Andrada J A, Von der Walde F E, Andrada E C
University of Buenos Aires, Argentina.
Immunol Ser. 1990;52:345-78.
The immunological basis of male sterility, as previously described, is related to alterations of spermatogenesis or impairment of seminal plasma formation. Both may be developed independently or may be related. Acute or subacute lesions of the genital tract or gonads may be more closely related to the presence of autosensitization than are chronic inflammatory processes or endocrine diseases of the testis. Oligo- or azoospermia may reflect the destruction of cells or halting of spermatogenesis. Immobilization and agglutination of sperm cells would depend predominantly on an allergic reaction that originates in the adnexal glands. Antibodies against testis do not affect adnexal glands but may immobilize epididymal spermatozoa, whereas antiseminal plasma antibodies react only with adnexal glands and seminal spermatozoa, but not with testicular cells. The pathogenic role of detectable antispermatic antibodies in sterile male or female patients are not sufficiently clarified. Their presence apparently correlate with unexplained cases of infertility, but this does not necessarily mean that they are specifically responsible for this abnormality; furthermore, they might be only an epiphenomenon of the immunological process involved.
如前所述，男性不育的免疫学基础与精子发生的改变或精浆形成的受损有关。两者可能独立发生，也可能相互关联。与睾丸的慢性炎症过程或内分泌疾病相比，生殖道或性腺的急性或亚急性病变可能与自身致敏的存在关系更为密切。少精子症或无精子症可能反映细胞的破坏或精子发生的停滞。精子细胞的制动和凝集主要取决于起源于附属腺的过敏反应。抗睾丸抗体不影响附属腺，但可能使附睾精子制动，而抗精浆抗体仅与附属腺和射出精子发生反应，而不与睾丸细胞发生反应。在不育男性或女性患者中，可检测到的抗精子抗体的致病作用尚未得到充分阐明。它们的存在显然与不明原因的不孕病例相关，但这并不一定意味着它们是导致这种异常的具体原因；此外，它们可能只是所涉及免疫过程的一种附带现象。
