el-Roeiy A, Valesini G, Friberg J, Shoenfeld Y, Kennedy R C, Tincani A, Balestrieri G, Gleicher N
Department of Obstetrics and Gynecology, Mount Sinai Hospital Medical Center, Chicago, IL 60608.
Am J Obstet Gynecol. 1988 Mar;158(3 Pt 1):596-603. doi: 10.1016/0002-9378(88)90037-3.
Antisperm antibodies have been implicated as a causative factor of infertility and pregnancy wastage. Since concomitant autoimmune phenomena were reported in men with antisperm antibodies, we investigated known antisperm antibody-positive sera from 25 women, 27 men, and the respective seminal plasma samples. The investigated autoimmune panel included a search for antinuclear antibodies, autoantibodies (in IgG, IgM and IgA isotypes) to seven phospholipids (cardiolipin, phosphatidylserine, phosphatidylglycerol, phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, and phosphatidic acid), to four histone subfractions (H1, H2A, H3, H4), and to four polynucleotides [ssDNA, dsDNA, poly(I), and poly(dT)], total immunoglobulin levels, and sperm antibody titers. The sera were also evaluated for the presence of a common anti-deoxyribonucleic acid antibody, and anticardiolipin antibody idiotypes. Levels of sperm antibody titers were significantly lower in women than in men. Both men and women with antisperm antibodies demonstrated elevated total IgG levels compared with those of normal control subjects. Only women showed elevated levels of total IgM. Sera from 24% of women and 11% of men with antisperm antibodies demonstrated antinuclear antibody titers greater than 1:40. The most striking autoantibody abnormalities were found among antiphospholipid antibodies. Sera from women with antisperm antibodies demonstrated higher autoantibody production than was found in their male counterparts. A significant correlation was found between antisperm antibodies and IgM anticardiolipin and IgA anti-phosphatidylinositol in women and between sperm antibodies and IgA phosphatidylserine antibodies in men. The presence of anticardiolipin and anti-deoxyribonucleic acid antibody idiotypes was significantly more frequent in women than in men. By means of discriminant analysis and variables selected by this mathematical model, the identification of 24 of 25 women and 26 of 27 men with antisperm antibodies was correctly predicted. These results suggest that women and men respond differently to sperm antigens. The apparent cross-reactivity between sperm antibodies and other autoantibodies, usually associated with autoimmune disease, suggests that a polyclonal B cell activation, similar to that seen in autoimmune diseases, occurs in patients with sperm antibodies.
抗精子抗体被认为是导致不孕和妊娠丢失的一个因素。自从有报道称抗精子抗体阳性的男性存在伴随的自身免疫现象以来，我们对25名女性、27名男性的已知抗精子抗体阳性血清以及相应的精浆样本进行了研究。所研究的自身免疫指标包括检测抗核抗体、针对七种磷脂（心磷脂、磷脂酰丝氨酸、磷脂酰甘油、磷脂酰胆碱、磷脂酰乙醇胺、磷脂酰肌醇和磷脂酸）、四种组蛋白亚组分（H1、H2A、H3、H4）以及四种多核苷酸[单链DNA、双链DNA、聚肌苷酸和聚脱氧胸苷酸]的自身抗体（IgG、IgM和IgA亚型）、总免疫球蛋白水平以及精子抗体滴度。还评估了血清中常见的抗脱氧核糖核酸抗体和抗心磷脂抗体独特型的存在情况。女性的精子抗体滴度水平显著低于男性。与正常对照受试者相比，抗精子抗体阳性的男性和女性的总IgG水平均升高。只有女性的总IgM水平升高。24%的抗精子抗体阳性女性和11%的抗精子抗体阳性男性的血清抗核抗体滴度大于1:40。最显著的自身抗体异常出现在抗磷脂抗体中。抗精子抗体阳性女性的血清产生的自身抗体比男性更多。在女性中，抗精子抗体与IgM抗心磷脂抗体和IgA抗磷脂酰肌醇抗体之间存在显著相关性，在男性中，精子抗体与IgA磷脂酰丝氨酸抗体之间存在显著相关性。抗心磷脂抗体和抗脱氧核糖核酸抗体独特型在女性中的存在频率显著高于男性。通过判别分析以及由该数学模型选择的变量，正确预测出了25名抗精子抗体阳性女性中的24名以及27名抗精子抗体阳性男性中的26名。这些结果表明，男性和女性对精子抗原的反应不同。精子抗体与通常与自身免疫性疾病相关的其他自身抗体之间明显的交叉反应性表明，抗精子抗体患者中发生了类似于自身免疫性疾病中所见的多克隆B细胞激活。
