Urogenital inflammation: changes of leucocytes and ROS

Abstract

The presence of excess leucocytes in the semen has been associated with male infertility. According to the WHO, concentrations of more than 106 leucocytes ml-1 are considered as leucocytospermia, indicating genital tract infections. Up to now, no consensus has been achieved on how leucocytes should be quantified in semen. Using the peroxidase staining and monoclonal antibodies to CD15, CD45 and CD68, we found significant differences between the detection methods. Only 47.4% of the semen samples that were assessed as leucocytospermic by CD45 were identified as such by peroxidase staining. The concentration of peroxidase-positive cells was significantly correlated with polymorphonuclear granulocyte (PMN) elastase (P < 0.0001). However, a negative correlation of peroxidase-positive cells with the sperm concentration was only found in oligozoospermic patients (P < 0.0001). Moreover, the slightly positive correlation with normal sperm morphology seems to be applicable only in cases of oligozoospermia. Significant negative correlation of the number of peroxidase-positive cells were found for both maximal inducible acrosome reaction (P = 0.0219) and the inducibility of acrosome reaction (P = 0.0370), indicating a rather deleterious effect of leucocytes on this important sperm function. Concerning the result in the in vitro fertilization programme, none of the examined parameters (PMN elastase, concentration of round cells and peroxidase-positive cells) showed a correlation with either fertilization or pregnancy. This result seems to be reasonable as severely damaged spermatozoa and leucocytes are eliminated from the ejaculate by different sperm separation methods. Interestingly, a significant negative correlation of the TUNEL assay as a measure of sperm DNA fragmentation was found only with pregnancy (P = 0.006) but not with fertilization. As DNA fragmentation can also be caused by ROS that are generated by leucocytes, this causality should not be neglected.

Sperm nuclear DNA fragmentation rate is associated with differential protein expression and enriched functions in human seminal plasma

“…Recently, Tremellen and Trunc correlated male fertility with the infiltration of neutrophils and activated macrophages in injured tissue resulting from infection and inflammation. These cells can damage sperm DNA by generation of reactive oxygen and nitrogen species, release of hydrolytic enzymes and cytokine‐induced apoptosis . A direct action of infectious organisms on sperm DNA integrity has also been reported .…”

Seminal elastase‐inhibitor complex, a marker of genital tract inflammation, and negative IVF outcome measures: role for a silent inflammation?

“…But, in our study, all men, except for two, were normozoospermic. In a recent study by Henkel et al. (2003a) no relationship was found between elastase and fertilization.…”

Role of asymptomatic genital tract inflammation in normozoospermic infertile men undergoing intracytoplasmic sperm injection

“…Henkel et al [26] reported significant negative correlation of leukocytes with sperm count in cases of less than 20 Â 10 6 sperms/ml being more evident in cases with sperm concentrations of less than 5 Â 10 6 sperms/ml. Wolff [20] and Aziz et al [21] observed that the total sperm motility was affected negatively by the presence of leukocytes, but this parameter was not affected in our study in agreement with Yilmaz et al [27].…”