El Feky Mohamed A, Hassan Ehsan Abdel Sabour, El Din Azza M Ezz, Hofny Eman R M, Afifi Noha Abdel Halim, Eldin Salwa S Seif, Baker Mohamed Osama
Department of Medical Microbiology Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Egypt J Immunol. 2009;16(1):49-59.
Chlamydia trachomatis infection is considered to be one of the most common sexually transmitted diseases. It is currently unclear whether chlamydial infection causes pathological conditions of the male accessory glands has consequences for male infertility. To determine the frequency of C. trachomatis Infection among infertile men with leukocytospermia using different diagnostic techniques such as the detection of secretory IgA antibodies (Abs) in seminal plasma by enzyme-linked immunosorbent assay (ELISA), plasmid DNA by polymerase chain reaction (PCR) and direct detection of elementary body by flowcytometric analysis in seminal fluid. To assess the relationship between C. trachomatis infection and semen quality hence male infertility. Seventy five infertile male patients with leukocytospermia and 25 apparently healthy age matched fertile men were included as controls. Routine semen analysis and LeucoScreen test were done for each patient and control. Detection of C. trachomatis secretory IgA in seminal plasma by ELISA and detection of plasmid DNA by PCR and elementary body by flowcytometric analysis in semen samples were performed. Primary and secondary infertility were detected in 55 (73.3%) and 20 (26.7%) of patients, respectively. Sperm concentration and sperm motility (A+B) were statistically significant lower in patients with leucocytospermia than control group (P < 0.0001). Sperm concentration in patients with pus cells more than 3 x 10(6)/ml was statistically significant lower than those with pus cells less than 2 x 10(6) /ml. ELISA-detected IgA Abs against C. trachomatis in patients seminal plasma were positive in 20 (26.7%) and equivocal in 5 (6.6%) patients. Flowcytometric analysis of semen sample for C. trachomatis was positive in 35 (46.6%) patients and C. trachomatis plasmid DNA detection by PCR was positive in 23 (30.7%) patients. In conclusions, Detection of C. trachomatis antibodies of IgA type by ELISA in seminal plasma appears to be as specific as PCR in diagnosis of C. trachomatis in seminal fluid. High detection rate of C. trachomatis by flowcytometry was observed. Concerning the effect of C. trachomatis on routine semen characteristics, no significant obvious changes could be detected. Further studies for the assessment of sperm viability and DNA integrity are recommended.
沙眼衣原体感染被认为是最常见的性传播疾病之一。目前尚不清楚衣原体感染是否会导致男性附属腺的病理状况，以及是否会对男性不育产生影响。为了使用不同的诊断技术，如通过酶联免疫吸附测定（ELISA）检测精浆中的分泌型IgA抗体（Abs）、通过聚合酶链反应（PCR）检测质粒DNA以及通过流式细胞术分析直接检测精液中的原体，来确定白细胞精子症不育男性中沙眼衣原体感染的频率。以评估沙眼衣原体感染与精液质量以及男性不育之间的关系。纳入75例白细胞精子症不育男性患者和25例年龄匹配的明显健康的可育男性作为对照。对每位患者和对照进行常规精液分析和白细胞筛选试验。通过ELISA检测精浆中沙眼衣原体的分泌型IgA，通过PCR检测质粒DNA，并通过流式细胞术分析精液样本中的原体。患者中分别检测到原发性不育55例（73.3%）和继发性不育20例（26.7%）。白细胞精子症患者的精子浓度和精子活力（A+B）在统计学上显著低于对照组（P<0.0001）。脓细胞超过3×10⁶/ml的患者精子浓度在统计学上显著低于脓细胞少于2×10⁶/ml的患者。ELISA检测患者精浆中抗沙眼衣原体的IgA抗体，20例（26.7%）呈阳性，5例（6.6%）为可疑阳性。精液样本沙眼衣原体的流式细胞术分析，35例（46.6%）患者呈阳性，PCR检测沙眼衣原体质粒DNA，23例（30.7%）患者呈阳性。结论：通过ELISA检测精浆中IgA型沙眼衣原体抗体在诊断精液中沙眼衣原体方面似乎与PCR一样具有特异性。观察到流式细胞术检测沙眼衣原体的检出率较高。关于沙眼衣原体对常规精液特征的影响，未检测到明显的显著变化。建议进一步研究评估精子活力和DNA完整性。
