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Soda K, Ikutama R, Hasegawa T. A Case of Human Seminal Plasma Allergy Diagnosed by Prick Test Using Seminal Plasma. Indian Dermatol Online J 2024; 15:643-645. [PMID: 39050060 PMCID: PMC11265744 DOI: 10.4103/idoj.idoj_415_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 07/27/2024] Open
Affiliation(s)
- Koki Soda
- Department of Dermatology and Allergology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Risa Ikutama
- Department of Dermatology and Allergology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Toshio Hasegawa
- Department of Dermatology and Allergology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
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Abstract
Atopic dermatitis (AD), a chronic inflammatory skin condition, negatively affects sexual health in various ways including causing physical discomfort and changes in physical appearance that can lead to low self-confidence. The chronic and debilitating nature of this disease can interfere with the sexual well-being of patients and their partners. This review describes the ways that AD affects sexual health. In addition, we review the impact that partnered relationships and physical intimacy can have on AD and provide practical recommendations for optimizing sexual health in AD patients.
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Lavery WJ, Stevenson M, Bernstein JA. An Overview of Seminal Plasma Hypersensitivity and Approach to Treatment. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2020; 8:2937-2942. [PMID: 33039013 DOI: 10.1016/j.jaip.2020.04.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 11/16/2022]
Abstract
Seminal plasma hypersensitivity (SPH) presents with localized vaginal and/or systemic allergic symptoms on exposure to protein components of seminal plasma. Although the true incidence is unclear, it is a likely underdiagnosed but an important cause of vulvovaginitis and dyspareunia that affects women across the entire globe. Systemic SPH is likely elicited by an IgE-mediated reaction to seminal plasma proteins other than spermatozoa. Localized reactions are likely mediated by a non-IgE immunologic mechanism. The diagnosis of both conditions is made clinically. Clinical presentation typically involves local vaginal discomfort and/or systemic symptoms including urticaria, angioedema, wheezing, dyspnea, gastrointestinal symptoms, or frank anaphylaxis. In roughly half of cases of localized SPH, reactions occur after first-time intercourse. Use of a condom prevents reactions, which aids confirming a diagnosis. In addition to a detailed history, skin prick and/or serologic testing may assist in making the diagnosis. Both local and systemic SPH are managed by the use of barrier contraception or intravaginal graded desensitization. Although SPH has not been shown to directly cause infertility, it may make conception challenging due to the discomfort or systemic symptoms caused by unprotected vaginal intercourse. Data indicate that women with localized reactions have variable fertility outcomes, although the majority are able to have resolution of symptoms after desensitization and have normal term pregnancies. This review provides a step-by-step approach for evaluating and treating women with localized or systemic SPH.
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Affiliation(s)
- William J Lavery
- Division of Allergy and Immunology, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Margo Stevenson
- Allergy & Immunology Associates of New England, Wilbraham, Mass
| | - Jonathan A Bernstein
- University of Cincinnati College of Medicine and Bernstein Allergy Group, Cincinnati, Ohio.
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Caminati M, Giorgis V, Palterer B, Racca F, Salvottini C, Rossi O. Allergy and Sexual Behaviours: an Update. Clin Rev Allergy Immunol 2019; 56:269-277. [PMID: 28653246 DOI: 10.1007/s12016-017-8618-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The exact prevalence of hypersensitivity reactions related to sexual behaviours is not known; however, they heavily impact on the quality of life and of sex life of affected patients. In fact, not only common respiratory and skin allergies, such as asthma, rhinitis, urticaria and atopic dermatitis, but also food and drug allergy have been found to negatively affect the quality of sex life. Allergic diseases impact on the sexual function in both physical and psychological ways, representing one of the main complaints of a considerable proportion of patients. Sexual behaviours may act as the triggers of allergic reactions or as the carriers of allergens. Food and drug allergens can be carried through human organic fluids, like saliva and semen. Latex in condoms and numerous substances in lubricants, spermicides, topical medications and cosmetics can cause allergic reactions or contact dermatitis. Sexual activity itself is also a potential trigger of symptoms in patients affected by respiratory allergies, like honeymoon asthma and rhinitis. In seminal plasma hypersensitivity, seminal fluid proteins are the culprit allergens. The present review aims at summarizing the state of the art about allergy and sexual behaviours. In clinical practice, the influence of common allergic diseases on the sexual quality of life should be taken carefully into account. Sexual behaviours need to be accounted in the differential diagnosis of hypersensitivity reactions, and awareness on those exposure routes should be raised between different specialists and general practitioners.
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Affiliation(s)
- Marco Caminati
- Allergy Unit and Asthma Center, Verona University and General Hospital, Verona, Italy
| | - Veronica Giorgis
- SSDDU Allergologia e Immunologia Clinica, Department of Medical Sciences, AO Ordine Mauriziano "Umberto I", University of Turin, Corso Re Umberto 109, 10128, Torino, Italy.
| | - Boaz Palterer
- Department of Experimental and Clinical Medicine, University of Florence, AOU Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesca Racca
- Personalized Medicine Clinic Asthma and Allergy, Humanitas Clinical and Research Center, Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy
| | - Chiara Salvottini
- Department of Internal Medicine and Therapeutics, University of Pavia, Piazzale Golgi, 19, 27100, Pavia, Italy
| | - Oliviero Rossi
- Department of Internal Medicine, Section of Immunoallergology and Respiratory Diseases, University of Florence, Florence, Italy
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Kounis NG, Ren HL, Kavalioti M, Koniari I, Theoharides TC. Intimate Contact Could Be Dangerous for Your Health. Clin Ther 2019; 41:1222-1226. [PMID: 31076202 DOI: 10.1016/j.clinthera.2019.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/28/2019] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To review evidence of hypersensitivity reactions to allergens and/or pathogens transmitted via intimate contact. METHODS We reviewed PubMed for publications in English between 1980 and 2018 using the terms allergy, drugs, foods, hypersensitivity, intercourse, kissing, Kounis syndrome, mast cells, and semen. FINDINGS In human RELATIONSHIPS, intimate contact can occasionally have disastrous or even fatal consequences because antigens and pathogens can be transmitted via the oral and vaginal mucosa. Hypersensitivity to semen is an underrecognized problem. Some individuals also developed acute coronary hypersensitivity, which mimics myocardial infarction, known as Kounis syndrome. IMPLICATIONS Hypersensitivity reactions to allergens and/or pathogens via intimate contact are common and should be recognized. Sensitive patients should be evaluated for atopic diathesis because such patients may be more susceptible and could also develop Kounis syndrome.
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Affiliation(s)
- Nicholas G Kounis
- Patras Highest Institute of Education and Technology, Patras, Greece
| | - Huali L Ren
- Department of Otolaryngology, Beijing Electric Power Hospital, Beijing, China
| | - Maria Kavalioti
- Department of Biomedical Sciences, University of Greenwich, United Kingdom
| | - Ioanna Koniari
- Patras Highest Institute of Education and Technology, Patras, Greece
| | - Theoharis C Theoharides
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston, MA, USA; Department of Internal Medicine, Tufts University School of Medicine, Boston, MA, USA.
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6
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Tanaka M, Nakagawa Y, Kotobuki Y, Katayama I. A case of human seminal plasma allergy sensitized with dog prostatic kallikrein, Can f 5. Allergol Int 2019; 68:259-260. [PMID: 30181013 DOI: 10.1016/j.alit.2018.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Mari Tanaka
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukinobu Nakagawa
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Yorihisa Kotobuki
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ichiro Katayama
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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Abstract
PURPOSE OF REVIEW Intimate behaviours may represent an unusual way of exposure to a culprit allergen, or the frame for sex-related allergies due to triggers typically linked to that situation. The present review aims at summarizing the state of the art about the topic, in order to spread the awareness and the basic know-how in the field of sexual-related allergies. RECENT FINDINGS Kiss-related IgE-mediated reactions are caused in sensitized partners mainly by the passive transport of allergenic molecules through saliva, skin or oral mucosa. It has also been recently suggested that kissing may act as an epicutaneous way for induction of allergic sensitization. Among food and drugs, not only but mostly, peanuts and beta-lactams, respectively, are the usual trigger. Although controversial, 1-hour wait before kissing and a proper mouth cleaning have been suggested as prevention strategies. Sexual intercourse related local or systemic symptoms can be caused by seminal plasma hypersensitivity, an IgE-mediated/type IV reaction due to prostate-specific antigen, which carries high homology to the canine prostatic kallikrein (Can f 5). Although applied to few patients, successful desensitization and immunotherapy protocols have been proposed. SUMMARY Intimate behaviours are possible modalities of contact with the allergen. The exact prevalence of such hypersensitivity reactions is not known, but for its implications on Quality of Life and reproductive wishes, the possible link between sex and allergy should become part of the personal culture of clinical allergists and every clinician, in order to extend and improve the diagnosis of unusual or unexplained conditions.
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Burguete-Cabanas MT, Fajardo-Ramirez OR, Yesaki R, Estrada-Maganas R, Salazar-Meza S, Rios-Chavez O, Meester I, Salas-Alanis JC. Omalizumab for hypersensitive reaction to seminal plasma: A case report. Allergol Int 2018; 67:278-279. [PMID: 28821383 DOI: 10.1016/j.alit.2017.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/09/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022] Open
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9
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Jankowski M, Kodyra E, Kaszubowska J, Czajkowski R. Characterization of patients with suspected hypersensitivity to cervicovaginal fluid. J Eur Acad Dermatol Venereol 2017; 32:86-90. [PMID: 28837242 DOI: 10.1111/jdv.14550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/07/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergic reaction to seminal plasma was described decades ago. In USA, only tens of thousands women are estimated to be affected. Not only seminal plasma but also cervicovaginal fluid contains sex-restricted antigens, yet allergy to cervicovaginal fluid has never been reported in medical literature. We came to a suspicion that because immunologic tests required to prove such a diagnosis, allergy to cervicovaginal fluid has never been reported yet it is not uncommon. OBJECTIVE The objective of this study was to use an Internet-based questionnaire to characterize the population of men with suspected hypersensitivity to cervicovaginal fluid. METHODS A questionnaire designed to cover localized and systemic symptoms of hypersensitivity reaction was made available via the Internet. Respondents with postcoital adverse reactions were invited to participate. Only respondents who presented with at least two symptoms suggestive to hypersensitivity to seminal plasma or cervicovaginal fluid and were negative for STI, and known hypersensitivity reactions such as latex allergy were a subject for further analysis. Board-certified dermatologists were surveyed for seeing bona fide cases of cervicovaginal fluid hypersensitivity. RESULTS We have identified 52 cases of suspected hypersensitivity to cervicovaginal fluid (CVF). Both localized and systemic types of hypersensitivity were identified. A substantial number of dermatologists admitted to witnessing cases of hypersensitivity to CVF. CONCLUSION Based on data from affected individuals as well as the opinions of dermatologists worldwide, we believe that allergic reaction to cervicovaginal fluid is at least as common as seminal plasma allergy. However, remains unreported due to technical difficulties in diagnosis and dermatologists' disbelief in its actual existence.
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Affiliation(s)
- M Jankowski
- Chair of Dermatology, Sexually Transmitted Diseases and Imuunodermatology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - E Kodyra
- Chair of Dermatology, Sexually Transmitted Diseases and Imuunodermatology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - J Kaszubowska
- Chair of Dermatology, Sexually Transmitted Diseases and Imuunodermatology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - R Czajkowski
- Chair of Dermatology, Sexually Transmitted Diseases and Imuunodermatology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
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10
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Abstract
A semen allergy is a type I reaction. Reliable figures about incidence/prevalence are not available. Symptoms can be characterized as local and systemic. After exposure to ejaculate, the patient may experience itching and swelling at points of contact, while systemically it may also lead to generalized urticaria with angioedema or higher grade anaphylaxis. As triggering allergens, substances in seminal plasma (SP) have been identified, which can be SP typical or SP atypical. Reactions against spermatozoa have not yet been clearly proven. With regard to SP-typical allergens, prostate-specific antigen (PSA) has been identified, while for SP-atypical allergens, medications or food allergens have been reported, which apparently accumulate in the SP and can then trigger symptoms in women with existing sensitization. The main criteria for the diagnosis of sperm allergy is freedom from symptoms when condoms are used during intercourse. In addition, skin prick tests and determination of allergen-specific IgE are used. In patients with a desire for children, washed, SP-free spermatozoa can be used for insemination. In addition, desensitization may be considered.
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11
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Brazdova A, Senechal H, Peltre G, Poncet P. Immune Aspects of Female Infertility. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:1-10. [PMID: 27123194 PMCID: PMC4845518 DOI: 10.22074/ijfs.2016.4762] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 12/31/2014] [Indexed: 12/24/2022]
Abstract
Immune infertility, in terms of reproductive failure, has become a serious health issue involving approximately 1 out of 5 couples at reproductive age. Semen that is defined as a complex fluid containing sperm, cellular vesicles and other cells and components, could sensitize the female genital tract. The immune rejection of male semen in the female reproductive tract is explained as the failure of natural tolerance leading to local and/or systemic immune response. Present active immune mechanism may induce high levels of anti-seminal/sperm antibodies. It has already been proven that iso-immunization is associated with infertility. Comprehensive studies with regards to the identification of antibody-targets and the determination of specific antibody class contribute to the development of effective immuno-therapy and, on the other hand, potential immuno-contraception, and then of course to complex patient diagnosis. This review summarizes the aspects of female immune infertility.
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Affiliation(s)
- Andrea Brazdova
- Department of Biochemistry, Allergy and Environment, Armand-Trousseau Hospital, Paris, France
| | - Helene Senechal
- Department of Biochemistry, Allergy and Environment, Armand-Trousseau Hospital, Paris, France
| | - Gabriel Peltre
- Department of Biochemistry, Allergy and Environment, Armand-Trousseau Hospital, Paris, France
| | - Pascal Poncet
- Department of Biochemistry, Allergy and Environment, Armand-Trousseau Hospital, Paris, France
- Department of Infection and Epidemiology, Pasteur Institute, Paris, France
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12
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Nishihara Y, Shimizu T, Ichihara S, Suekata Y, Maeda K. Seminal Plasma Allergy : A Literature Review. J Gen Fam Med 2015. [DOI: 10.14442/jgfm.16.4_265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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13
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Calogiuri G, Nettis E, DiLeo E, Foti C, Vacca A. Is the localized seminal plasma hypersensitivity the mucosal aspect of protein contact dermatitis? J Allergy Clin Immunol 2015; 135:1090-1091. [DOI: 10.1016/j.jaci.2014.11.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 11/24/2014] [Accepted: 11/26/2014] [Indexed: 11/29/2022]
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14
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Bernstein JA. Human Seminal Plasma Hypersensitivity: An Under-Recognized Women's Health Issue. Postgrad Med 2015; 123:120-5. [DOI: 10.3810/pgm.2011.01.2253] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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16
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Callero A. The dog as a trigger factor of allergy liquid semen. Actas Urol Esp 2014; 38:346. [PMID: 24279985 DOI: 10.1016/j.acuro.2013.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 10/11/2013] [Indexed: 10/26/2022]
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Gallup GG, Reynolds CJ. Evolutionary Medicine: Semen Sampling and Seminal Plasma Hypersensitivity. EVOLUTIONARY PSYCHOLOGY 2014. [DOI: 10.1177/147470491401200117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Evidence suggests that each male may have a unique semen signature, and there are reasons to consider the possibility that semen sampling (i.e., being inseminated by different prospective mates during courtship) may be part of an evolved female mate assessment strategy. Here we theorize that seminal plasma hypersensitivity represents the extreme negative end of this continuum and functions as a deterrent to mating with genetically incompatible suitors.
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Affiliation(s)
- Gordon G. Gallup
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Collin J. Reynolds
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
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18
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Carroll M, Horne G, Antrobus R, Fitzgerald C, Brison D, Helbert M. Testing for hypersensitivity to seminal fluid-free spermatozoa. HUM FERTIL 2013; 16:128-31. [PMID: 23751111 DOI: 10.3109/14647273.2013.800238] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hypersensitivity to human semen (HHS) is an increasingly reported condition with symptoms manifested locally and systemically, which in some cases may result in anaphylaxis. This report describes four cases of HHS all with positive allergy skin prick tests to partner's whole semen. None of the patients elicited a response to seminal fluid-free washed spermatozoa. In cases of high risk of anaphylaxis, we recommend avoiding exposure to semen. By carrying out an allergy skin prick test on seminal fluid-free washed spermatozoa, the risk of immunogenic reaction to the spermatozoa could be eliminated.
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Affiliation(s)
- Michael Carroll
- Department of Reproductive Medicine, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.
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20
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Morrow EH, Innocenti P. Female postmating immune responses, immune system evolution and immunogenic males. Biol Rev Camb Philos Soc 2011; 87:631-8. [PMID: 22188485 DOI: 10.1111/j.1469-185x.2011.00214.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Females in many taxa experience postmating activation of their immune system, independently of any genital trauma or pathogenic attack arising from male-female genital contact. This response has always been interpreted as a product of natural selection as it either prepares the female immune system for antigens arising from an implanted embryo (in the case of placental mammals), or is a "pre-emptive strike" against infection or injury acquired during mating. While the first hypothesis has empirical support, the second is not entirely satisfactory. Recently, studies that have experimentally dissected the postmating responses of Drosophila melanogaster females point to a different explanation: male reproductive peptides/proteins that have evolved in response to postmating male-male competition are directly responsible for activating particular elements of the female immune system. Thus, in a broad sense, males may be said to be immunogenic to females. Here, we discuss a possible direct role of sexual selection/sexual conflict in immune system evolution, in contrast to indirect trade-offs with other life-history traits, presenting the available evidence from a range of taxa and proposing ways in which the competing hypotheses could be tested. The major implication of this review is that immune system evolution is not only a product of natural selection but also that sexual selection and potentially sexual conflict enforces a direct selective pressure. This is a significant shift, and will compel researchers studying immune system evolution and ecological immunity to look beyond the forces generated by parasites and pathogens to those generated by the male ejaculate.
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Affiliation(s)
- Edward H Morrow
- Department of Ecology and Genetics, Evolutionary Biology Center, Uppsala University, Norbyvägen 18D, SE-752 36 Uppsala, Sweden.
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21
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Song WJ, Kim DI, Kim MH, Yang MS, Kim YJ, Kim SH, Cho SH, Min KU, Chang YS. Human seminal plasma allergy: successful pregnancy after prophylactic anti-histamine treatment. Asia Pac Allergy 2011; 1:168-71. [PMID: 22053314 PMCID: PMC3206244 DOI: 10.5415/apallergy.2011.1.3.168] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 09/20/2011] [Indexed: 11/17/2022] Open
Abstract
Human seminal plasma allergy is a rare phenomenon. Its clinical manifestations are diverse, and range from mild local pruritus to fatal anaphylaxis. Treatment varies with severity of the reactions: abstinence, condom usage or immunotherapy (subcutaneous or intravaginal) with seminal fluid. Local allergic reactions can be managed by prophylactic use of antihistamines or local cromolyn cream. A 33-year-old female visited the Asthma and Allergy Clinic in Seoul National University Bundang Hospital for the recurrent generalized urticarial reactions after sexual intercourse. She had been suffering from asthma, allergic rhinoconjunctivitis and atopic dermatitis for 10 years. She gave birth to a baby 6 months ago and no problem before. However, recently she began to recognize unexpected generalized urticaria that occurred after the sexual intercourse with husband. She wanted to have the second baby but hesitated because of the recurrent symptoms after the intercourse. She showed positive response to skin prick test with her husband's seminal fluid. The IgE-binding components were 15, 22, 28, and 35 kDa. Considering her moderate cutaneous reactions, we decided to try prophylactic treatments with oral anti-histamine one hour before sexual intercourse. She did not experience urticarial reactions with intercourse while oral anti-histamine was administered in advance. Finally, treatment outcome was successful, and the couple successfully gave birth to their second baby. We suppose that prophylactic antihistamine may be also applied in seminal plasma allergy patients if systemic reactions are limited to mild to moderate generalized urticaria.
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Affiliation(s)
- Woo-Jung Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea
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22
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Sublett JW, Bernstein JA. Seminal Plasma Hypersensitivity Reactions: An Updated Review. ACTA ACUST UNITED AC 2011; 78:803-9. [DOI: 10.1002/msj.20283] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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23
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Affiliation(s)
- Ashok Shah
- Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110 007, India
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25
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Bajardeen B, Melendez J, Yoong W. Human seminal plasma hypersensitivity: an unusual indication for in vitro fertilization. Eur J Obstet Gynecol Reprod Biol 2010; 153:226-7. [PMID: 20678853 DOI: 10.1016/j.ejogrb.2010.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 06/29/2010] [Accepted: 07/07/2010] [Indexed: 11/25/2022]
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Frapsauce C, Berthaut I, de Larouziere V, d'Argent EM, Autegarden JE, Elloumi H, Antoine JM, Mandelbaum J. Successful pregnancy by insemination of spermatozoa in a woman with a human seminal plasma allergy: should in vitro fertilization be considered first? Fertil Steril 2010; 94:753.e1-3. [PMID: 20172516 DOI: 10.1016/j.fertnstert.2010.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/07/2010] [Accepted: 01/11/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To raise the possibility that pregnancy can be obtained by assisted reproductive techniques in patients with human seminal plasma allergy. DESIGN Case report. SETTING University hospital. PATIENT(S) A woman consulted for a 3-year primary infertility. She reported lack of intercourse because of a seminal plasma allergy. INTERVENTION(S) One intrauterine insemination associated with antihistamine treatment was performed with carefully washed spermatozoa. RESULT(S) Immediately after the insemination, the patient had an allergic reaction treated by steroids. Fortunately, this single attempt led to a successful pregnancy, and the patient gave birth to a healthy girl. CONCLUSION(S) Pregnancies can be obtained in patients with seminal plasma hypersensitivity by means of intrauterine insemination. However, serious complications may occur after performing intrauterine insemination, which is not a totally reliable method to prevent an allergic reaction. Thus a multidisciplinary team should follow such patients carefully and watch for the potential risks and side effects. In vitro fertilization may represent the more cautious option.
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Affiliation(s)
- Cynthia Frapsauce
- Department of Histology and Biology of Reproduction, Tenon Hospital (Assistance Publique Hôpitaux de Paris), Paris, France.
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27
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Lee J, Kim S, Kim M, Chung YB, Huh JS, Park CM, Lee KH, Kim JH. Anaphylaxis to husband's seminal plasma and treatment by local desensitization. Clin Mol Allergy 2008; 6:13. [PMID: 19061511 PMCID: PMC2615785 DOI: 10.1186/1476-7961-6-13] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 12/05/2008] [Indexed: 11/10/2022] Open
Abstract
Hypersensitivity to human seminal fluid is rare but can be life threatening. We report a case of IgE-mediated anaphylaxis to seminal plasma that was diagnosed by skin prick tests and successfully treated by local desensitization. A 32-year-old woman suffering from angioedema and hypotension after exposure to semen was treated with epinephrine upon admission. Skin prick tests and immunoblotting for IgE binding components showed that she was sensitized to her husband's seminal plasma. Local desensitization, which persisted for six months, was achieved by intravaginal administration of serial dilutions of her husband's seminal plasma.
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Affiliation(s)
- Jaechun Lee
- Department of Medicine, School of Medicine, Jeju National University, Jeju, Korea.
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Makino A, Sato T, Hattori Y, Saito C, Sugiura-Ogasawara M, Saito C, Shintani Y. Successful pregnancy after artificial insemination in a case of human seminal plasma allergy. Reprod Med Biol 2008; 7:119-122. [PMID: 29699292 PMCID: PMC5906891 DOI: 10.1111/j.1447-0578.2008.00208.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Human seminal plasma allergy in women is uncommon, but causes a variety of serious reactions, including urticaria, dyspnea and vomiting, in those that are affected. Semen barriers, such as condoms, are the most widely advocated method for avoiding these reactions. However, this is not acceptable to couples who wish to have children. We present a case of a woman with human seminal plasma allergy who became pregnant after the eighth cycle of artificial insemination using washed sperm from her spouse. (Reprod Med Biol 2008; 7: 119-122).
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Affiliation(s)
| | - Takeshi Sato
- Department of Human Reproduction and Embryology and
| | | | - Chieko Saito
- Department of Human Reproduction and Embryology and
| | | | - Chiyo Saito
- Department of Geriatric and Environmental Dermatology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoichi Shintani
- Department of Geriatric and Environmental Dermatology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
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Liccardi G, Senna G, Rotiroti G, D'Amato G, Passalacqua G. Intimate behavior and allergy: a narrative review. Ann Allergy Asthma Immunol 2007; 99:394-400. [PMID: 18051207 DOI: 10.1016/s1081-1206(10)60562-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine how sex and intimate contacts can represent a risk factor for allergic reactions, because they may favor direct contact with sensitizing substances. DATA SOURCES We collected in this review the available literature on this subject. The MEDLINE database was searched by a combination of keywords: sex OR sexual intercourse OR kiss OR seminal plasma OR condom AND allergy OR allergic reaction. STUDY SELECTION The studies retrieved were independently evaluated by the authors and included in this review based on their clinical pertinence (i.e., dealing with clinical presentation, diagnosis, or treatment). RESULTS Sex and intimate behavior seem to be increasingly described as triggers of allergic reactions, although the pertaining literature is represented mostly by case reports. Kissing has been described as a risk factor for food- and drug-induced severe reactions. Seminal plasma allergy has been repeatedly described and investigated. In this case, practical diagnostic algorithms have been proposed, and desensitization protocols are available. Similarly, there are numerous case reports of allergic reaction due to latex condoms, for which the diagnostic procedure is standardized. CONCLUSIONS The available literature on intimate behavior, and sex in general, as a trigger of allergic reactions is not abundant. This is probably because of the particular nature of the problem, which concerns intimacy. Nevertheless, reliable diagnostic procedures are available in some specific cases. The possible link between sex and allergy should become part of the personal culture of allergists to extend and improve the diagnosis of unusual or unexplained conditions.
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Affiliation(s)
- Gennaro Liccardi
- Division of Pneumology and Allergology, Department of Chest Diseases, A. Cardarelli Hospital, Naples, Italy
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Basagaña M, Bartolomé B, Pastor C, Torres F, Alonso R, Vivanco F, Cisteró-Bahíma A. Allergy to human seminal fluid: cross-reactivity with dog dander. J Allergy Clin Immunol 2007; 121:233-9. [PMID: 18061650 DOI: 10.1016/j.jaci.2007.10.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 10/09/2007] [Accepted: 10/10/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Human seminal plasma (HSP) allergy is uncommon, with symptoms ranging from vulvovaginal pruritus to life-threatening anaphylaxis. Although several seminal plasma allergens have been reported and their molecular masses have been estimated to range between 12 and 75 kd, the prostate-specific antigen (PSA) has recently been identified as a causative allergen. Given that in a large number of cases symptoms appeared during or after the first intercourse, a cross-reactivity phenomenon might be implicated. OBJECTIVE We sought to assess the presence of IgE cross-reactivity among proteins from dog epithelium and HSP and to attempt to identify the allergens involved. METHODS Forty-one patients with dog epithelium allergy were selected. One of them experienced anaphylaxis in contact with her husband's seminal plasma. Skin prick tests, serum specific IgE measurements, SDS-PAGE immunoblotting, and inhibition tests were performed to study the pattern of IgE-binding proteins and the potential cross-reactivity between HSP and dog epithelium. Mass spectrometry was carried out to identify the protein involved in allergy reactions. RESULTS Twenty-four percent of the sera from patients with dog epithelium allergy recognized an IgE-binding band of 28 kd in HSP immunoblotting. Mass spectrometry identified this band as the PSA. SDS-PAGE immunoblotting-inhibition showed a complete IgE-binding inhibition when sera from these patients were preincubated with dog dander extract. CONCLUSIONS IgE cross-reactivity among proteins from dog dander and human PSA is demonstrated.
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Affiliation(s)
- Maria Basagaña
- Allergy Department, Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Abstract
Human seminal plasma allergy (HSPA) is a rare allergic reaction to specific protein fractions of seminal plasma, whereof PSA seems to be a relevant allergen. Predominantly Type I-immunoreactions can occur. The main symptoms are localized and generalized urticaria and sometimes anaphylactic symptoms. The diagnosis is based on history, skin tests and on the determination of specific IgE-levels for (un)fractionated seminal plasma. Here we report a patient with recurrent episodes of generalized urticaria after unprotected sexual intercourse and positive prick-test-reaction on seminal plasma.
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Affiliation(s)
- U M Winter
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Philipp-Rosenthal-Str. 23-25, 04103 Leipzig.
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Abstract
Allergies to sperm are very uncommon. A 23-year old woman with atopic dermatitis complained of three attacks of angioedema, urticaria, wheezing and weakness. When questioned about factors causing exercise-induced anaphylaxis, the patient reported having had sexual intercourse with the same partner one hour before each event. When using condoms, no symptoms occurred. Human seminal plasma allergy was confirmed by positive skin testing with the partner's sperm. Specific IgE-antibodies against human seminal plasma were not found. The patient received an emergency kit for anaphylaxis.
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Affiliation(s)
- Gabriele C Nist
- Department of Dermatology and Allergology, Center for Skin Diseases, Stuttgart Clinic, Germany.
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Levin RJ. Sexual activity, health and well-being – the beneficial roles of coitus and masturbation. SEXUAL AND RELATIONSHIP THERAPY 2007. [DOI: 10.1080/14681990601149197] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Current World Literature. Curr Opin Allergy Clin Immunol 2005. [DOI: 10.1097/01.all.0000175939.68435.7e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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ACVECC News. J Vet Emerg Crit Care (San Antonio) 2005. [DOI: 10.1111/j.1476-4431.2005.00148.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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