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Le sperme « inflammatoire »: ses relations avec la fertilité

“Inflammatory” sperm: relationship with fertility

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Résumé

Objectifs

L’inflammation du sperme résulte d’une infection bactérienne ou virale du tractus urogénital male (TUGM); elle est souvent cliniquement silencieuse. Le dilemme existe quant aux rapports de cause à effet entre leucocytes, marqueurs de l’inflammation et mauvaise qualité du sperme. Nous nous sommes intéressés aux modifications des spermatozoïdes à l’échelon moléculaire en rapport avec l’inflammation.

Matériel et méthodes

Cette étude repose sur une revue de la littérature et des résultats personnels. Chez 200 hommes, partenaires de couples infertiles au spermogramme normal, nous avons étudié la condensation nucléaire et les dérivés actifs de l’oxygène (DAO) déterminés par cytométrie en flux après marquage à l’acridine orange et au dihydroéthidium en fonction des taux d’élastase du plasma séminal.

Résultats

Dans la littérature, on a décrit une relation positive entre infection et exacerbation de l’apoptose des spermatozoïdes avec augmentation de la nécrose et diminution du potentiel de membrane mitochondriale. Nous avons retrouvé une corrélation positive entre le taux de spermatozoïdes avec ADN dénaturé et celui d’élastase. Ce taux passait de 8,6 % à un taux d’élastase entre 0 et 100 μg/l à 15,7 % pour un taux d’élastase entre 100 et 250 μg/l, cette augmentation ne dépendant pas de la sécrétion de DAO. Le taux de spermatozoïdes avec ADN dénaturé se normalisait pour des taux d’élastase supérieurs à 600 μg/l.

Discussion et conclusion

Les modifications de l’ADN ou des membranes des spermatozoïdes n’influencent pas automatiquement les caractéristiques classiques du sperme ni ne réduisent la fertilité male. Elles peuvent cependant retentir négativement sur la capacitation et la réaction acrosomique, avec absence de fécondation ou mauvais développement embryonnaire. Avant de traiter, on tiendra compte du lieu et de la durée de l’inflammation ainsi que des lésions occasionnées sur les spermatozoïdes.

Abstract

Objectives

Sperm inflammation is caused by bacterial or viral infection of the male genitourinary tract; it is often clinically asymptomatic. There is a dilemma about the causal relationship between leukocytes as markers of inflammation and poor semen quality. We were interested in sperm changes at molecular level caused by inflammation.

Material and methods

This study was based on a literature review and personal data. In 200 male partners of infertile couples with normal semen analysis, the percentage of sperm with DNA denaturation and the level of reactive oxygen species (ROS) were determined by flow cytometric analysis, after acridine orange and dihydroethidium stainings, and correlated with seminal plasma elastase levels.

Results

In the literature, a positive relationship between inflammation and increased sperm apoptosis was found with increased necrosis and decreased mitochondrial membrane potential. We found a positive correlation between the percentage of sperm with denatured DNA and elastase levels. The percentage increased from 8.6% at elastase level 0–100 μg/l to 15.7% at elastase level 100–250 μg/l; this increase was not dependent on ROS production. The percentage of sperm with denatured DNA normalized at elastase levels above 600 μg/l.

Discussion and conclusion

Changes in sperm DNA or membranes do not necessarily affect classical semen characteristics or reduce fertility in males. They can, however, have a negative effect on capacitation and acrosomal reaction, resulting in failed fertilization or poor embryo development. Before treatment, we must take into account the location and the duration of the inflammation as well as the damage done to sperm.

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Correspondence to B. Zorn.

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Zorn, B. Le sperme « inflammatoire »: ses relations avec la fertilité. Basic Clin. Androl. 19, 35–44 (2009) doi:10.1007/s12610-008-0005-8

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Mots clés

  • ADN
  • Analyse microbienne
  • Dérivés actifs de l’oxygène
  • Élastase
  • Leucocytes
  • Mitochondries
  • Prostasomes
  • Spermogramme
  • Tests fonctionnels

Keywords

  • DNA
  • Elastase
  • Functional tests
  • Leukocytes
  • Microbial analysis
  • Mitochondria
  • Prostasomes
  • Reactive oxygen species
  • Semen analysis