Bigazzi P
Prog Clin Biol Res. 1981;70:461-76.
Vasectomy is a widely accepted surgical procedure for male sterilization, with the unique characteristic of eliciting immune responses to self-antigens. Persistent humoral autoimmune responses to spermatozoa and transient responses to other antigens have been demonstrated in vasectomized men. Little information is available on delayed hypersensitivity reactions to spermatozoa, as well as histopathology and immunohistopathology of the testes and other organs in vasectomized individuals. Overall, the data obtained in men do not point to any immediate cause for concern and seem to justify the optimistic view that vasectomy is a safe procedure. A review of the studies performed in experimental animals similarly shows that vasectomy is followed by humoral and/or cell-mediated immune responses to spermatozoal antigens. In some species, such as rabbits and guinea pigs, it is also followed by testicular lesions, mediated by in situ immune complexes and/or delayed hypersensitivity reactions. Other sequelae may be glomerulonephritis and an increased severity of atherosclerotic lesions. Therefore, the rather encouraging picture emerging from the human studies is to a certain extent offset by the findings in experimental animals. Additional research on the effects of vasectomy is obviously necessary, as well as caution in advising this procedure to individuals who may be genetically predisposed to autoimmune disease.
输精管切除术是一种被广泛接受的男性绝育手术，其独特之处在于会引发针对自身抗原的免疫反应。输精管切除术后的男性体内已证实存在对精子的持续性体液自身免疫反应以及对其他抗原的短暂性反应。关于对精子的迟发型超敏反应以及输精管切除个体睾丸和其他器官的组织病理学和免疫组织病理学的信息较少。总体而言，在男性身上获得的数据并未表明存在任何直接令人担忧的原因，似乎也证实了输精管切除术是一种安全手术的乐观看法。对在实验动物身上进行的研究的综述同样表明，输精管切除术后会出现针对精子抗原的体液和/或细胞介导的免疫反应。在某些物种中，如兔子和豚鼠，输精管切除术后还会出现由原位免疫复合物和/或迟发型超敏反应介导的睾丸病变。其他后遗症可能是肾小球肾炎和动脉粥样硬化病变严重程度增加。因此，人体研究中出现的相当令人鼓舞的情况在一定程度上被实验动物的研究结果所抵消。显然有必要对输精管切除术的影响进行更多研究，并且在向可能具有自身免疫性疾病遗传易感性的个体建议进行该手术时要谨慎。
