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睾丸和附睾炎症的免疫生理学与病理学

Immunophysiology and pathology of inflammation in the testis and epididymis.

作者信息

Hedger Mark P

机构信息

Monash Institute of Medical Research, Monash University, 27-31 Wright St, Clayton, Victoria, Australia.

出版信息

J Androl. 2011 Nov-Dec;32(6):625-40. doi: 10.2164/jandrol.111.012989. Epub 2011 Jul 15.

Abstract

The ability of spermatogenic cells to evade the host immune system and the ability of systemic inflammation to inhibit male reproductive function represent two of the most intriguing conundrums of male reproduction. Clearly, an understanding of the underlying immunology of the male reproductive tract is crucial to resolving these superficially incompatible observations. One important consideration must be the very different immunological environments of the testis, where sperm develop, and the epididymis, where sperm mature and are stored. Compared with the elaborate blood-testis barrier, the tight junctions of the epididymis are much less effective. Unlike the seminiferous epithelium, immune cells are commonly observed within the epithelium, and can even be found within the lumen, of the epididymis. Crucially, there is little evidence for extended allograft survival (immune privilege) in the epididymis, as it exists in the testis, and the epididymis is much more susceptible to loss of immune tolerance. Moreover, the incidence of epididymitis is considerably greater than that of orchitis in humans, and susceptibility to sperm antibody formation after damage to the epididymis or vas deferens increases with increasing distance of the damage from the testis. Although we still know relatively little about testicular immunity, we know less about the interactions between the epididymis and the immune system. Given that the epididymis appears to be more susceptible to inflammation and immune reactions than the testis, and thereby represents the weaker link in protecting developing sperm from the immune system, it is probably time this imbalance in knowledge was addressed.

摘要

生精细胞逃避宿主免疫系统的能力以及全身炎症抑制男性生殖功能的能力,是男性生殖领域最引人入胜的两个谜题。显然,了解男性生殖道潜在的免疫学对于解决这些表面上相互矛盾的观察结果至关重要。一个重要的考虑因素必须是睾丸(精子在此发育)和附睾(精子在此成熟并储存)截然不同的免疫环境。与精细的血睾屏障相比,附睾的紧密连接效果要差得多。与生精上皮不同,免疫细胞通常可见于附睾上皮内,甚至可在附睾管腔内发现。至关重要的是,与睾丸中存在的情况不同,几乎没有证据表明附睾存在延长的同种异体移植存活(免疫豁免)现象,而且附睾更容易丧失免疫耐受。此外,人类附睾炎的发病率远高于睾丸炎,附睾或输精管受损后精子抗体形成的易感性会随着损伤部位与睾丸距离的增加而升高。尽管我们对睾丸免疫仍然知之甚少,但对附睾与免疫系统之间的相互作用了解更少。鉴于附睾似乎比睾丸更容易受到炎症和免疫反应的影响,从而在保护发育中的精子免受免疫系统攻击方面成为薄弱环节,或许是时候解决这种知识上的不平衡了。

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