Saitz Theodore R, Ostrowski Kevin A, Martinez Acevedo Ann, Bash Jasper C, Klimek John, Fuchs Eugene F, David Larry L, Hedges Jason C
Department of Urology, Oregon Health & Science University, Portland, OR, USA.
Department of Surgery, Nellis Air Force Base Hospital, Uniformed Services University of the Health Sciences, Nellis AFB, NV, USA.
Transl Androl Urol. 2020 Oct;9(5):2000-2006. doi: 10.21037/tau-20-703.
The microscopic characteristics of vasal fluid at time of vasectomy reversal (VR) guide operative decision making and predict fertility outcomes. The proteomic profile of this vasal fluid has not been described or correlated with the microscopic fluid appearance. To characterize the vasal fluid proteome at time of VR and evaluate the variation of the vasal fluid proteome with respect to microscopic presence of sperm.
A prospective cohort study was conducted enrolling twenty-five men undergoing VR for infertility and/or pain at a University-affiliated hospital. Vasal fluid samples obtained at time of VR were grouped based on presence of sperm on light microscopy at time of VR. Proteomic profiles were generated using liquid chromatography/ tandem mass spectrometry, and MS/MS protein spectral counts compared between individuals and treatment groups, controlling for less than 5% protein false discovery rate (FDR). Proteins were matched with the human swissprot database using the Comet search engine, and categorized by Gene Ontology (GO) terms.
There was large variability between the 46 vasal fluid samples collected, with 1,692 unique proteins detected. The three most abundant proteins were Lactotransferrin, Cysteine-rich secretory protein 1, A-kinase anchor protein 4. There was no correlation between the proteome and microscopic sperm presence. Prevalent GO terms included viral process, signal transduction, innate immune response, protein folding and spermatogenesis.
We describe the proteome and the most common proteins in vasal fluid at time of VR. Numerable sperm, testis and epididymis specific proteins were present even in the absence of sperm on microscopy. Further evaluation is needed to determine if a protein biomarker may better guide operative decision making and predict VR fertility outcomes.
输精管复通术（VR）时输精管液的微观特征指导手术决策并预测生育结果。这种输精管液的蛋白质组学特征尚未被描述，也未与微观液体外观相关联。为了表征VR时输精管液蛋白质组，并评估输精管液蛋白质组相对于精子微观存在情况的变化。
在一家大学附属医院进行了一项前瞻性队列研究，招募了25名因不育和/或疼痛接受VR的男性。VR时获得的输精管液样本根据VR时光学显微镜下精子的存在情况进行分组。使用液相色谱/串联质谱法生成蛋白质组学图谱，并比较个体和治疗组之间的MS/MS蛋白质光谱计数，控制蛋白质错误发现率（FDR）低于5%。使用Comet搜索引擎将蛋白质与人类swissprot数据库进行匹配，并根据基因本体论（GO）术语进行分类。
收集的46份输精管液样本之间存在很大差异，共检测到1692种独特蛋白质。三种最丰富的蛋白质是乳铁蛋白、富含半胱氨酸的分泌蛋白1、A激酶锚定蛋白4。蛋白质组与微观精子存在情况之间没有相关性。常见的GO术语包括病毒过程、信号转导、先天免疫反应、蛋白质折叠和精子发生。
我们描述了VR时输精管液中的蛋白质组和最常见的蛋白质。即使在显微镜下没有精子的情况下，也存在大量精子、睾丸和附睾特异性蛋白质。需要进一步评估以确定蛋白质生物标志物是否可以更好地指导手术决策并预测VR生育结果。
