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DEFB126 变异在男性不育和医学辅助生殖技术结局中的作用。

The role of DEFB126 variation in male infertility and medically assisted reproduction technique outcome.

机构信息

Department of Genetics, Reproductive Biomedicine Research Centre, Royan Institute for Reproductive Biomedicine, ACECR Tehran, Iran.

Department of Andrology, Reproductive Biomedicine Research Centre, Royan Institute for Reproductive Biomedicine, ACECR Tehran, Iran.

出版信息

Reprod Biomed Online. 2019 Oct;39(4):649-657. doi: 10.1016/j.rbmo.2019.05.012. Epub 2019 May 21.

Abstract

RESEARCH QUESTION

Human DEFB126 is an important component of the glycocalyx of human spermatozoa. Beta-defensins play a primary role in male infertility due to their involvement in maturation and capacitation of spermatozoa. A 2-nt deletion of DEFB126 affects sperm function and so this study investigated the possible association between DEFB126 variants and its protein expression on medically assisted reproduction (MAR) technique outcome in Iranian infertile males.

DESIGN

The presence of a 2-nt deletion of DEFB126, and its protein expression in spermatozoa, were investigated by standard polymerase chain reaction (PCR) sequencing and immunocytochemistry, respectively. MAR technique outcome according to clinical pregnancy rates was assessed in 277 Iranian males with unexplained infertility, including 139 patients who underwent intrauterine insemination (IUI) and 103 patients who underwent IVF/intracytoplasmic sperm injection (ICSI), as well as 35 infertile males who declined to use any MAR treatment. As the control group, 100 fertile males with a normal spermiogram were enrolled.

RESULTS

The 2-nt deletion of DEFB126 was significantly higher in infertile patients than controls (P ≤ 0.05). The presence of this deletion resulted in significantly lower clinical pregnancy rates following IUI (P ≤ 0.05); however, there were no differences in IVF/ICSI outcomes according to genotype. The protein expression in del/del males was also remarkably lower than that of the other genotypes.

CONCLUSIONS

This sequence variation of DEFB126 may impair male reproductive function and can be related to male infertility. Interestingly, males with the del/del genotype have a normal spermiogram; however, their spermatozoa are evidently functionally impaired, which can affect IUI treatment outcome, but not treatment by IVF/ICSI.

摘要

研究问题

人 DEFB126 是人类精子糖萼的重要组成部分。β-防御素在精子的成熟和获能中起主要作用,因此在男性不育中起主要作用。DEFB126 的 2-nt 缺失会影响精子功能,因此本研究调查了伊朗不育男性中 DEFB126 变体及其蛋白表达与医学辅助生殖 (MAR) 技术结局之间的可能关联。

设计

通过标准聚合酶链反应 (PCR) 测序和免疫细胞化学分别检测 DEFB126 的 2-nt 缺失及其在精子中的蛋白表达。根据临床妊娠率评估 277 名伊朗不明原因不育男性的 MAR 技术结局,包括 139 名接受宫腔内人工授精 (IUI) 的患者和 103 名接受体外受精/胞浆内精子注射 (ICSI) 的患者,以及 35 名拒绝使用任何 MAR 治疗的不育男性。作为对照组,纳入了 100 名精子正常的生育男性。

结果

不育患者的 DEFB126 2-nt 缺失明显高于对照组 (P ≤ 0.05)。这种缺失导致 IUI 后的临床妊娠率显著降低 (P ≤ 0.05);然而,根据基因型,IVF/ICSI 结果没有差异。del/del 男性的蛋白表达也明显低于其他基因型。

结论

DEFB126 的这种序列变异可能损害男性生殖功能,并与男性不育有关。有趣的是,del/del 基因型的男性具有正常的精子计数;然而,他们的精子显然功能受损,这可能会影响 IUI 治疗结局,但不会影响 IVF/ICSI 治疗。

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