La Vignera Sandro, Basile Livia, Aversa Antonio, Calogero Aldo E, Grillo Agata, Cannarella Rossella, Mongioì Laura M, Condorelli Rosita A
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
Department of Drug and Health Sciences, University of Catania, 95123 Catania, Italy.
J Clin Med. 2022 Aug 11;11(16):4691. doi: 10.3390/jcm11164691.
Background: Few data are currently available on the treatment of patients with HPV infection. In particular, there is no agreement on the use of antioxidants in these patients. Ellagic acid and annona muricata appear to improve HPV clearance in infected women. However, it is presently unknown whether they could enhance the clearance of HPV infection in infertile male patients. Aim: To evaluate the effects of a commercially available combined compound containing ellagic acid and annona muricata on semen quality in patients with documented papillomavirus (HPV) infection, and on the frequency of HPV DNA detection in seminal fluid after treatment. In addition, anti-sperm antibodies and the percentage of spermatozoa with fragmented DNA were evaluated. Materials and methods: This was a retrospective case-control study including patients attending our center for infertility. Fifty selected patients who were positive for high risk (HR)-HPV with available semen analysis results were consecutively enrolled. Patients were classified into two groups, according to the clinician’s decision to either administer ellagic acid 100 mg and annona muricata 100 mg (combined tablet formulation) for a period of three months (Group A; 25 patients), or to re-evaluate HPV DNA after a period of active surveillance only (protected sexual intercourse) (Group B; 25 patients). Results: Group A patients had a mean age of 31.0 ± 11.0 years, while Group B was 33.0 ± 8.0 years old (p > 0.05). After three months of treatment with ellagic acid and annona muricata, all conventional seminal parameters improved more significantly in Group A than in Group B patients: sperm concentration = 45 mil/mL vs. 20 mil/mL (p < 0.05); sperm progressive motility = 45% vs. 18% (p < 0.05); and normal sperm morphology = 18% vs. 6% (p < 0.05). After the treatment, the frequency of persistence of HPV DNA in the seminal fluid was significantly lower in Group A patients compared to those in Group B (12/25 = 48% vs. 22/25 = 88%; p < 0.05). Finally, after 3 months, Group A showed a significant reduction in anti-sperm antibodies and in the percentage of spermatozoa with fragmented DNA. Conclusion: The results of this study demonstrate, for the first time, the effects of a commercially available combined compound containing ellagic acid and annona muricata on semen quality in patients with HR-HPV infection, and that this therapy is also associated with a significant reduction in the persistence of HPV DNA in the seminal fluid.
目前关于人乳头瘤病毒（HPV）感染患者的治疗数据较少。特别是，对于这些患者使用抗氧化剂尚无共识。鞣花酸和番荔枝似乎可提高感染女性的HPV清除率。然而，目前尚不清楚它们是否能提高不育男性患者HPV感染的清除率。目的：评估一种市售的含鞣花酸和番荔枝的复合化合物对已确诊乳头瘤病毒（HPV）感染患者精液质量的影响，以及治疗后精液中HPV DNA检测频率的变化。此外，还评估了抗精子抗体和DNA碎片化精子的百分比。材料与方法：这是一项回顾性病例对照研究，纳入在我们中心就诊的不育患者。连续纳入50例高危（HR）-HPV阳性且有可用精液分析结果的患者。根据临床医生的决定，将患者分为两组，一组给予100mg鞣花酸和100mg番荔枝（复合片剂）治疗三个月（A组；25例患者），另一组仅在经过一段时间的主动监测（安全性行为）后重新评估HPV DNA（B组；25例患者）。结果：A组患者的平均年龄为31.0±11.0岁，B组为33.0±8.0岁（p＞0.05）。用鞣花酸和番荔枝治疗三个月后，A组所有常规精液参数的改善均比B组患者更显著：精子浓度=4500万/mL对2000万/mL（p＜0.05）；精子前向运动率=45%对18%（p＜0.05）；正常精子形态=18%对6%（p＜0.05）。治疗后，A组患者精液中HPV DNA持续存在的频率显著低于B组（12/25 = 48%对22/25 = 88%；p＜0.05）。最后，三个月后，A组抗精子抗体和DNA碎片化精子的百分比显著降低。结论：本研究结果首次证明了一种市售的含鞣花酸和番荔枝的复合化合物对HR-HPV感染患者精液质量的影响，并且这种治疗还与精液中HPV DNA持续存在的显著降低有关。
