[Sperm flagella and cilia with pathologic motility and ultrastructure].

Motility of sperm flagella as well as of cilia is mechanically based on the principle of 9 + 2-tubules. It functions essentially by coordinated action between microtubules and the adenosine-triphosphatase dynein and was already present at the beginning of the evolution of the eucaryotes. Experimentally induced mutations in algae have resulted in numerous variations of the flagellar 9 + 2-structure. A mutation of this kind is also found in man, as immotile cilia syndrome (ICS) where anomalies in spermatozoa and in cilia (e.g. of the respiratory tract) are observed. Clinical manifestations of the syndrome have long been known (chronic bronchitis, bronchiectasis, sinusitis and male sterility). In addition, half of the patients exhibit situs inversus viscerum, known as Kartagener's syndrome, a subgroup of ICS. Electron microscopy was used to investigate sperm flagella with reduced motility from 9 patients (one with ICS) with primary infertility. Cilia of the respiratory tract from 7 patients (several with ICS) with chronic bronchial problems were analyzed for motility (using video techniques) and ultrastructure. Reduced motility or immotility of spermatozoa and immotile or dyskinetic cilia were always accompanied by ultrastructural anomalies. In spermatozoa, lack of dynein arms, 9 + 0-configuration and extratubuli were most frequently observed. The fibrous sheath was always asymmetrical. Structural ciliary defects resulted in non-parallel arrangements, electron dense matrix substance, extratubuli and lack of radial spokes. In one case, ciliary microtubuli were found in microvilli. In two patients, cilia as well as spermatozoa were analyzed. In the first, immotile spermatozoa without dynein arms and structurally normal cilia were observed.(ABSTRACT TRUNCATED AT 250 WORDS)