Role of granulocyte elastase and interleukin-6 in the diagnosis of male genital tract inflammation

Abstract

Chronic genital tract inflammations are a frequent cause or at least a concomitant factor of male fertility disturbances. The diagnosis is difficult because of the mostly asymptomatic course of the disease. Therefore, determination of biochemical markers of inflammation in addition to the number of leucocytes in the seminal plasma has been recommended. The aim of the study was to find out whether determination of granulocyte elastase and interleukin-6 provide comparable and reliable results with regard to diagnosis of genital tract inflammation; in addition, the association between genital tract inflammation and semen quality should be evaluated with special focus on potentially disturbed sperm functions like sperm motility and DNA integrity. In a prospective study, the concentrations of interleukin-6 (IL-6) and granulocyte elastase were determined in seminal plasma samples from 340 patients to investigate the relationship with other parameters of genital tract inflammation such as the number of peroxidase-positive cells and conventional semen parameters. Microbiological investigations were included. As post-testicular inflammatory influences may cause sperm DNA damage, the correlation between IL-6 and elastase and DNA integrity was evaluated by the sperm chromatin structure assay. IL-6 and elastase were significantly correlated both with each other (P < 0.01) and the number of peroxidase-positive cells (P < 0.01). IL-6 showed a highly significant negative correlation with sperm vitality (P < 0.01) and a significant negative correlation with sperm motility (P < 0.05). Elastase concentrations were highly significantly associated with the number of peroxidase-positive cells (P < 0.01) and negatively correlated with sperm vitality (P < 0.01). Moreover, there were significantly negative correlations with sperm motility (P < 0.05), progressive motility according to WHO a quality (P < 0.05) as well as sperm morphology (P < 0.05). In addition, a significant negative correlation was observed between elastase concentrations and percentage of spermatozoa with intact DNA, which may suggest the use of anti-inflammatory treatment. It can be concluded that both IL-6 and granulocyte elastase are useful and suitable as markers for silent genital tract inflammation; in contrast to previous contributions there were clear correlations of IL-6 and granulocyte elastase with sperm parameters, the relationship of elastase with semen quality being more marked. Moreover, the results of the study confirm the need for a change of the threshold value of peroxidase-positive cells according to WHO definition to lower levels for definition of silent genital tract inflammation.

Mechanisms of the harmful effects of bacterial semen infection on ejaculated human spermatozoa: potential inflammatory markers in semen

“…However, the harmful effect of cytokines on sperm membranes appears to be closely associated with the accompanying leukocytospermia. This has been confirmed by numerous reports that have documented correlations between seminal leukocyte count and proinflammatory cytokine concentrations [140,[143][144][145][146][147][148]. Also in our own in vitro observations, the peroxidative damage of sperm membrane lipids was markedly enhanced in the simultaneous presence of cytokines and leukocytes [149].…”

The Impact of Bacterial Infections on Human Spermatozoa

“…Male urogenital tract infections (UTIs) play an important role in male infertility, being associated with 8%-35% of male infertility. Asymptomatic bacteriospermia play a major role (37,38). A recent study mentioned that UTIs are associated with about 15% of male infertility (1).…”

Raised Inflammatory Markers in Semen From Men With Asymptomatic Chlamydial Infection

“…A number of studies have specifically excluded a correlation between leukocytospermia and semen quality (Eggert-Kruse et al, 2001;Ludwig et al, 2003). However, because the commonly used method for diagnosis of leukocytospermia only detects granulocytes that are intact, degranulated granulocytes could be missed (Kopa et al, 2005), suggesting that additional markers of inflammation such as cytokines in the seminal plasma might be of value in diagnosing infections in semen.…”

“…Certain proinflammatory cytokines, such as interleukin (IL)-6 and IL-8, are involved in inflammatory processes. Previous studies have investigated levels of seminal IL-6, IL-8, or both in infertile patients, and controversy exists as to whether elevated cytokine levels are related to semen quality (Comhaire et al, 1994;Dousset et al, 1997;EggertKruse et al, 2001;Kopa et al, 2005). To our knowledge, there has been no study in which levels of IL-6 and IL-8 have been measured in semen from males infected with C trachomatis and comparisons made with a group shown not to be infected with chlamydia.…”