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沙眼衣原体感染与年轻前列腺炎患者精液质量差有关。

Chlamydia trachomatis infection is related to poor semen quality in young prostatitis patients.

机构信息

Sexually Transmitted Disease Centre, Santa Maria Annunziata Hospital, Florence, Italy.

出版信息

Eur Urol. 2010 Apr;57(4):708-14. doi: 10.1016/j.eururo.2009.05.015. Epub 2009 May 27.

Abstract

BACKGROUND

The impact of chronic prostatitis resulting from Chlamydia trachomatis infection on male fertility is controversial.

OBJECTIVE

To investigate the correlation between C. trachomatis infection and semen quality in young male patients affected by chronic prostatitis resulting from C. trachomatis infection and to evaluate the correlation between anti-C. trachomatis immunoglobulin (Ig) A against heat shock protein 60 (HSP60), heat shock protein 70 (HSP70), and semen parameters.

DESIGN, SETTING, AND PARTICIPANTS: All patients with clinical and instrumental diagnosis of chronic prostatitis underwent microbiological cultures for common bacteria, DNA extraction, mucosal and serum antibody evaluation for C. trachomatis, and semen parameter analysis. Western blot analysis of mucosal anti-C. trachomatis IgA was performed.

INTERVENTIONS

Subjects were split into two groups: Group A consisted of patients with chronic prostatitis resulting from common bacteria (uropathogens), and group B consisted of patients with chronic prostatitis resulting from C. trachomatis infection.

MEASUREMENTS

The relationship between C. trachomatis infection and semen parameters as well as the correlation among IgA levels, IgA characterisation, and semen analysis were determined.

RESULTS AND LIMITATIONS

We enrolled 1161 patients (mean age: 36.5 yr). Of these, 707 patients were placed in group A, and 454 were placed in group B. Significant statistical differences were reported between groups in terms of sperm concentration (p<0.001), percentage of motile sperm (p<0.001), and normal morphologic forms (p<0.001). Strong correlations between mucosal anti-C. trachomatis IgA and sperm concentration (p<0.001) and normal morphologic forms (p<0.001) were reported. Correlations among positivity to HSP60, HSP70, and sperm concentration (p<0.003) and normal morphologic forms (p<0.001) were also reported.

CONCLUSIONS

This study demonstrated the role of chronic prostatitis resulting from C. trachomatis in male fertility decrease, highlighting probable immunomediated damage to germinal cells because of C. trachomatis infections.

摘要

背景

沙眼衣原体感染引起的慢性前列腺炎对男性生育力的影响存在争议。

目的

探讨沙眼衣原体感染引起的慢性前列腺炎患者精液质量与沙眼衣原体感染的相关性,评估沙眼衣原体热休克蛋白 60(HSP60)、热休克蛋白 70(HSP70)免疫球蛋白 A(IgA)与精液参数的相关性。

设计、地点和参与者:所有临床和仪器诊断为慢性前列腺炎的患者均进行常规细菌培养、DNA 提取、沙眼衣原体黏膜和血清抗体评估以及精液参数分析。进行黏膜抗沙眼衣原体 IgA 的 Western blot 分析。

干预措施

将受试者分为两组:A 组为普通细菌(尿路病原体)引起的慢性前列腺炎患者,B 组为沙眼衣原体感染引起的慢性前列腺炎患者。

测量

确定沙眼衣原体感染与精液参数的关系,以及 IgA 水平、IgA 特征与精液分析之间的相关性。

结果和局限性

共纳入 1161 例患者(平均年龄:36.5 岁)。其中 707 例患者归入 A 组,454 例患者归入 B 组。两组间精子浓度(p<0.001)、活动精子百分比(p<0.001)和正常形态(p<0.001)均有显著统计学差异。黏膜抗沙眼衣原体 IgA 与精子浓度(p<0.001)和正常形态(p<0.001)呈强相关。还报告了 HSP60、HSP70 阳性与精子浓度(p<0.003)和正常形态(p<0.001)之间的相关性。

结论

本研究表明沙眼衣原体感染引起的慢性前列腺炎会降低男性生育能力,提示沙眼衣原体感染可能通过免疫机制对生殖细胞造成损害。

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