P-067 Correlation between Zn/Cu ratio and Bisphenol A in seminal plasma in men with varicocele

Study question

Is there a relationship between concentration of Bisphenol A (BPA), Zn contents and Zn/Cu ratio in seminal fluid and spermiogram parameters in men with varicocele?

Summary answer

Our results document correlations between BPA, Zn/Cu and sperm motility. We found that the negative effect of BPA can be attenuated by higher Zn/Cu levels.

What is known already

A range of environmental factors including organic endocrine disruptors affects spermatogenesis. Bisphenols are endocrine disruptors often used in production of plastics. BPA is an endocrine disruptor with negative effects on reproduction. Presence of BPA also induces production of reactive oxygen species with negative impact on spermatogenesis. Zinc and copper are trace elements important for human spermatogenesis. Zn and especially the ratio of Zn/Cu are good parameters of the antioxidant potential of seminal plasma. The relationship between BPA levels, Zn concentration and Zn/Cu ratio with human sperm parameters is still unclear.

Study design, size, duration

In this study, we evaluated correlation between BPA concentration, Zn concentration and ratio of Zn/Cu in seminal plasma in relation to sperm concentration, number of spermatozoa, total motility, progressive motility, morphology and DNA fragmentation. A total of 123 nonsmoking patients aged 18 - 45 (average 28) years with varicocele were included in this prospective study from 2019 to 2021.

Participants/materials, setting, methods

All the men signed an informed consent and agreed with analyses. Ethical Committee of University Hospital Brno approved analyses. Seminal plasma was collected after centrifugation. BPA was determined by the LC-MS/MS method (liquid chromatography-tandem mass spectrometry). The concentrations of Zn and Cu were measured by inductively coupled plasma mass spectrometry (Agilent 8900 ICP-MS/MS). Statistical evaluation was performed using Spearmen test (p = 0.05). The relationship between parameters was expressed by Spearman's correlation coefficient (ρ).

Main results and the role of chance

Analytical examination of seminal fluids detected presence of BPA in 89 samples (72.3 % of all samples analysed with average value 0.1627 ng/ml). In 18 samples, the concentration was under the level of detection and in 16 samples under the level of quantification. Zn was detected in all 123 patients with average concentration 139.44 µg/ml. The Zn/Cu ratio was calculated with average value 1.73. Subsequently, individual parameters of spermiogram plus DNA integrity were assessed. In case of BPA, negative correlations were found between BPA concentration and total motility (p = 0.010) and progressive motility (p = 0.012). Similarly, positive significant correlations between Zn/Cu ratio and total motility (p = 0.032) and progressive motility (p = 0.028) were found. For Zn concentration, we found positive non-significant correlation with total motility (p = 0.144) or progressive motility (p = 0.147). There were non-significant correlations between the BPA, Zn/Cu ratio or Zn and other parameters. Similarly, for BPA and Zn/Cu ratio a non-significant positive correlation was found (p = 0.157) and neither significant correlation was found between BPA and Zn (p = 0.452). In several cases we observed normal progressive and total motility in patients with high BPA concentrations together with high Zn/Cu ratio which probably has a protecting effect from the high BPA levels.

Limitations, reasons for caution

A limitation for this study is the final number of patients analysed in this study, which slightly reduced the power of statistical analysis. Currently, more analyses focused on detection of BPA in seminal plasma are being carried out in order to obtain sufficiently larger data set.

Wider implications of the findings

In this study, BPA was detected in 72 % of analysed samples. Our first results indicate a higher sensitivity of spermatozoa to BPA presence in seminal fluid, affecting mainly their motility. Interestingly, a higher Zn/Cu ratio is potent to reduce partially the negative impact of BPA on human spermatozoa.

Trial registration number

Supported by Czech Health Research Council (NV18-01-00544 and NV18-08-00291) and MH CZ – DRO (FNBr, 65269705). Jana Navratilova was supported by the Czech Ministry of Education, Youth and Sports (CZ.02.2.69/0.0/0.0/19_074/0012727). Authors also thanks to Research Infrastructure RECETOX RI (No LM2018121) financed by the Ministry of Education, Youth and Sports, and Operational Programme Research, Development and Innovation - project CETOCOEN EXCELLENCE (No CZ.02.1.01/0.0/0.0/17_043/0009632) for supportive background.

P–006 Simultaneous determination of bisphenol A and S in the samples of human seminal fluid

Study question

Can we quantitatively determine concentrations of endocrine disruptors namely bisphenol A and S in seminal fluid?

Summary answer

We developed selective analytical method to simultaneously screen for the presence of bisphenol A (BPA) and S (BPS).

What is known already

The male reproductive system involves processes, which may be influenced by the disruption of the endocrine system by chemicals called endocrine disruptors (EDs). There is a growing evidence that EDs such as bisphenol A and S may be responsible for the decline in male reproductive health. To date, the claimed adverse effects on male fertility are largely based on the results from studies assessing the relationship between urinary BPA and BPS concentration and semen parameters. The best evidence of an adverse effect of BPA and BPS directly on spermatozoa could be provided by measuring bisphenols concentration directly in seminal fluid.

Study design, size, duration

To selectively and quantitatively analyzed bisphenols in any biological matrix advanced analytical tools and selective sample preparation protocols must be employed. In this study we developed targeted analytical method based on liquid chromatography tandem mass (LC-MS/MS) detection to measure bisphenol A and S in seminal fluid samples obtained from IVF clinic. A total of 140 samples were analysed.

Participants/materials, setting, methods

BPA and BPS was extracted from 140 seminal fluid samples using solvent extraction followed by preconcentration step. Samples were analyzed on Agilent 6495 Triple Quadrupole (Agilent Technologies, Santa Clara, CA) operating in the ESI-negative mode. Two MS/MS transitions were used for quantitative LC-MS/MS analyses. Chromatographic separation was achieved on Waters™ ACQUITY™ UPLC™BEH C18 (100 × 2.1 mm, 1.7 µm) column using gradient elution with a mixture of 0.1mM ammonium fluoride and methanol as mobile phases.

Main results and the role of chance

We developed selective sample preparation method for detection of BPA and BPS in seminal fluid followed by LC-MS/MS detection. The method validation was performed based on FDA guidelines. Validation criteria included limit of detection (LOD), limit of quantitation (LOQ), accuracy and precision. Due to the lack of the certified reference material the validation criteria of the method were assessed in pool of spiked seminal samples. The accuracy of the LC-MS/MS method was evaluated as a percent recovery of the amount of target analyte added into the sample. Recovery rates were above 80% for both analytes. LOD was 0.04 ng/mL for BPA and 0.01 ng/mL for BPS. LOQ was 0.14 ng/mL and 0.02 ng/mL for BPS. Measured BPA concentration ranged from 0.04 ng/mL to 1.62 ng/mL. For BPS, the concentration ranged from 0.01 ng/mL to 0.47 ng/mL. BPA and BPS were detected in 64% and 81% of samples, respectively. Interestingly, BPA showed lower detection frequency compared to BPS. These results are consistent with other studies performed on urine samples.

Limitations, reasons for caution

The limitation of the developed method is the time-consuming sample preparation and analysis cost.

Wider implications of the findings: These results document for the first time the presence of BPS in seminal fluid. Knowing the concentration of BPA and BPS in seminal fluid is crucial for mitigating the associated health risks and initiating intervention and prevention strategies. Our future work will evaluate the influence of BPS concentration on spermatozoa.

Trial registration number

AZV NV18–01–00544; CZ.02.2.69/0.0/0.0/19_074/0012727

CD34⁺ cell content in unrelated allogeneic peripheral blood stem cell grafts transported internationally. Does the inter-laboratory variability affect comparability of graft quality data?

BACKGROUND

Increasing numbers of unrelated hematopoietic stem cell grafts are transported internationally and evaluated concurrently in different laboratories. The graft quality assessment using the CD34(+) enumeration could be influenced by inter-laboratory variability.

METHODS

We retrospectively analyzed the content of CD34(+) cells in 154 consecutive collections being performed in different transplant centers during two periods (2003-2004, 2007-2010). All samples were tested twice in our own and partner laboratories. CD34(+) percentage and absolute number were compared.

RESULTS

The percentage and the total CD34(+) content correlated well in both observed periods (CD34(+)%: r=0.899 and r=0.922; CD34(+)×10(8)/kg: r=0.966 and r=0.880; p<0.0001). Median CD34(+) percentages obtained in our centre in comparison with other laboratories were 0.54% vs. 0.46% in 2003-2004 and 0.69% vs. 0.70% in 2007-2010 period. The degree of laboratory compliance was affected by the laboratory identity. CD34(+) percentage reported by one laboratory and CD34(+)×10(8)/kg reported by three from twelve laboratories lacked statistically significant correlation with our own data.

CONCLUSIONS

The study documented that results of CD34(+) cell dose assessment of the same grafts reported by different transplant centers are comparable. The graft quality data and the CD34(+) enumeration possess a limited level of inter-laboratory variability.

[Patient with B-CLL with a history of unrelated hematopoietic cells donation--retrospective analysis of CLL development and implication for the recipient]

BACKGROUND

Donor cell leukemia (DCL) is a relatively rare but well documented complication of hematopoietic stem cell transplantation. So far, publications described only DCL arising de novo in the recipient.

OBSERVATION

In this study, we describe a case of chronic lymphocytic leukemia (B-CLL) developing in a volunteer unrelated donor from the Czech National Marrow Donors Registry (CNMDR) several years after donation. From archival DNA sample, we have retrospectively found that subclinical CLL clone was already present at the time of donation but early death of recipient prevented eventual development of DCL. This case documents well the long period between detection of B-CLL clone and full development of clinical-laboratory symptomatology. The medical and ethical questions posed by an isolated case of detection of hematological malignancy present either only in the donor or only in the recipient are discussed.

CONCLUSION

The case demonstrates the increasing risk of development of various forms of DCL and thus highlights the need for long-term monitoring of stem cell donor, not only in terms of health of donor but also in terms of potential risks for the recipient.

[The incidence of malignancies and surveillance of hematopoietic stem cells donors--the results of the Haemato-Oncology Department University Hospital in Plzen (Pilsen) and Czech National Marrow Donors Registry observation]

BACKGROUNDS

Granulopoesis colony-stimulating factor filgrastim is used to mobilize peripheral stem cells but there are concerns regarding an elevated risk of haematological malignancies. We analyzed the incidence of malignancies and the system of haematopoietic stem cells donor surveillance.

PATIENTS AND METHODS

prospective observation of sibling donors of the Haemato-Oncology Department University Hospital in Plzen (Pilsen) and of unrelated donors of the Czech National Marrow Donors Registry (CNMDR) in 2001-2010.

RESULTS

No malignancy was observed in a group of 344 unrelated CNMDR donors, providing 753 person-years; one case of chronic lymphocytic leukaemia manifested 6 years after bone marrow donation, with leukaemia clone retrospectively detected by DNA analysis in blood samples taken prior to the marrow donation. Acute myeloid leukaemia, non-Hodgkin lymphoma, renal and colorectal carcinoma were observed in a group of 84 peripheral stem cells sibling donors, providing 337 person-years observation. The respective incidence of the two haematologic malignancies was 593 cases and the expected incidence rate was 143 per 100,000. The sibling (related) donors age was significantly higher: 48 (16-75) vs. 31 (20-42) years, (p<0.0001). Significantly more lost-to-follow-up donors were among the related donors (32% vs. 3%, p<0.0001), even though active surveillance system was implemented.

CONCLUSION

The development of malignancies in hematopoietic stem cells donors can naturally be expected. Related (sibling) donors are at higher risk because of their generally older age, and higher susceptibility to haematological malignancies developed within the family. The contribution of filgrastim exposure needs to be further investigated. The follow-up cooperation with related (sibling) donors is limited.

Degradation of 5-nitroguaiacol by soil bacteria of the genus Rhodococcus

Two bacterial strains were isolated from forest soil by selective enrichment of the mineral medium containing 4-nitropyrocatechol as the sole carbon and energy source. Both strains could utilize 4-nitropyrocatechol and 5-nitroguaiacol. Degradation of 5-nitroguaiacol and stoichiometric release of nitrites was measured during its degradation both in growing culture and for resting cells. Both strains were unable to degrade other nitroaromatic compounds such as 4-nitroguaiacol, 2-nitrophenol, 3-nitrophenol, 4-nitrophenol, 2,4-dinitrobenzoic acid, 4,5-dimethoxy-2-nitrobenzoic acid and 2,3-difluoro-6-nitrophenol. One strain was identified as Rhodococcus opacus and the second one as Rhodococcus sp.

[Asynchronous occurrence of three neoplastic diseases: chronic B-cell lymphatic leukemia, renal carcinoma and prostatic adenocarcinoma]

Authors present a case of three asynchronous malignancies in man working life-long in chemical industry. Course of diseases and their treatment are described: B chronic lymphatic leukaemia (B-CLL) (age of 55), conventional clear cell renal carcinoma (CRCC) (age of 61) and adenocarcinoma of prostate (CaP) (age of 72). B-CLL treatment was chlorambucil for 2 years and follow-up subsequently. CRCC treatment was radical transperitoneal nephrectomy. Due to locally advanced CaP bilateral orchiectomy and radical external beam radiotherapy were performed. Patients is alive 30 months without any signs of any malignity. Incidence of multiple malignancies and particularly triplicities are discussed in this article. Authors point out pertinence of radical therapeutic approach also in multiple malignancies and oncological screening not only in patients with heamatological malignancy, but considering it in all tumours.

[Blunt injury of the kidney--personal experience and present views on its therapy]

Between 1972 to 1994 there were admitted 105 patients with blunt trauma of the kidney, 89 men and 16 women with median age 32 years. In 53 patients the left kidney was affected and in 52 of them the right side was injured. According to the grade of trauma we evaluated in 77 patients a contusion (73.3%), by 16 patients a laceration (15.2%), in 11 patients a rupture of the kidney with fragmentation of the parenchyma and in one the renal artery was injured. The mechanism leading to the blunt trauma of the kidney was following: traffic accident in 52 patients (49.5%), during sport in 20 patients (19.5%). 16 patients were injured in own home (9.5%) and 7 patients in work (6.7%). In 28 patients the trauma of the kidney was serious, by 5 of them we have done nephrectomy (17.8%), in two suture of the parenchyma (7.1%) and in further two patients heminephrectomy. After considering clinical status, grade of hypovolemic shock and finding on CT scan we prefer lately conservative steps in the treatment serious trauma of the kidney.

[Renal angiomyolipoma]

The authors present their own experience as well as data from the literature concerning the diagnosis and treatment of renal angiomyolipomas. In a group of 320 patients hospitalised at the Urological Clinic in 1990-1994 these tumours were diagnosed before surgery and confirmed by histological examination in 7 patients (2.2%). The group comprised three men and four women, mean age 51.7 years. Only one female patient had classical manifestations of tuberous sclerosis, the remaining patients did not have manifestations of tuberous sclerosis. Two patients were admitted with symptoms of haemorrhage into the retroperitoneum, three suffered from pain on pressure in the side and in two patients the tumour was revealed incidentally during US examination. Four patients were subjected to nephrectomy, in two enucleation of the tumour was performed and in one female patient with classical manifestations of tuberous sclerosis with a bilateral tumour conservative treatment was applied.

[Bilateral renal tumors]

At the Urological Clinic in Hradec Králové in 1990-1994 320 patients with renal tumours were admitted and treated. In 12 the tumour was bilateral (3.7%), incl. 8 patients where it was synchronous and four where it was asynchronous. Only in one female patient bilateral nephrectomy was performed, in 8 patients unilateral nephrectomy and on the other side enucleation of the tumour, in two patients bilateral enucleation of the tumour and in one patient with a malignant lymphoblastic lymphoma only unilateral enucleation of the tumour and epinephrectomy. In 10 patients histological examination confirmed a renal carcinoma, in one patient a malignant lymphoblastic lymphoma, in one female patient a bilateral multifocal oncocytoma. The patients survival was not evaluated in the report.

[Conservative surgical treatment of kidney tumors: indications, techniques, results]

At the Urological Department in Hradec Králové the authors operated in 1989-1993 287 patients with renal tumours, in 45 of them a conservative procedure was used (15.6%). The group comprises 29 men and 16 women, mean age 56.5 years. The contralateral kidney was normal in 29 patients (64%), in 5 patients nephrectomy was performed on account of carcinoma and in 9 patients (20%) the second kidney was hypofunctional (hydronephrosis, cysts). In two patients a conservative procedure was used on account of malignity of the blood. In 33 patients the tumour was enucleated (73.3%), in 12 the upper or lower pole of the kidney was resected. In 6 patients the tumour was in the first clinical stage, but in four already in T 3a (imperative indication). Twenty-seven tumours were evaluated by the histologist as medium differentiated, 2 of 35 as poorly differentiated. Thirty-five tumours were carcinomas (77.7%), 8 were adenomas, one was angiomyolipoma and in one instance the scar after PEC was removed which was not reliably diagnosed before surgery. The preoperative examination comprised also immunological examination which, however, was not made in two patients. The immunologist evaluated the criteria as favourable in 21 patients (60%), as risky in 12, incl. 6 were immunotherapy was administered. One patient developed a urinous fistula which healed on a stent. During the investigation period no local relapse was observed.

[Adrenal gland hemorrhage in adulthood]

The author presents five case-histories of haemorrhage into the adrenal in adult age. He emphasizes specially the difficulty of preoperative diagnosis.

Conservative surgery for renal cell carcinoma--indications, technique and results

At the Department of urology in Hradec Králové between 1989-1993 287 patients with a tumor of the kidney were operated on, in 45 of them (15.6%) conservatively. In this set there are 29 men and 16 women with the mean age 56.5 years. In 29 patients the contralateral kidney was normal (64%), 5 patients underwent nephrectomy for renal cell carcinoma, in 9 patients the opposite kidney was hypofunctionalised (hydronephrosis, cysts). In two patients the conservative approach was used for reasons of another type of malignancy (haematological). In 33 (73.3%) patients enucleation, in 12 patients resection of the lower or upper pole were done. The tumor was classified as T 1 stage in 6 patients, but in 4 patients already as T 3a (in patients with imperative indication). In 35 patients the tumor was moderately differentiated, in two ones with histologically confirmed renal cell carcinomas the tumors were poorly differentiated, in 8 patients there were histologically adenomas, in one angiomyolipoma and in another case scar after PCN (percutaneous nephrolithotomy). Preoperative examination included immunological examination, this was not done in two patients. Good results were obtained in 21 patients (60%), 12 patients were in high risk and 6 of them received immunotherapy. As an early complication one patient had urinary fistula, which resolved after introduction of stent. Relapse of malignancy in the screening period was not noticed.

[Tumor thrombosis of the inferior vena cava--personal experience with surgical therapy]

Patients treated at the Urological Clinic in Hradec Králové on account of carcinoma of the kidney are systematically followed up since 1962. In the submitted paper the authors evaluate patients treated during 1985-1991. During the mentioned period at the Urological Clinic in Hradec Králové 365 patients with carcinoma of the kidney were treated. In 55 (15%) invasion into the renal or inferior vena cava was proved (in 43 men and 12 women). In 38 patients the tumour with a thrombus of the inferior vena cava was on the right side, in 17 a tumour of the left kidney was removed. The right to left ratio is 2.2:1. Surgery of tumourous thrombosis depends on the level of the upper margin of the tumourous thrombus. A tumourous thrombus in the subhepatic part of the inferior vena cava can be treated either by massaging into the renal vein after obliteration of the artery or by parietal resection of the inferior vena cava. In 18 patients the authors were able to remove the thrombus by massaging into the renal vein. In 32 patients the inferior vena cava was resected. In five the tumourous invasion was not resolved, either because of extensive secondaries (in the liver and lungs) or because of direct tumourous infiltration of the wall of the inferior vena cava.(ABSTRACT TRUNCATED AT 250 WORDS)

[Conn's syndrome in tumors of the adrenal cortex]

During the period from Jan. 1 1989 to June 30 1992 at the Urological Clinic in Hradec Králové three women with cortical adenomas were treated, the tumour being the cause of primary hyperaldosteronism. The age of the patients was 25-40 years, in one woman the tumour was on the right side, in two on the left side. All patients complained of marked muscular weakness, fatigue, one woman developed cramps of the hands when working and another patient was repeatedly hospitalized at the neurological department on account of attacks of weakness. In one patient the interval from the onset of complaints to assessment of the diagnosis was 23 years. All patients had complete examinations at specialized departments before operation, in all the diagnosis was established by biochemical examinations and CT. In all instances minor tumours--diameter 2-3 cm--were involved which were easily removed by surgery. The postoperative course in all patients was without complications.