Relationship between an asymptomatic male genital tract exposure to Chlamydia trachomatis and an autoimmune response to spermatozoa

Abstract

The relationship between a localized genital tract humoral immune response to Chlamydia trachomatis and the presence of antisperm antibodies on the surface of motile spermatozoa in the ejaculate was examined in 227 asymptomatic male partners of infertile couples with no history of exposure to C.trachomatis. Semen and serum samples were assayed for immunoglobulin (Ig) A and IgG antibodies to C.trachomatis by enzyme-linked immunosorbent assay employing a recombinant Chlamydia-specific lipopolysaccharide fragment (Medac, Hamburg, Germany), while motile spermatozoa were tested for bound autoantibodies by immunobead binding. Semen samples from 24.7 and 10.9% of the men were positive for IgA and IgG antibodies to C.trachomatis respectively. In comparison, antichlamydial IgA was less prevalent in sera (14.5%) than in semen (P = 0.01), while antichlamydial IgG was most prevalent (21.5%) in sera (P = 0.003). In 75.0% of the men with antichlamydial IgA in their semen, this antibody was undetectable in sera obtained at the time of semen collection. Conversely, 84.0% of the men with seminal antichlamydial IgG were also IgG seropositive. Antisperm IgG and/or IgA were detected on motile spermatozoa from 16.3% of the men; their occurrence was strongly correlated with the presence of antichlamydial IgA in semen (P < 0.0001). Weaker associations between antisperm antibodies and either seminal IgG antibodies to C.trachomatis (P = 0.01) or circulating IgA and IgG antichlamydial antibodies (P = 0.03) were also observed. Men with antichlamydial IgA in their semen had a lower median sperm count (82 versus 144 x 10(6)/ml) than those men without (P = 0.003); sperm morphology and motility were comparable in both groups. These data suggest that asymptomatic male genital tract exposure to C.trachomatis is a frequent event among this population and that the presence of a humoral immune response to this organism is correlated with the development of an autoimmune response to spermatozoa.

Chlamydia Trachomatis Detected by Ligase Chain Reaction in the Semen of Asymptomatic Patients Without Pyospermia or Pyuria

“…The effect of latent C. trachomatis on semen quality and urogenital organs is debatable [5,9,10]. There have been few studies on the long-term consequences of persistent asymptomatic C. trachomatis infections of the male genital tract [9].…”

“…The role of semen microbiology in treating cases of male infertility remains controversial [5,9,10]. Chlamydia trachomatis infections of the male and female genital tracts are often asymptomatic, and may thus persist undetected for long periods of time.…”

“…Chlamydia trachomatis infections of the male and female genital tracts are often asymptomatic, and may thus persist undetected for long periods of time. The chronic immune activation elicited by C. trachomatis within the genital tract may precipitate a sperm-directed autoimmune response, that is, it may induce a humoral immune response to spermatozoa [9]. Recently a sensitive method for detecting C. trachomatis has been developed using a ligase chain reaction (LCR) [1,2,4,6].…”

IgA ANTIBODIES TOCHLAMYDIA TRACHOMATISAND SEMINAL PARAMETERS IN ASYMPTOMATIC INFERTILE MALES

“…Antichlamydial IgA detection in seminal plasma is a highly specific test for C. trachomatis diagnosis that has good agreement with other speciesspecific methods, such as ELISA, and more sensitivity than microimmunofluorescence [4,25]. There is an association between the presence of IgA antibodies to C. trachomatis in semen and alterations in some seminal parameters such as motility or leucocytospermia [25,34]. Nevertheless, other authors have not found such a relationship [16,27].…”

Radial spoke protein 44 (human meichroacidin) is an axonemal alloantigen of sperm and cilia

“…Anti-sperm antibodies may also be formed as a result of cross-reactivity between sperm antigens and bacterial antigens (Witkin et al, 1995). A complete understanding of the mechanism behind immunologic infertility, as well as improved diagnosis and treatment, depends on knowledge of the identities of specific sperm antigens capable of eliciting the production of functionally relevant sperm antibodies.…”