Henkel R, Maass G, Hajimohammad M, Menkveld R, Stalf T, Villegas J, Sánchez R, Kruger T F, Schill W-B
Centre of Dermatology and Andrology, Justus Liebig University, Giessen, Germany.
Andrologia. 2003 Oct;35(5):309-13.
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.
精液中白细胞过多与男性不育有关。根据世界卫生组织的标准，白细胞浓度超过10⁶个/毫升被视为白细胞精子症，表明存在生殖道感染。到目前为止，关于如何在精液中定量白细胞尚未达成共识。使用过氧化物酶染色以及针对CD15、CD45和CD68的单克隆抗体，我们发现不同检测方法之间存在显著差异。通过CD45评估为白细胞精子症的精液样本中，只有47.4%通过过氧化物酶染色被鉴定为白细胞精子症。过氧化物酶阳性细胞的浓度与多形核粒细胞（PMN）弹性蛋白酶显著相关（P < 0.0001）。然而，仅在少精子症患者中发现过氧化物酶阳性细胞与精子浓度呈负相关（P < 0.0001）。此外，与正常精子形态的微弱正相关似乎仅适用于少精子症病例。过氧化物酶阳性细胞数量与最大诱导顶体反应（P = 0.0219）和顶体反应诱导率（P = 0.0370）均呈显著负相关，表明白细胞对这一重要精子功能具有相当有害的影响。关于体外受精程序的结果，所检测的参数（PMN弹性蛋白酶、圆形细胞浓度和过氧化物酶阳性细胞）均与受精或妊娠无相关性。这一结果似乎是合理的，因为通过不同的精子分离方法，严重受损的精子和白细胞会从射精中被清除。有趣的是，作为精子DNA片段化指标的TUNEL检测仅与妊娠呈显著负相关（P = 0.006），而与受精无关。由于DNA片段化也可能由白细胞产生的活性氧引起，这种因果关系不应被忽视。
