remain asymptomatic (“silent”) with the result that they are then passed on to the relevant sexual partner leading to fertilization and pregnancy failure as well as illness of the offspring. With the worldwide increasing problem of antibiotic resistance of pathogens, proper diagnosis and therapy of the patient is important. This testing, however, should include not only aerobic microbes but also anaerobic as these can be found in almost all ejaculates with about 71% being potentially pathogenic. Therefore, in cases of any indication of a male genital tract infection, a semen culture should be carried out, particularly in patients with questionable semen quality. Globally, an estimate of 340 million new infections with sexually transmitted pathogens is recorded annually. Among these, the most prevalent pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, and Mycoplasma hominis. Escherichia coli are considered the most common nonsexually transmitted urogenital tract microbes. These pathogens cause epididymitis, epididymo-orchitis, or prostatitis and contribute to increased seminal leukocyte concentrations.
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Affiliation(s)
- Michael Solomon
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
| | - Ralf Henkel
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
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Ferrero DV, Meyers HN, Ferrero GM, Schultz DE. Self-collected glans/meatal 'dry' swab specimen and NAAT technology detects Chlamydia trachomatis and Neisseria gonorrhoeae - implications for public policy changes. Int J STD AIDS 2016. [PMID: 28632470 DOI: 10.1177/0956462416684693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increasing Chlamydia trachomatis (CT) rates and ever-present Neisseria gonorrhoeae (NG) infections in women have given rise in the past to consideration of male screening programs in order to address the silent male reservoir. Non-medical venues (e.g. home collection, restrooms or other private locations) may be viable venues to reach certain populations that in the past have not been accessed. Effortlessly collected, non-invasive, self-collected male specimens that are stable and easy to transport would enhance the success of male screening programs. We designed a head-to-head study to consider the effectiveness of non-invasive self-collected glans/meatal dry swab (SCS) specimens to detect CT and NG nucleic acid when compared to traditional clinician-collected swab (CCS) specimens and first-catch urine (FCU) specimens. A total of 284 male patients were included in the study. Specimens were processed using the Becton Dickinson ProbeTec ET system. The overall sensitivity of SCS was 91.1% with a specificity of 99.2%. There was an overall SCS agreement of 97.7% with CCS specimens and 90.4% with FCU specimens. Dry swab specimens are easy to collect, transport and test. Non-invasive dry self-collected glans/meatal swab specimens are a viable specimen choice.
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Affiliation(s)
- Dennis V Ferrero
- 1 Department of Biological Sciences, University of the Pacific, Lodi, CA, USA
| | - Holly N Meyers
- 2 Regional Public Health Laboratory, San Joaquin County Public Health Services, Stockton, CA, USA
| | - Gina M Ferrero
- 3 School of Medicine, The University of Queensland, Australia
| | - Diane E Schultz
- 2 Regional Public Health Laboratory, San Joaquin County Public Health Services, Stockton, CA, USA
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Redgrove KA, McLaughlin EA. The Role of the Immune Response in Chlamydia trachomatis Infection of the Male Genital Tract: A Double-Edged Sword. Front Immunol 2014; 5:534. [PMID: 25386180 PMCID: PMC4209867 DOI: 10.3389/fimmu.2014.00534] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/09/2014] [Indexed: 01/16/2023] Open
Abstract
Chlamydia trachomatis (CT) is the most prevalent bacterial sexually transmitted infection in the world, with more than 100 million cases reported annually. While there have been extensive studies into the adverse effects that CT infection has on the female genital tract, and on the subsequent ability of these women to conceive, studies into the consequences on male fertility have been limited and controversial. This is in part due to the asymptomatic nature of the infection, where it is estimated that 50% of men with Chlamydia fail to show any symptoms. It is accepted, however, that acute and/or persistent CT infection is the causative agent for conditions such as urethritis, epididymitis, epididymo-orchitis, and potentially prostatitis. As with most infections, the immune system plays a fundamental role in the body’s attempts to eradicate the infection. The first and most important immune response to Chlamydia infection is a local one, whereby immune cells such as leukocytes are recruited to the site of infections, and subsequently secrete pro-inflammatory cytokines and chemokines such as interferon gamma. Immune cells also work to initiate and potentiate chronic inflammation through the production of reactive oxygen species (ROS), and the release of molecules with degradative properties including defensins, elastase, collagenase, cathespins, and lysozyme. This long-term inflammation can lead to cell proliferation (a possible precursor to cancer), tissue remodeling, and scarring, as well as being linked to the onset of autoimmune responses in genetically disposed individuals. This review will focus on the ability of the immune system to recognize and clear acute and persistent chlamydial infections in the male genital tract, and on the paradoxical damage that chronic inflammation resulting from the infection can cause on the reproductive health of the individual.
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Affiliation(s)
- Kate A Redgrove
- Priority Research Centre in Reproductive Biology and Chemical Biology, University of Newcastle , Callaghan, NSW , Australia ; School of Environmental and Life Science, University of Newcastle , Callaghan, NSW , Australia
| | - Eileen A McLaughlin
- Priority Research Centre in Reproductive Biology and Chemical Biology, University of Newcastle , Callaghan, NSW , Australia ; School of Environmental and Life Science, University of Newcastle , Callaghan, NSW , Australia
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Mackern-Oberti JP, Motrich RD, Breser ML, Sánchez LR, Cuffini C, Rivero VE. Chlamydia trachomatis infection of the male genital tract: an update. J Reprod Immunol 2013; 100:37-53. [PMID: 23870458 DOI: 10.1016/j.jri.2013.05.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/03/2013] [Accepted: 05/06/2013] [Indexed: 12/30/2022]
Abstract
Chlamydia trachomatis (CT) is the most prevalent cause of sexually transmitted diseases. Although the prevalence of chlamydial infection is similar in men and women, current research and screening are still focused on women, who develop the most severe complications, leaving the study of male genital tract (MGT) infection underrated. Herein, we reviewed the literature on genital CT infection with special focus on the MGT. Data indicate that CT certainly infects different parts of the MGT such as the urethra, seminal vesicles, prostate, epididymis and testis. However, whether or not CT infection has detrimental effects on male fertility is still controversial. The most important features of CT infection are its chronic nature and the presence of a mild inflammation that remains subclinical in most individuals. Chlamydia antigens and pathogen recognition receptors (PRR), expressed on epithelial cells and immune cells from the MGT, have been studied in the last years. Toll-like receptor (TLR) expression has been observed in the testis, epididymis, prostate and vas deferens. It has been demonstrated that recognition of chlamydial antigens is associated with TLR2, TLR4, and possibly, other PRRs. CT recognition by PRRs induces a local production of cytokines/chemokines, which, in turn, provoke chronic inflammation that might evolve in the onset of an autoimmune process in genetically susceptible individuals. Understanding local immune response along the MGT, as well as the crosstalk between resident leukocytes, epithelial, and stromal cells, would be crucial in inducing a protective immunity, thus adding to the design of new therapeutic approaches to a Chlamydia vaccine.
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RAKHMATULLINA MR, POPOV DV, PLAKHOVA KI. Current concepts of the epidemiology, clinical picture, diagnostics and therapy of non-complicated and complicated forms of the urogenital chlamydia infection in men. VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors present the results of recent studies of the epidemiology and immunopathogenesis of non-complicated and complicated forms of the urogenital chlamydia infection in men. They also present the results of a study of clinical features of the chlamydia infection and describe up-to-date diagnostics and treatment methods.
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Male rat genital tract infection with Chlamydia muridarum has no significant consequence on male fertility. J Urol 2012; 187:1911-7. [PMID: 22425040 DOI: 10.1016/j.juro.2011.12.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Indexed: 11/21/2022]
Abstract
PURPOSE Chlamydia trachomatis infection of the male genital tract was proposed to alter male fertility. We studied the putative consequences of chlamydial male genital tract infection on semen quality and male fertility in an experimental rat model of infection. MATERIALS AND METHODS We used 36 male and 40 female Wistar rats. Male genital infection was created by inoculating Chlamydia muridarum in the meatal urethra. The presence of C. muridarum was evaluated by polymerase chain reaction in semen and male genital tract organs early (15 days) and late (80 days) after infection. Sperm quality parameters were assayed in seminal and epididymal sperm from sham infected and infected rats. Mating studies with sexually mature females were performed and fertility parameters were assayed, including potency, fecundity and fertility indexes, fetal size, and pre-implantation and post-implantation embryo loss. RESULTS Male rats showed ascending, disseminated infection 15 days after infection. Bacteria persisted in the prostate and seminal vesicles 80 days after infection. C. muridarum was detected in semen in most rats regardless of acute or chronic infection. Seminal or epididymal sperm quality did not differ in infected and sham infected rats 15 or 80 days after infection. Sperm apoptosis was also minimal in infected rats. No differences were observed in fertility parameters between infected and sham infected rats. CONCLUSIONS C. muridarum infects the rat male genital tract and persists mainly in the prostate. Although C. muridarum was detected in semen during acute and chronic infection, no alterations in sperm quality were observed. C. muridarum infection does not impair male fertility.
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Re: Eggert-Kruse et al.: Are chlamydial lipopolysaccharide-directed antibodies in seminal plasma or serum clinically significant during investigation of male infertility? (Urology 2011;77:1101-1106). Urology 2011; 78:723; author reply 723-4. [PMID: 21884923 DOI: 10.1016/j.urology.2011.04.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 03/28/2011] [Accepted: 04/08/2011] [Indexed: 11/22/2022]
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Mackern-Oberti JP, Motrich RD, Breser ML, Cejas H, Cuffini C, Maccioni M, Rivero VE. Male Rodent Genital Tract Infection With Chlamydia Muridarum: Persistence in the Prostate Gland That Triggers Self-Immune Reactions in Genetically Susceptible Hosts. J Urol 2011; 186:1100-6. [DOI: 10.1016/j.juro.2011.04.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Juan Pablo Mackern-Oberti
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ruben Dario Motrich
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Maria Laura Breser
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Hugo Cejas
- Hospital Nuestra Señora de la Misericordia, III Cátedra de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Cecilia Cuffini
- Instituto de Virología “J. M. Vanella”, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Mariana Maccioni
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Virginia Elena Rivero
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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Mackern-Oberti JP, Maccioni M, Breser ML, Eley A, Miethke T, Rivero VE. Innate immunity in the male genital tract: Chlamydia trachomatis induces keratinocyte-derived chemokine production in prostate, seminal vesicle and epididymis/vas deferens primary cultures. J Med Microbiol 2010; 60:307-316. [PMID: 21109628 DOI: 10.1099/jmm.0.024877-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Chlamydia trachomatis is an intracellular pathogen that infects mucosal epithelial cells, causing persistent infections. Although chronic inflammation is a hallmark of chlamydial disease, the proinflammatory mechanisms involved are poorly understood. Little is known about how innate immunity in the male genital tract (MGT) responds to C. trachomatis. Toll-like receptors (TLRs) are a family of receptors of the innate immunity that recognize different pathogen-associated molecular patterns (PAMPs) present in bacteria, viruses, yeasts and parasites. The study of TLR expression in the MGT has been poorly investigated. The aim of this work was to investigate the keratinocyte-derived chemokine (KC) response of MGT primary cultures from C57BL/6 mice to C. trachomatis and different PAMPs. KC production by prostate, seminal vesicle and epididymis/vas deferens cell cultures was determined by ELISA in culture supernatants. TLR2, 3, 4 and 9 agonists induced the production of KC by all MGT primary cultures assayed. In addition, we analysed the host response against C. trachomatis and Chlamydia muridarum. Chlamydial LPS (cLPS) as well as C. trachomatis and C. muridarum infection induced KC secretion by all MGT cell cultures analysed. Differences in KC levels were observed between cultures, suggesting specific sensitivity against pathogens among MGT tissues. Chemokine secretion was observed after stimulation of seminal vesicle cells with TLR agonists, cLPS and C. trachomatis. To our knowledge, this is the first report showing KC production by seminal vesicle cells after stimulation with TLR ligands, C. trachomatis or C. muridarum antigens. These results indicate that different receptors of the innate immunity are present in the MGT. Understanding specific immune responses, both innate and adaptive, against chlamydial infections, mounted in each tissue of the MGT, will be crucial to design new therapeutic approaches where innate and/or adaptive immunity would be targeted.
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Affiliation(s)
- Juan Pablo Mackern-Oberti
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, Ciudad Universitaria, 5016 Córdoba, Argentina
| | - Mariana Maccioni
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, Ciudad Universitaria, 5016 Córdoba, Argentina
| | - Maria Laura Breser
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, Ciudad Universitaria, 5016 Córdoba, Argentina
| | - Adrian Eley
- Henry Wellcome Laboratories for Medical Research, Department of Infection and Immunity, University of Sheffield Medical School, Sheffield S10 2RX, UK
| | - Thomas Miethke
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Technische Universität München, Trogerstr. 30, 81675 München, Germany
| | - Virginia E Rivero
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, Ciudad Universitaria, 5016 Córdoba, Argentina
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Carey AJ, Beagley KW. Chlamydia trachomatis, a hidden epidemic: effects on female reproduction and options for treatment. Am J Reprod Immunol 2010; 63:576-86. [PMID: 20192953 DOI: 10.1111/j.1600-0897.2010.00819.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The number of genital tract Chlamydia trachomatis infections is steadily increasing worldwide, with approximately 50-70% of infections asymptomatic. There is currently no uniform screening practice, current antibiotic treatment has failed to prevent the increased incidence, and there is no vaccine available. We examined studies on the epidemiology of C. trachomatis infections, the effects infections have on the female reproductive tract and subsequent reproductive health and what measures are being taken to reduce these problems. Undetected or multiple infections in women can lead to the development of severe reproductive sequelae, including pelvic inflammatory disease and tubal infertility. There are two possible paradigms of chlamydial pathogenesis, the cellular and immunological paradigms. While many vaccine candidates are being extensively tested in animal models, they are still years from clinical trials. With no vaccine available and antibiotic treatment unable to halt the increased incidence, infection rates will continue to increase and cause a significant burden on health care systems.
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Affiliation(s)
- Alison J Carey
- Institute of Health & Biomedical Innovation, School of Life Sciences, Faculty of Science, Queensland University of Technology, Brisbane, Qld, Australia
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Abstract
There is increasing evidence that the function of human spermatozoa can be significantly affected by direct exposure to the bacterium Chlamydia trachomatis. This may contribute to sub-fertility in infected individuals by a route that is independent of any damage to the reproductive epithelium. In addition, if a C. trachomatis infection is undiagnosed it could contribute to poor outcomes in assisted conception techniques such as in vitro fertilization. The antibiotics routinely used in IVF culture systems are largely ineffective against chlamydia, emphasizing the importance of screening patients prior to treatment. Moreover, given the many thousands of semen samples provided for analysis by men in primary care (many of which will never undergo assisted conception treatment), it is suggested that this may represent a wasted opportunity to provide screening (and treatment) for the infection using an appropriate test specimen and without the need for additional hospital visits.
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Affiliation(s)
- A A Pacey
- Academic Unit of Reproductive and Developmental Medicine, Royal Hallamshire Hospital, Sheffield, UK.
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Mazzoli S, Cai T, Addonisio P, Bechi A, Mondaini N, Bartoletti R. Chlamydia trachomatis infection is related to poor semen quality in young prostatitis patients. Eur Urol 2009; 57:708-14. [PMID: 19482415 DOI: 10.1016/j.eururo.2009.05.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Accepted: 05/06/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND The impact of chronic prostatitis resulting from Chlamydia trachomatis infection on male fertility is controversial. OBJECTIVE To investigate the correlation between C. trachomatis infection and semen quality in young male patients affected by chronic prostatitis resulting from C. trachomatis infection and to evaluate the correlation between anti-C. trachomatis immunoglobulin (Ig) A against heat shock protein 60 (HSP60), heat shock protein 70 (HSP70), and semen parameters. DESIGN, SETTING, AND PARTICIPANTS All patients with clinical and instrumental diagnosis of chronic prostatitis underwent microbiological cultures for common bacteria, DNA extraction, mucosal and serum antibody evaluation for C. trachomatis, and semen parameter analysis. Western blot analysis of mucosal anti-C. trachomatis IgA was performed. INTERVENTIONS Subjects were split into two groups: Group A consisted of patients with chronic prostatitis resulting from common bacteria (uropathogens), and group B consisted of patients with chronic prostatitis resulting from C. trachomatis infection. MEASUREMENTS The relationship between C. trachomatis infection and semen parameters as well as the correlation among IgA levels, IgA characterisation, and semen analysis were determined. RESULTS AND LIMITATIONS We enrolled 1161 patients (mean age: 36.5 yr). Of these, 707 patients were placed in group A, and 454 were placed in group B. Significant statistical differences were reported between groups in terms of sperm concentration (p<0.001), percentage of motile sperm (p<0.001), and normal morphologic forms (p<0.001). Strong correlations between mucosal anti-C. trachomatis IgA and sperm concentration (p<0.001) and normal morphologic forms (p<0.001) were reported. Correlations among positivity to HSP60, HSP70, and sperm concentration (p<0.003) and normal morphologic forms (p<0.001) were also reported. CONCLUSIONS This study demonstrated the role of chronic prostatitis resulting from C. trachomatis in male fertility decrease, highlighting probable immunomediated damage to germinal cells because of C. trachomatis infections.
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Affiliation(s)
- Sandra Mazzoli
- Sexually Transmitted Disease Centre, Santa Maria Annunziata Hospital, Florence, Italy
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Cunningham KA, Carey AJ, Finnie JM, Bao S, Coon C, Jones R, Wijburg O, Strugnell RA, Timms P, Beagley KW. ORIGINAL ARTICLE: Poly-Immunoglobulin Receptor-Mediated Transport of IgA into the Male Genital Tract is Important for Clearance of Chlamydia muridarum Infection. Am J Reprod Immunol 2008; 60:405-14. [DOI: 10.1111/j.1600-0897.2008.00637.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cunningham KA, Beagley KW. Male Genital Tract Chlamydial Infection: Implications for Pathology and Infertility1. Biol Reprod 2008; 79:180-9. [DOI: 10.1095/biolreprod.108.067835] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Sylvan S, Christenson B. Increase in Chlamydia trachomatis infection in Sweden: time for new strategies. ARCHIVES OF SEXUAL BEHAVIOR 2008; 37:362-364. [PMID: 18058014 DOI: 10.1007/s10508-007-9283-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Abstract
Chlamydia species are responsible for a variety of infections in humans. Chlamydia trachomatis represents the most frequently found species among Chlamydia in urogenital infections of females and males. The clinically most relevant infection appears to be bacterial adnexitis of the female that may cause sterility. However, Chlamydia also indicates a remarkably high prevalence in the urogenital tract of asymptomatic males. This review summarizes the most current developments in the diagnostics and therapeutical approaches in Chlamydia infections of the male accessory sex glands.
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Affiliation(s)
- W Weidner
- Klinik und Poliklinik für Urologie und Kinderurologie, Justus-Liebig-Universität, Rudolf-Buchheim-Strasse 7, 35292 Giessen, Deutschland.
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Idahl A, Abramsson L, Kumlin U, Liljeqvist JA, Olofsson JI. Male serum Chlamydia trachomatis IgA and IgG, but not heat shock protein 60 IgG, correlates with negatively affected semen characteristics and lower pregnancy rates in the infertile couple. ACTA ACUST UNITED AC 2006; 30:99-107. [PMID: 17132153 DOI: 10.1111/j.1365-2605.2006.00718.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The objective of this study was to evaluate whether serum Chlamydia trachomatis immunoglobulin-A (IgA), IgM and C. trachomatis heat shock protein 60 (CHSP60) IgG are of additional value to C. trachomatis IgG regarding the impact on fecundity in infertile couples, and to relate C. trachomatis serum antibodies to semen characteristics, diagnoses and pregnancy outcome. METHODS A total of 226 infertile couples, previously tested for C. trachomatis IgG, were tested for C. trachomatis IgA, IgM and CHSP60 IgG, and semen samples from all men were analysed. RESULTS Chlamydia trachomatis serum IgA in men (but not in women) correlated with reduced chances of achieving pregnancy [p = 0.021, relative risk (RR) =0.65, 95% confidence interval (CI) 0.42-1.005] and in combination with C. trachomatis IgG the chance was further reduced (p =0.001, RR = 0.35, 95% CI 0.15-0.84). Chlamydia trachomatis serum IgA was also significantly correlated with reduced motility of the spermatozoa (-8.7%, p = 0.023), increased number of dead spermatozoa (+10.5%, p = 0.014) and higher prevalence of leucocytes in semen (+122%, p = 0.005), and in combination with C. trachomatis IgG positivity, there was also a decrease in sperm concentration (-35%, p = 0.033), the number of progressive spermatozoa (-14.8%, p = 0.029) and a rise in the teratozoospermia index (+4.4%, p = 0.010). CHSP60 IgG correlated with reduced motility (-5.6%, p = 0.033), and in the women to tubal factor infertility (p = 0.033), but no correlations of C. trachomatis serum IgM or CHSP60 IgG with pregnancy rates were found. CONCLUSIONS Chlamydia trachomatis serum IgA in the male partner of the infertile couple has an additive value to IgG in predicting pregnancy chances, and serum IgA and IgG are associated with subtle negative changes in semen characteristics.
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Affiliation(s)
- A Idahl
- Department of Clinical Science/Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
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Abstract
Idiopathic oligoasthenoteratozoospermia (iOAT) affects approximately 30% of all infertile men. This mini-review discussed recent data in this field. Age, non-inflammatory functional alterations in post-testicular organs, infective agents (Chlamydia trachomatis, herpes virus and adeno-associated viruses), alterations in gamete genome, mitochondrial alterations, environmental pollutants and "subtle" hormonal alterations are all considered possible causes of iOAT. Increase of reactive oxygen species in tubules and in seminal plasma and of apoptosis are reputed to affect sperm concentration, motility and morphology. iOAT is commonly diagnosed by exclusion, nevertheless spectral traces of the main testicular artery may be used as a diagnostic tool for iOAT. The following can be considered therapies for iOAT: 1) tamoxifen citrate (20 mg/d) + testosterone undecanoate (120 mg/d) (pregnancy rate per couple/month [prcm]: 3.8%); 2) folic acid (66 mg/d) + zinc sulfate (5 mg/d); 3) L-carnitine (2 g/d) alone or in combination with acetyl-L-carnitine (1 g/d) (prcm: 2.3%); and 4) both carnitines = one 30 mg cinnoxicam suppository every 4 days (prcm: 8.5%). Alpha-blocking drugs improved sperm concentration but not morphology, motility or pregnancy rate. Tranilast (300 mg/d) increased sperm parameters and pregnancy rates in an initial uncontrolled study. Its efficacy on sperm concentration (but not on sperm motility, morphology or prcm) was confirmed in subsequent published reports. The efficacy of tamoxifen + testosterone undecanoate, tamoxifen alone, and recombinant follicle-stimulating hormone is still a matter for discussion.
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Affiliation(s)
- Giorgio Cavallini
- Operative Unit of Andrology, Società Italiana di Medicina della Riproduzione, Via Mazzini 12, 40138 Bologna, Italy.
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Engeler DS, John H, Maake C. Prostatitis and male factor infertility: A review of the literature. ACTA ACUST UNITED AC 2006. [DOI: 10.1007/s11918-006-0021-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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