Gerasun Borys, Kopets Roman, Hrytsko Roman, Herasun Oleksandr
Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Reproduction center 'Parents - Ukraine', Lviv, Ukraine.
Cent European J Urol. 2017;70(4):424-428. doi: 10.5173/ceju.2017.903. Epub 2017 Aug 28.
Cold-shock precipitating proteins - cryoglobulins damage various vessels and, depending on the localization of damages, may lead to functional disorders of various organs and body systems. Evidently, cryoglobulinemia may have a negative influence on the reproductive system's condition, thus, this process requires detailed study.
Clinical examples, indicating connection between cryoglobulinemia and spermatogenesis impairment are presented in the article. The proof is improvement of spermogram due to inhibition of cryoglobulin synthesis by the method of intradermal immunization with native autoleukocytes. Leukocytes are isolated by precipitation of a patient's heparinized peripheral venous blood in thermostat at 37°С for 90-140 minutes. After precipitation, blood plasma is aspirated, leukocytes are precipitated by centrifugation. Autoleukocytes are injected in the dose 0.1 ml into 8-12 points of the skin in the back.
In the spermogram indices considerably improved due to the inhibition of cryoglobulin synthesis in patients with idiopathic oligoasthenoteratozoospermia. However, we have determined that in men with other forms of infertility, including severe ones, presence of an increased level of cryoglobulins significantly deteriorates prognosis considering successful correction of spermatogenesis impairment. Their elimination, in most cases, has a positive influence on spermatogenesis and makes additional conditions for efficacy improvement in the treatment of infertility.
Examination for cryoglobulinemia should be included to methodical recommendations/instructions for examination of patients with impaired fertility, since the reduction of cryoglobulin level by means of intradermal immunization with autoleukocytes has a positive influence on spermogram indices.
冷休克沉淀蛋白——冷球蛋白会损害各种血管,根据损伤的部位不同,可能导致各个器官和身体系统的功能紊乱。显然,冷球蛋白血症可能会对生殖系统状况产生负面影响,因此,这一过程需要详细研究。
本文列举了临床实例,表明冷球蛋白血症与精子发生受损之间存在关联。证据是通过用天然自身白细胞进行皮内免疫的方法抑制冷球蛋白合成后,精液分析结果得到改善。通过将患者肝素化的外周静脉血在37℃恒温箱中沉淀90 - 140分钟来分离白细胞。沉淀后,吸出血浆,通过离心沉淀白细胞。将0.1毫升自身白细胞注射到背部皮肤的8 - 12个点。
在特发性少弱畸精子症患者中,由于冷球蛋白合成受到抑制,精液分析指标有显著改善。然而,我们已经确定,在患有其他形式不育症的男性中,包括严重不育症患者,冷球蛋白水平升高会显著恶化精子发生受损成功纠正的预后。在大多数情况下,消除冷球蛋白对精子发生有积极影响,并为提高不育症治疗效果创造了额外条件。
对于生育能力受损患者的检查方法建议/指南中应包括冷球蛋白血症检查,因为通过用自身白细胞进行皮内免疫来降低冷球蛋白水平对精液分析指标有积极影响。