Chlamydia trachomatis and sperm lipid peroxidation in infertile men

Aim: To relate the presence of anti-Chlamydial trachomatis IgA in semen with sperm lipid membrane peroxidation and changes in seminal parameters. Methods: Semen samples of the male partners of 52 couples assessed for undiagnosed infertility were examined for the presence of IgA antibody against C. trachomatis. The level of sperm membrane lipid peroxidation was estimated by determining the malondialdehyde (MDA) formation. Results: Sperm membrane of infertile males with positive IgA antibodies against C. trachomatis showed a higher level of lipid peroxidation than that of infertile males with negative IgA antibody (P<0.05). There was a positive correlation (P< 0.01) between the level of C. trachomatis antibody and the magnitude of sperm membrane lipid peroxidation. All the other tested semen parameters were found to be similar in the two groups. Conclusion: The activation of immune system by C. trachomatis may promote lipid peroxidation of the sperm membrane. This could be the way by which C. trachomatis a     

Study of Chlamydia trachomatis in chronic prostatitis]

To assess the pathogenetic role of Chlamydia trachomatis in non-bacterial prostatitis (NBP), aspiration biopsied specimens were examined for C. trachomatis by using in situ DNA hybridization and antibody titer to C. trachomatis was measured. An enzyme-linked immunosorbent assay (ELISA) for C. trachomatis specific IgA was employed using purified C. trachomatis type L2 EBs. The positive rates of IgA antibodies to C. trachomatis in serum, EPS and VB3 were 25.6%, 31.5% and 29.4%, respectively. They were significantly higher (p less than 0.05) in the control groups. A good correlation (0.78) of IgA antibody titer to C. trachomatis was found between EPS and VB3. In 9 husbands with positive antibodies to C. trachomatis, 5 wives showed positive serum antibodies. In the NBP patients with a high positive antibody titer, the decrease of titers was shown after treatment with drugs effective against C. trachomatis. Transrectal aspiration biopsies were performed on 7 patients with high positive IgA antibody titers to C. trachomatis, and 2 specimens showed hybrids in the cells by using in situ DNA hybridization. These findings indicate that C. trachomatis is a predominant pathogen for NBP.     

IgG and IgA antibodies specific for Chlamydia trachomatis in acute epididymitis

The possibility of using elevated Chlamydia trachomatis-specific serum IgG and IgA as a screening test for Chlamydia-associated epididymitis was analyzed in 28 acute epididymitis patients and 42 apparently healthy men by the single antigen (L2) immunoperoxidase assay. The prevalence rates of C. trachomatis IgG antibody titer greater than or equal to 64 and elevated C. trachomatis IgG titers (greater than or equal to 128) were significantly higher in the epididymitis patients (75 vs. 40%, p less than 0.01, and 39 vs. 14%, p less than 0.025, respectively) than in controls. The prevalence rate of C. trachomatis IgA antibodies (titer greater than or equal to 8) was significantly higher (p less than 0.001) in epididymitis patients as compared to controls (46 vs. 10%, respectively). The potential application of elevated serum C. trachomatis IgG and IgA antibodies as a noninvasive screening marker in epididymitis patients is discussed.     

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

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.     

Studies on detection of serum IgA and IgG antibodies specific for Chlamydia trachomatis in latent infections in males

We determined the serum concentrations of IgA and IgG antibodies specific for Chlamydia trachomatis (C. trachomatis) by an indirect immunoperoxidase assay (IPAzyme kit, Savyon Diagnostics, Ltd., Bee, Shova, Israel) to evaluate their diagnostic significance in latent infections in males. Forty-five asymptomatic males whose wife or partner was suspected to be infected with C. trachomatis were studied and the incidence of serum IgA (titer greater than or equal to 16) and IgG (titer greater than or equal to 64) antibodies for C. trachomatis was compared with that in a healthy group, a group with non-gonococcal urethritis (NGU) patients. Changes in IgA titer during treatment were also examined. The incidence of IgA and IgG antibodies in the healthy group was found to be 2.4% and 11.9% in males, and 4.8% and 18.1% in females, respectively. In patients whose wife or partner who was positive to C. trachomatis, the incidence of IgA and IgG antibodies was 42.2% and 75.6%, respectively. In the NGU patients the incidence of IgA and IgG antibodies was 56.3% and 62.5%, respectively. The incidence of IgA and IgG antibodies in patients whose wife or partner was antibody-positive were significantly higher (p less than 0.01) than the corresponding value in healthy men and women, but there was no significant difference from NGU patients or the elderly group. The IgA antibody titer during treatment of C. trachomatis infection showed no reduction in some cases. This study revealed frequent latent incidence of C. trachomatis infection in male patients. Determination of C. trachomatis IgA and IgG antibodies is considered to be supplemental for diagnosis of chlamydial latent infections.     

IgA antibodies to Chlamydia trachomatis and seminal parameters in asymptomatic infertile males

Prevalence of IgA antibodies to Chlamydia trachomatis in semen samples from infertile men was estimated and its clinical meaning is discussed. The ejaculate of 102 infertile men without any symptom of genital infection was studied, and seminal alterations were classified according to WHO criteria. Antichlamydial IgA antibodies were detected using a solid-phase, enzyme-linked immunoassay (ImmunoComb II Chlamydia trachomatis monovalent IgA) and related to sperm count, motility and membrane integrity, seminal leucocyte count, and past history of sexually transmitted disease (STD). Prevalence of IgA antibodies to C. trachomatis was 23%. There was no relationship between IgA antibodies and the sperm variables or leucocyte count in semen. However, a strong association between antichlamydial IgA antibodies and the antecedent of STD was found (p < .005; OR = 6). IgA antibodies to C. trachomatis did not cause alterations in sperm function and they were not associated with inflammatory response. However, these antibodies in semen of asymptomatic infertile men would indicate a risk of C. trachomatis infection for the couples of those patients.     

Semen inflammatory markers and Chlamydia trachomatis infection in male partners of infertile couples

Previous studies have given conflicting results about the effect of generally infection and Chlamydia trachomatis on seminal ILs and semen parameters. The aim of this study was to investigate the relationship between semen quality and the level of seminal interleukins (ILs) in infertile couples with C. trachomatis. Blood, first void urine (FVU) and semen were obtained from 250 infertile men who had failed to conceive after 12 months of trying. Serological analysis for specific IgA, IgM and IgG antibodies to C. trachomatis in serum, the presence of C. trachomatis in FVU and semen sample and semen analysis were carried out. The main results are as follows: (i) elevated IL‐6 and IL‐8 are observed in C. trachomatis‐positive men, but this is not significant and it varies by diagnostic method; and (ii) IL‐6 and IL‐8 levels were correlated with each other and the concentration of leucocytes, but IL‐8 was correlated with semen volume and patient's age. This study showed that men with such an infection in FVU samples (PCR positive) had only lower semen volume compared with men without infection.     

Cytodiagnosis of Chlamydia trachomatis by the immunoperoxidase technic

The PAP-immunocytochemistry using a monoclonal antibody against Chlamydia trachomatis was applied to male patients with clinically manifest urethritis and their female sex partners. In addition, serum levels of the antibody were determined by means of an ELISA system. Immunoperoxidase reactions were recognized on urethral scrapes in 53 (33%) out of 160 cases, and on endocervical specimens in 13 (59%) out of 22 sex partners of PAP-positive patients. In patients with gonococcal urethritis, an infection of C. trachomatis was revealed immunocytochemically in 11 (31%) out of 36 cases, and in 29 (46%) out of 62 cases with non-gonococcal urethritis. Following medication with 200 mg of minocycline or doxycycline per day, PAP staining became negative in 23 (66%) out of 35 cases. The levels of serum antibody against C. trachomatis were undetectable in 8 (26%) out of 29 PAP-positive cases, but positive in 7 (15%) out of 44 PAP-negative cases.     

Investigations on the detection of Chlamydia trachomatis infections in infertile male outpatients

Summary. The determination of Chlamydia antibodies in serum is unsuitable for diagnosing infertility in men. The determination of secretory IgA in seminal plasma would seem to be of greater relevance. Since antibodies against C. trachomatis and C. pneumoniae can be detected, a species-specific test for the diagnosis of infections of the male genital tract should be used. Only at relatively high titers (≥ 1:400) do genus-specific tests agree with the species-specific micro-immunofluorescence test. Whether such values can be taken as a true indicator of a local, chronic infection remains to be investigated.     

Local antibody in semen for rapid diagnosis of Chlamydia trachomatis epididymitis

Etiologic studies including micro-immunofluorescence serology for Chlamydia trachomatis were done on 45 consecutive men with acute epididymitis. Of the men 21, all less than 35 years old, had type specific Chlamydia trachomatis antibody in the semen. All patients with semen antibody also had Chlamydia trachomatis antibody in the serum, while only a few of the patients without semen antibody had serum antibody. Chlamydia antibody titers in the semen specimens were higher than those in the sera and they persisted longer. In only 1 patient with semen antibody was another potential etiological agent for epididymitis demonstrated, while most of the patients without semen antibody had bacterial causes for the epididymitis. It was concluded that measurement of Chlamydia trachomatis antibody in semen offered a noninvasive, sensitive and specific method, useful despite prior antibiotic therapy, for diagnosis of the etiology of epididymitis in young men.     

The relationship of circulating antisperm antibodies to sperm surface antibodies in infertile men

The correlation between the amount and location of antisperm antibody binding to the sperm surface and the level measured in the serum has not been previously reported. Hence, the value and limitations of screening blood sera from men with suspected immunologic infertility are not currently known. In this study 70 paired sera and semen samples were assayed by the immunobead test (IBT). A screening protocol for blood sera was constructed to be 100% sensitive for detecting semen specimens with 20% or more of sperm binding IgG or IgA immunobeads. The specificity of this screening protocol was determined to be 79%. Serum IgA was not a good predictor of IgA on the sperm surface. The true positive predictive rate for antisperm antibodies on the sperm surface using circulating antisperm antibodies as a screening assay was estimated to be as low as 35%. There was little correlation between the site of immunobead binding following passive antibody transfer from patients' sera to donor sperm and the site of naturally occurring antibodies on the patients' sperm surface. Although direct assessment of antibodies on the sperm surface is preferred, these data suggest that serum IgG alone can be used as a sensitive screening assay for antisperm antibodies in men. A positive screen dictates that a direct assay on semen should be performed.     

The possible role of Chlamydia trachomatis in perineal suppurative hidradenitis.

OBJECTIVE: To find out if there is an association between perineal suppurative hidradenitis and Chlamydia trachomatis infection. DESIGN: Open study. SUBJECTS: Seven consecutive patients treated for perineal suppurative hidradenitis during the past three years, and 10 control subjects who were being treated for acute cryptogenic perianal abscesses. MAIN OUTCOME MEASURE: Presence of C. trachomatis detected by direct immunofluorescent staining. RESULTS: All but one patient had serological evidence of C. trachomatis infection. All 10 control subjects failed to react to IgA antibodies to C. trachomatis, and two reacted to IgG antibodies. CONCLUSION: There may be a link between C. trachomatis infection and suppurative hidradenitis, but it is uncertain whether it is a direct cause or a predisposing factor.     

无症状不育病人精液抗沙眼衣原体IgG、IgM类别抗体的检测

目的 :探讨无症状不育病人精液抗沙眼衣原体 (Chlamydiatrachomatis,CT) IgG、 IgM抗体检测的临床意义。　方法 :随机选择 116例无生殖道感染症状的不育病人及 18例生育男性 ,作精液常规参数分析 ,然后分离精浆 ,测定其抗CT IgG、 IgM抗体。 　结果 :①不育病人精浆抗CT IgG、 IgM抗体阳性率分别为13 .8% ( 16/ 116)和3 .4% ( 4/ 116) ,而生育男性分别为 11.1% ( 2 / 18)和 0 ,两组相比差异均无显著性 (P均 >0 .0 5 )。② 116例不育病人中有 2 2例为无精子症。其余 94例病人中 ,精子密度异常组的精浆抗CT IgG、 IgM抗体阳性率分别为2 1.4% ( 6/2 8)和 7.1% ( 2 / 2 8) ,精子密度正常组则较低 ,分别为 12 .1% ( 8/ 66)和 3 .0 % ( 2 / 66) ,但差异均无显著性 (P均 >0 .0 5 ) ;精子活率正常组和异常组之间的精浆抗CT IgG、 IgM抗体阳性率也无明显差异 (P均 >0 .0 5 )。③ 116例不育病人中 3 0例CT阳性 ( 2 5 .9% )。　结论 :无症状不育病人的精浆抗CT IgG、 IgM抗体阳性率与生育男性相似 ,与其精液参数改变无关 ,不能作为CT感染的辅助指标     

Significance of sperm antibodies detected by the mixed antiglobulin reaction and the tray agglutination test

Summary. The most widely used tests to detect seminal and serum sperm antibodies are the mixed antiglobulin reaction (MAR as recommended by WHO) and the tray agglutination test (TAT). It has been suggested that the prognostic significance of sperm antibody tests might be influenced by a concomitant reduction of sperm numbers and/or sperm motility. Furthermore, the relative sensitivity of these sperm antibody tests to detect sperm antibodies is not known. We therefore compared TAT, performed with serum and MAR results retrospectively for 565 infertile patients and MAR IgA and MAR IgG results for 1189 infertile patients. The association of TAT and MAR results with changes in sperm number, morphology and motility was assessed for 565 and 1185 patients, respectively. The influence of MAR and TAT results on sperm cervical mucus penetration test (SCMPT) results was investigated for 349 and 434 patients, respectively. Whereas only 23% of all MAR IgG positive patients were also MAR IgA positive, 82% of all MAR IgA positive patients were also MAR IgG positive. There was a significant ( P < 0.0001) correlation between serum TAT, and MAR results. Positive MAR and TAT results were not associated with reductions in sperm number, motility and morphology. There was a significant correlation between MAR IgG and MAR IgA results and the sperm cervical mucus penetration test (SCMPT) results. According to these results, the MAR IgG would be sufficient as an initial screening for seminal sperm antibodies. MAR IgG negative patients with strong indication for immunologic infertility should also be investigated with the MAR IgA and the serum TAT. Serum and seminal sperm antibodies do not seem to influence male fertility via reductions of sperm number, motility and morphology. However because of their significant influence on SCMPT results, MAR IgG and MAR IgA results seem to be of prognostic significance.     

Relationship between Chlamydia trachomatis and Mycoplasma genitalium infection and pregnancy rate and outcome in Iranian infertile couples

The study was performed to investigate the prevalence of Chlamydia trachomatis and Mycoplasma genitalium in a population of infertile couples from Iran and how this relates to tubal factor infertility, pregnancy rate and outcome of pregnancy. Blood, semen and first‐void urine samples were obtained from 250 infertile couples and 250 fertile women as a control. Infertile couples were followed up after 24 months to determine diagnosis, referral for assisted conception, any pregnancy and pregnancy outcome. Data were analysed with regard to the results of (i) serological analysis for specific antibodies to C. trachomatis in serum; (ii) the presence of C. trachomatis and M. genitaliumDNA in first‐void urine; and (iii) in a semen sample of the male partner. Prevalence of C. trachomatis in our study population was comparable to other studies using similar methods and test specimens. No evidence of M. genitalium infection was found. Detection of C. trachomatis in one partner rarely correlated with infection in the other. The risk of tubal factor infertility and the probability of pregnancy and pregnancy outcome were unrelated to the results of serological tests for C. trachomatis antibodies or the presence of C. trachomatisDNA in first‐void urine of both partners and in a semen sample provided by the male.     

微量沙眼衣原体组织培养法的建立及临床应用

建立了微量沙眼衣原体组织培养法，并应用于不同人群的生殖道标本的沙眼衣原体培养。结果生殖道沙眼衣原体培养的阳性率：男性尿道炎患者１４７％（９／６１）；正常孕妇３３％（７／２１０）；急性和亚急性盆腔炎女性患者６７％（７／１０４）；性病门诊患者１８２％（４９／２６９）。由于９６孔培养板及倒置荧光显微镜的应用，微量培养法试剂用量少、过程简化；自制的抗沙眼衣原体单克隆抗体大大降低了培养后的染色成本，适用于大宗标本。     

Chlamydia trachomatis infection as a problem among male partners of infertile couples

Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease supposed to cause urethritis, epididymitis, prostatitis and infertility in men. The objective of this study was to assess the frequency of C. trachomatis infection in male partners of infertile couples at childbearing age. Sixty infertile couples and a control group of 40 healthy volunteers were included in the study. Urethral swabs were taken from all the male participants and cervical swabs from the female partners of the infertile couples. Culturing on McCoy cell line and PCR were the methods used for detection of the infection. C. trachomatis was found in five out of the 60 male urethral samples. Three of the female partners of these five positive males were diagnosed with C. trachomatis infection, too. We registered a woman with C. trachomatis infection whose partner's samples were negative for the bacterium. The control group showed one specimen positive for C. trachomatis . The frequency of C. trachomatis infection was 8.3% in the male partners of infertile couples at childbearing age when compared with 2.5% in the control group. It is most likely that infertility in the couples with chlamydial infection was due to the pathogen studied.     

Assessment of Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium in semen and first void urine specimens of asymptomatic male partners of infertile couples

The purpose of this study was threefold: to compare semen and first void urine (FVU) specimens from asymptomatic infertile men for the detection of Chlamydia trachomatis, genital ureaplasma, and genital mycoplasma infections using in-house inhibitor-controlled polymerase chain reaction (PCR)-microtiter plate hybridization assay; to determine the prevalence of those organisms in infertile men in Tunisia; and to study the relationship between these bacteria and male infertility. Paired urine and semen specimens from 104 patients were examined by in-house PCR for the presence of DNA of Chlamydia trachomatis, genital ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) and genital mycoplasmas (Mycoplasma hominis and Mycoplasma genitalium). Semen analysis was assessed according to the guidelines of the World Health Organization. Nominal scale variables, the Mann-Whitney test, and the Kruskal-Wallis nonparametric analysis of variance test were used for statistical analysis. There was a very high concordance (>95%) and a very good agreement (kappa > 0.9) between the detection of Chlamydia trachomatis, genital ureaplasmas, and Mycoplasma hominis in semen and corresponding FVU specimens. Our findings also show a high concordance (81.1%) and a good agreement (kappa = 0.79) between the detection of Mycoplasma genitalium in both specimens. C trachomatis, genital mycoplasmas, and genital ureaplasmas were found to be widespread among infertile male patients in Tunisia, as shown by their respective prevalences of 43.3%, 18.3%, and 14.4%. The mean values of seminal volume, sperm concentration, sperm viability, sperm motility, sperm morphology, and leukocyte count were not significantly related either to the detection of C trachomatis DNA or to that of genital ureaplasma or mycoplasma DNA in semen specimens. Using our in-house PCR, both semen and FVU were found to be sensitive diagnostic specimens for the detection of C trachomatis, ureaplasmas, and mycoplasmas. The FVU, a less invasive and self-collected specimen, can serve as a marker for the presence of these organisms in the genital tract and can be used as a reliable way of detecting asymptomatic carriers of infection.     

Chlamydia trachomatis in 'abacterial' prostatitis: microbiological, cytological and serological studies

Chlamydia trachomatis was isolated from urethral swabs after prostatic massage in patients with 'abacterial' prostatitis. After exclusion of prostatic infections by gram-negative bacteria, enterococci and ureaplasmas, in 20 of 43 patients with apparent monoinfection by C. trachomatis, a leucocytal reaction was demonstrated in prostatic secretions. By microimmunofluorescence test, antibody titers greater than or equal to 1:8 against various types of C. trachomatis were detected in these patients, whereas serology was negative in chlamydia-positive patients without increased leucocyte counts (prostatodynia).     

Oral challenge with cow's milk in patients with IgA nephropathy--estimation of serum antibodies to cow's milk protein]

The author investigated the serum levels of antibodies against casein, beta-lactoglobulin and lactalbumin before and after challenging with cow's milk in 35 patients with IgA nephropathy, 18 with primary glomerulonephritis except for IgA nephropathy (GN control) and 11 healthy volunteers (H control). Blood samples were obtained at fasting, and at 30, 60, 120 and 180 min after oral challenging with 400 ml of cow's milk. IgA and IgG anti-cow's milk proteins antibodies were analyzed by ELISA. The same challenge was tested after administration of the antiallergic agent, sodium cromoglycate (SCG), in 11 patients with IgA nephropathy and 4 H controls. Serum levels of IgA anti-casein, -beta-lactoglobulin and lactalbumin antibodies in patients with IgA nephropathy were significantly higher than in control groups before challenging. However, those of IgG antibodies were not. The percent change of antibody titer after challenging with cow's milk did not elevate in any group, except for the level of IgA anti-beta-lactoglobulin antibody at 60 min in IgA nephropathy. Cases in which challenging produced marked elevation above the M + 2SD of the levels found in H control were expressed as "positive". The number of "positive" cases was 16 (45.7%) with IgA nephropathy, but none with GN control. There was no significant correlations between "positive" and "negative" cases with IgA nephropathy in clinical manifestations. In 3 out of 4 "positive" patients with IgA nephropathy, the levels of IgA antibody were suppressed after administration of SCG. It is concluded that the serum levels of IgA antibodies against cow's milk proteins are significantly elevated in IgA nephropathy, and are inhibited in elevation after oral challenge with cow's milk by administration of an antiallergic agent in some patients with IgA nephropathy.