Sinisi A A, D'Apuzzo A, Pasquali D, Venditto T, Esposito D, Pisano G, De Bellis A, Ventre I, Papparella A, Perrone L, Bellastella A
Institute of Endocrinology, Second University, Naples, Italy.
Int J Androl. 1997 Feb;20(1):23-8. doi: 10.1046/j.1365-2605.1997.00101.x.
In several childhood diseases which have the ensuing risk of infertility in adult life because of direct hypothalamic-pituitary-testicular axis involvement, or as a consequence of therapeutic toxicity, the role of antisperm antibodies (ASA) is rarely addressed. The aim of this study was to investigate the occurrence of ASA in a large prepubertal male population (aged 1.2-13 years) consisting of three groups: Group I, 52 patients affected by malignant diseases (lymphoblastic leukaemia, malignant lymphoma, or Wilm's tumour, n = 42), or by nephrotic syndrome (n = 10); Group II, 212 patients with either genital tract abnormalities (cryptorchidism, inguinal hernia, funicular torsion or hypospadias, n = 202), or cystic fibrosis (n = 10); Group III: 100 age-matched normal boys. Group I and II patients were investigated at diagnosis and during or after treatment (drug, radiation or surgical therapy). Group III was used as controls. ASA were detected in sera by the Tray Agglutination Test (TAT) and indirect IgG, IgA and IgM immunobead tests (iIBT). All normal boys were ASA-negative using both tests. Twenty-six out of the 264 patients (9.8%) in Groups I and II were ASA-positive: 23 (8.7%) patients had a positive TAT with a titre of 1:32 to 1:128, whilst 14 (5.3%) had IgG-ASA after iIBT. Eleven patients (4.1%) were ASA-positive in both tests. Of the 26 ASA-positive boys, 24 had genital tract abnormalities (cryptorchidism, testicular torsion, hypospadias) and two had leukaemia with testicular infiltration. Treatment did not modify antibody positivity. Our data confirm that ASA can occur in prepubertal boys, mostly among cases with urogenital pathology, but that it is rare among other cases. Therefore autoimmune reaction against spermatozoa is another factor that should be considered in the evaluation of several conditions in childhood involving reproductive tract alteration and potential impairment of the blood testis (Sertoli cell) barrier.
在几种儿童疾病中，由于直接累及下丘脑 - 垂体 - 睾丸轴或治疗毒性的影响，成年后存在不育风险，但抗精子抗体（ASA）的作用很少被提及。本研究的目的是调查一大群青春期前男性（年龄1.2 - 13岁）中ASA的发生情况，这些男性分为三组：第一组，52例患有恶性疾病（淋巴细胞白血病、恶性淋巴瘤或威尔姆斯瘤，n = 42）或肾病综合征（n = 10）的患者；第二组，212例患有生殖道异常（隐睾症、腹股沟疝、精索扭转或尿道下裂，n = 202）或囊性纤维化（n = 10）的患者；第三组：100例年龄匹配的正常男孩。第一组和第二组患者在诊断时以及治疗期间或治疗后（药物、放疗或手术治疗）接受调查。第三组用作对照。通过托盘凝集试验（TAT）以及间接IgG、IgA和IgM免疫珠试验（iIBT）检测血清中的ASA。使用这两种检测方法，所有正常男孩的ASA均为阴性。第一组和第二组的264例患者中有26例（9.8%）ASA呈阳性：23例（8.7%）患者TAT呈阳性，滴度为1:32至1:128，而14例（5.3%）患者iIBT后IgG - ASA呈阳性。11例患者（4.1%）两种检测均为ASA阳性。在26例ASA阳性男孩中，24例患有生殖道异常（隐睾症、睾丸扭转、尿道下裂），2例患有白血病伴睾丸浸润。治疗并未改变抗体阳性情况。我们的数据证实，ASA可出现在青春期前男孩中，主要见于泌尿生殖系统病理情况的病例，但在其他病例中很少见。因此，针对精子的自身免疫反应是在评估儿童期涉及生殖道改变和血 - 睾（支持细胞）屏障潜在损害的几种情况时应考虑的另一个因素。
