Elastase as an indicator of silent genital tract infection in infertile men

Abstract

Due to the absence of clinical symptoms, silent genital tract inflammation can be diagnosed only by laboratory tests. In this study we have evaluated seminal plasma elastase levels, using an immunoabsorbent assay, in a group of 84 infertile men. Seminal plasma levels of elastase were correlated with the number of white blood cells in the ejaculate, the number of peroxidase-positive leucocytes and with sperm culture. A high number of leucocytes (greater than 10) and a significantly higher number of men with peroxidase-stained leucocytes exceeding 10(6)/ml was found in a group of men with elastase levels greater than 250 ng/ml. There was a significant correlation between sperm culture results and elastase levels, most men with negative sperm culture having a lower seminal plasma elastase level. Following the treatment with antibiotics of men with an elevated elastase level, sperm parameters improved in 67% of those in whom elastase levels were lowered after treatment. In those men with persisting elevated levels of elastase improvement of sperm parameters was found in only 10%. It is concluded that an elevated level of elastase is a sensitive indicator of asymptomatic genital tract infection and that a single determination gives a reliable criterion and relatively exact quantification of infection.

Semen Polymorphonuclear Neutrophil Leukocyte Elastase as a Diagnostic and Prognostic Marker of Genital Tract Inflammation – A Review

“…When the diagnosis of inflammation is evident from clinical and bacteriological findings, elastase determination is superfluous. When elastase level does not decrease, the treatment should be re-considered (70) and foci of chronic inflammation have to be searched for (34). When elastase level does not decrease, the treatment should be re-considered (70) and foci of chronic inflammation have to be searched for (34).…”

“…Only antibiotic therapy has proved efficient in eradicating microorganisms and in decreasing cellular and humoral inflammatory parameters (78). After antibiotic therapy the elastase level in infertile men with chronic inflammation has been reported to decrease (36,43,70) and has proved to be useful in following the patients. The decrease in elastase levels is a good indicator of efficient treatment.…”

Destabilization of acrosome and elastase influence mediate the release of secretory phospholipase A2from human spermatozoa

“…Successful fertilization of the oocyte can only take place with spermatozoa that are capable of passing through capacitation, acrosome reaction, binding and penetration through the oocyte surrounding complex. This sequence of fertilization events may be impaired by silent genital tract inflammations, which are often not recognized because of the mostly asymptomatic course of the disease [17], but may be associated with reduced sperm motility and vitality as well as with sperm apoptosis [17,18]. Increased levels of the leukocyte protease elastase as well as cytokines as TNFα, IL 1β or IL 8 are often found at areas of inflammation [16,19,20,21].…”