ABSTRACT:The goal of this study was to determine whether inactivating specific cytokines in seminal plasma improves sperm motility in men affected by spinal cord injury (SCI). For this purpose, we used monoclonal antibodies to interleukin 6 (IL6), interleukin 1 beta (IL1-), and tumor necrosis factor alpha (TNF-␣), all 3 cytokines having been previously detected at high concentrations in the seminal plasma of patients with SCI. In a group of 17 SCI men with low sperm motility (mean Ϯ SE, 20.1% Ϯ 3.1%), treatment with the 3 monoclonal antibodies at the median neutralization dose concentrations for 1.0 to 1.5 hours improved sperm motility in all cases. Effectiveness was higher in those specimens with a pretreatment sperm motility between 11% and 30% (from 19.3% Ϯ 1.4% to 41.9% Ϯ 4.9%, P Ͻ .0002), suggesting that pretreatment sperm motility might represent an indicator of cell damage and, therefore, a factor that influences monoclonal antibody effectiveness. To the best of our knowledge, these results represent the first rational treatment for improving low sperm motility in these severely affected patients.Key words: Infertility, ejaculation, semen, IL1-, IL6, TNF-␣.
J Androl 2004;25:922-925P atients with spinal cord injury (SCI) have impaired sexual function and a unique sperm profile characterized by normal to high sperm concentrations and abnormally low sperm motility (Brackett et al, 1996b(Brackett et al, , 1997. The cause of this condition is unknown but might be related to abnormalities in the seminal plasma. Activated Tcell subpopulations were identified in the semen of these patients (Basu et al, 2002), and abnormal concentrations of cytotoxic cytokines were found in seminal plasma of SCI men with low sperm motility (Basu et al, 2004). To determine whether elevated cytokines contribute to low sperm motility in men with SCI, this study evaluated the usefulness of specific monoclonal antibodies to improve sperm motility by blocking cytokine activity in fresh semen samples. Miami, Fla). The mean (ϮSEM) age of subjects was 35.2 Ϯ 2.2 years (range 21 to 43 years). All subjects were past the acute phase of injury, and their mean time postinjury was 13.3 Ϯ 3.8 years (range 3 to 32 years). Levels of injury were C5 to C6 in 5 subjects, T1 to T7 in 6 subjects, and T8 to T12 in 6 subjects. Each subject had undergone at least 4 ejaculations spaced 4 to 8 weeks apart prior to semen collection for this study. All subjects were in good health and did not have any condition, other than SCI, known to interfere with fertility.
Materials and Methods
Subjects
Semen Collection and AnalysisOnly antegrade semen (ie, no retrograde semen) was collected from subjects by the standard method of penile vibratory stimulation (Brackett, 1999) because semen quality can be altered in retrograde ejaculates or if semen is collected by electroejaculation . Semen analysis was performed according to World Health Organization criteria (1999). Each semen specimen was first allowed to liquefy at room temperature. Sperm parameters were assessed b...