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

Abstract

Elastase is a protease released by polymorphonuclear neutrophils (PMN) during the inflammatory process. Since 1987, seminal elastase-inhibitor complex (Ela/alpha1-PI) has been proposed as a marker of male silent genital tract inflammation. Measured by immunoassay in seminal plasma, Ela/alpha1-PI at a cut-off level of > or = 230 microg/l, is useful in the detection of genital tract inflammation. The prevalence of increased seminal Ela/alpha1-PI in infertile men is significantly higher than that observed in fertile men. The Ela/alpha1-PI level is positively correlated with other seminal fluid markers of male genital tract inflammation: reduced semen volume, citric acid, fructose, and increased albumin, complement component C3, caeruloplasmin, immunoglobulins IgG and IgA, and cytokines interleukins-8 and -6. A higher seminal Ela/alpha1-PI level is significantly associated with tubal damage in female partners. After antibiotic therapy, a decrease of Ela/alpha1-PI level is observed. The presence of tubal damage in the partner may negatively affect the response to antibiotic treatment. A higher seminal Ela/alpha1-PI is associated with lower percentage of sperm with single-stranded deoxyribonucleic acid (DNA) and better fertilization rate in in vitro fertilization. Besides infertility, the determination of Ela/alpha1-PI is useful to confirm the presence of prostate and other male accessory gland bacterial inflammation. Screening for PMN Ela/alpha1-PI is easy to perform and reproducible and is a reliable quantitative test for diagnosis and prognosis of silent genital tract inflammation of couples. Moreover, sequential determinations allow the follow-up of inflammation during and after therapy.

The Impact of Bacterial Infections on Human Spermatozoa

“…The inflammatory response of the genitourinary tract to the invasion of microorganisms and inflammation is considered to be extremely similar to the reaction observed in other sites of the body (70). This physiological response activates leukocytes and inflammatory mediators such as cytokines and reactiveoxygen species (ROS) which are known to play important roles in sperm DNA fragmentation and male infertility (67).…”

Analyse d’articles

“…En effet, si un antécédent d'infection du tractus génital est un facteur prédictif important d'une inflammation actuelle de l'appareil géni-tal, un tel antécédent n'est retrouvé que dans 5-14 % des cas [7,8]. De plus, une inflammation chronique de l'appareil génital est significativement plus fréquente chez les hommes inféconds, et la majorité des cas sont cliniquement asymptomatiques [9,10].…”

“…En ce qui concerne l'utilisation du finastéride à la dose de 1 mg/j, en 1999, une étude en double insu avec placebo chez des hommes jeunes, en bonne santé et avec une spermatogenèse normale ne montrait aucun effet sur la spermatogenèse [6]. Mais par la suite, deux publications rapportaient en 2004 [7] et 2008 [8] une altération de la spermatogenèse réversible ou améliorée après arrêt du finastéride chez cinq patients.…”

Sperm function and assisted reproduction technology

“…81,86 In the pig, an additional low molecular weight (21 kDa) glycoprotein (ZP 4 ) has been identified. 80 Results obtained by Hasegawa et al 87 have provided evidence that porcine ZP 4 and ZP 2 are derived from a common parent polypeptide by proteolytic cleavage. Porcine ZPC seems to be the primary receptor and ZPB the secondary receptor.…”

“…During recent years, apart from the light microscopical determination of sperm count and morphological malformations, evaluation of functional sperm parameters has become a powerful tool in andrological laboratories. Some of these assays determine biochemical parameters, such as α-glucosidase 1,2 or the polymorphonuclear granulocyte (PMN)-elastase 3,4 which have been found to be important for sperm function. Most of them, however, determine biological functions of spermatozoa, and consequently the capability to fertilize an oocyte (i.e.…”