Hinting A, Vermeulen L, Comhaire F
Department of Internal Medicine, State University Hospital, Ghent, Belgium.
Fertil Steril. 1988 Jun;49(6):1039-44. doi: 10.1016/s0015-0282(16)59958-0.
A simple procedure is described for the detection of antisperm antibodies of the IgG class in human serum using the indirect mixed antiglobulin reaction (MAR) test. The test uses only one dilution of serum (1/16) and no washing procedures. The test was performed in 361 sera. Comparative studies were conducted with the tray agglutination test (TAT) in 164 sera and with the direct MAR test on semen in 110 cases. In 24 sera with borderline test results, and in 13 sera with discordant findings, evidence of antisperm antibody activity was investigated by means of additional testing, namely, the adenosine triphosphate release cytotoxicity test (ARCT) and the indirect immunobead tests (IB) for IgA and IgM. Using the value of 40% reaction between motile spermatozoa and coated latex particles as the lower limit of significant activity, the indirect SpermMAR test has a sensitivity of 96% and specificity of 87%. The two false-negative indirect MAR results occurred in cases with IgM, the clinical significance of which is doubtful. Hence, the indirect MAR test appears to be an ideal screening procedure for sperm antibodies in serum since it is easy to perform and sensitive. Considering the false-positive rate of 13%, additional tests should, however, be performed on sera with a reaction of 40% or more in order to assess the relevance of the antibodies as a cause of infertility.
本文描述了一种使用间接混合抗球蛋白反应（MAR）试验检测人血清中IgG类抗精子抗体的简单方法。该试验仅使用一种血清稀释度（1/16），且无需洗涤步骤。对361份血清进行了该试验。对164份血清进行了托盘凝集试验（TAT）比较研究，并对110例精液进行了直接MAR试验。对24份临界试验结果的血清和13份结果不一致的血清，通过额外检测即三磷酸腺苷释放细胞毒性试验（ARCT）以及针对IgA和IgM的间接免疫珠试验（IB）来研究抗精子抗体活性证据。以活动精子与包被乳胶颗粒之间40%的反应值作为显著活性的下限，间接精子MAR试验的敏感性为96%，特异性为87%。两个假阴性间接MAR结果出现在IgM病例中，其临床意义尚不确定。因此，间接MAR试验似乎是血清中精子抗体的理想筛查方法，因为它操作简便且灵敏。然而，考虑到13%的假阳性率，对于反应率达到或超过40%的血清应进行额外检测，以评估抗体作为不孕原因的相关性。
