Tronchon V, Vialard F, El Sirkasi M, Dechaud H, Rollet J, Albert M, Bailly M, Roy P, Mauduit C, Fenichel P, Selva J, Benahmed M
INSERM, U407, Oullins, France.
Hum Reprod. 2008 Dec;23(12):2858-66. doi: 10.1093/humrep/den277. Epub 2008 Aug 9.
One of the most well-documented cytokines suspected as a hazard to male fertility is tumor necrosis factor-alpha (TNFalpha). Genetic factors such as single-nucleotide polymorphisms (SNPs) in the TNF gene cluster impact TNFalpha levels. Our objective was to establish the potential involvement of -308 TNF SNP in male infertility risk.
In 684 infertile male patients undergoing an intracytoplasmic sperm injection procedure, we used allele-specific polymerase chain reaction (PCR) and PCR-RFLP to investigate the distribution of the guanine (G)-to-adenosine (A) substitution at position -308 in the promoter region of the TNFalpha gene.
An increased frequency of the -308 TNFalpha A allele was found in patients with low sperm count of testicular origin [P = 0.002; odds ratio (OR) = 2.93] or with normal production count but altered sperm motility (P = 0.003; OR = 2.32), compared with a patient group with normal sperm count and quality (morphology and motility). In patients with low sperm count exhibiting TNFalpha A allele, compared with those with G allele, an alteration in hormonal balance was observed with increased inhibin B levels and subsequent reduced FSH plasma levels, leading to an FSH/inhibin B ratio roughly half as high (from 0.07 +/- 0.01 in TNFA versus 0.13 +/- 0.02 in TNFG allele groups, P < 0.0001).
As the -308 TNFalpha A allele has been associated with an increased expression/production of TNFalpha, the potential use of therapies based on inhibition of TNFalpha activities could represent possible therapeutic opportunities for patients with low sperm count (i.e. primary testicular dysfunction) or with altered sperm motility.
肿瘤坏死因子-α(TNFα)是有充分文献记载的、被怀疑对男性生育力有危害的细胞因子之一。TNF基因簇中的单核苷酸多态性(SNP)等遗传因素会影响TNFα水平。我们的目的是确定TNF基因-308位点SNP与男性不育风险之间的潜在关联。
在684名接受胞浆内单精子注射手术的不育男性患者中,我们采用等位基因特异性聚合酶链反应(PCR)和PCR-限制性片段长度多态性分析(PCR-RFLP),研究TNFα基因启动子区域-308位点鸟嘌呤(G)到腺嘌呤(A)的替换分布情况。
与精子数量和质量正常的患者组相比,睾丸源性精子数量低的患者(P = 0.002;优势比[OR] = 2.93)或精子生成数量正常但精子活力改变的患者(P = 0.003;OR = 2.32)中,-308 TNFα A等位基因的频率增加。在精子数量低且携带TNFα A等位基因的患者中,与携带G等位基因的患者相比,观察到激素平衡发生改变,抑制素B水平升高,随后血浆促卵泡生成素(FSH)水平降低,导致FSH/抑制素B比值大约减半(TNF A等位基因组为0.07±0.01,而TNF G等位基因组为0.13±0.02,P < 0.0001)。
由于-308 TNFα A等位基因与TNFα表达/产生增加有关,基于抑制TNFα活性的疗法可能为精子数量低(即原发性睾丸功能障碍)或精子活力改变的患者提供可能的治疗机会。