TBILISI STATE MEDICAL UNIVERSITY
ANNALS OF
BIOMEDICAL RESEARCH AND EDUCATION
2003
January/March, Volume 3, Issue 1
Content of Antispermatic
Antibodies (ASA) in Blood before and after Treatment of
Infectious-Inflammatory
Diseases of Urogenital Tract in Infertile Males
George Galdava*, Shorena
Chiokadze**
* Department of Andrology of
S\R Institute of Dermatology and Venerology,
** Diagnostic Department,
"Health house" LTD,
Abstract
It has been shown by
investigations that the infectious-inflammatory processes of urogenital tract
(STI), chronic urethroprostatitis, epididymitis, etc., are the most common
factors of antispermatic antibodies (ASA) formation in blood of infertile
males. Application of novel immunomodulating remedies (Glutoxim, Neovir,
Cycloferon, ets.) and physiotherapeutic means the (the laser apparatus
"Yarilo-Synchro") in complex therapy of autoimmune infertility
developed as a result of excretory-toxic and excretory-obstructive forms of
infertility favors the liquidation of etiologic agent of the inflammatory
process and promotes normalization of autoimmune processes. As a result of an
adequate anti-inflammatory treatment of infertile males with
infectious-inflammatory diseases ASA content in blood comes back to the norm.
After treatment a positive effect has been achieved in 62.7% of patients
treated on STI, in 67% of those treated on chronic prostatitis, and in 57.9% of
patients with epididymitis.
Keywords: ASA, STI,
prostatitis, epididymitis, infertitity
Introduction
nflammatory diseases of male
urogenital organs became widely spread during the resent years. Sexually
transmitted infections (STI), chronic urethroprostatitis and epididymitis
occupy a special position among them. It is established by investigations
[1,3,7] that ureaplasmas, chlamydias and other STI may cause male infertility
via direct action on spermatozoids as a result of close adhesion of these
microorganisms to male gametes. The
latter prevents the ovule from fertilization. As a result of prolonged course
of these pathologies not only excretory-toxic and excretory-obstructive forms
of infertility develop [2,4,7], but also the breaking of permeability of
hematotesticular barrier (HTB), triggering of immune mechanisms of defense both
on local and systemic levels and subsequent progress of autoimmune processes take
place resulting autoimmune infertility [5,6].
According to the data of some
authors [2,4] therapy of autoimmune infertility is complicated and often
ineffective. Some cases of successful treatment of patients with high ASA level
using short-term courses of steroid hormones are described. There are some
references on the efficacy of contraceptive therapy, but there is the lack of
information in literature on the technique and results of treatment of
autoimmune infertility developed against the background of excretoryand
excretory-obstructive forms of infertility.
Material and Methods
A total of 267 infertile
males (age 17-35, being married for 1.5-8 years) with chronic
infectious-inflammatory processes of urogenital organs and high ASA level in
blood were under observation.
Inflammatory pathologies of
urogenital tract were diagnosed using the bacteriologic, bacterioscopic,
immunofluorescent and other methods of investigation.
Both the native prostatic
secret and the smear stained according to Gram were subjected to the microscopy
in order to determine the amount of amyloids, lipoids, leukocytes and
epithelial tissues and composition of bacterial flora (gonococcus, trichomonas,
gardnereria
and fungi).
Ultrasonography of prostatic
gland, testes, epididymides and vesicles were performed using the apparatus of
Medison SA 6000 C Capacace, equipped with 5-10 MHz and 3.5-5 MHz sensors of
transabdominal approach.
ASA were detected by
immunoenzymatic method, using the laboratory set of the firm
"IBL-HAMBOURG",
Control laboratory
investigations of ASA concentration were performed in 1 and 3 months after
treating the inflammatory diseases.
Results
According to laboratory
investigations the following pathologies of urogenital tract have been revealed
in 169 (63.3%) patients with STI: Chlamydia trachomatis 62 (36.69%), Ureaplasma
urealyticum 33 (19.53%), Trichomonas vaginalis 54 (31.95%), Neisseria
gonorrhoeae 20 (11.83%) in mono or mixed form; in 79 (29.6%) of those patients chronic
urethroprostatitis was diagnosed and in 19 (7.1%) epididymitis was established
(unilateral in 11 males and bilateral in 8 ones). These pathologies of
urogenital tract are responsible for increased content of ASA in blood.
Concentration of ASA in infertile
males with chlamydial infection, in those with parenchymal and follicular
prostatitis and at bilateral epididymitis was found to be higher than at other
pathologies of urogenital organs. All the patients underwent complex
anti-inflammatory treatment using the antibioticotherapy, vitaminotherapy and
immunostimulation according to the generally accepted guidelines. Different
immunomodulating remedies (Glutoxim, Neovir, Cycloferon, etc.) were used for
correction of immune system.
Taking into consideration the
etiologic agent of infectious-inflammatory process and according to the results
of bacteriologic investigation, i. e. antibioticogram, various preparations
were applied while treating STI and other pathologies of urogenital tract.
The method of physiotherapy,
implying the use of electrolaser apparatus "Yarilo-Synchro" was
applied in complex with antibioticotherapy and immunostimulation at chronic
urethroprostatitis treatment, while in case of epididymitis autohemotherapy was
combined with antibioticotherapy.
In a majority of patients who
suffered earlier with Ureaplasma urealyticum, Trichomonas vaginalis and
Neisseria gonorrhoeae, after the course of STI treatment the concentration of
ASA in blood reverted to the norm. But in case of patients with Chlamydia
trachomatis concentration of ASA in blood became normal only in 25.8% of males.
During a monthafter the course of treatment ASA level in blood reverted to the
normal level in 106 (62.7%) out of 169 patients, but in three months it became
normal in 106 (62.7%) of patients (Tab.1).
Treatment of chronic
urethroprostatitis by physiotherapyusing the apparatus
"Yarilo-Synchro" was performed in 60 patients, 12 procedures, every
day, on the background of antibioticotherapy and immunostimulation. The control
group was comprised of 19 males, who were treated by the traditional method -
antibioticotherapy combined with prostatic massage. In 3 months after treatment
concentration of ASA in blood became normal in a majority of patients of the
main group (75%), while in those of control group it was normalized only in
42.1% of patients. In general, out of 79 patients suffered earlier with chronic
prostatitis ASA concentration reverted to the norm in 53 (67%) of group of
patients with chronic prostatitis.
After treatment of
epididymitis ASA content in blood was norm in 8 (72.7%) patients with
unilateral epididymitis and only in 3 (37.5%) patients with bilateral
epididymitis.
In total after recovery from
epididymitis ASA concentration was normalized in 11 (57.9%) males out of 19
ones (Tab.2).
At inflammatory pathologies
of urogenital tract an increased level of leukocytes in ejaculate
(leukocytospermia) was
revealed in 115 (43%) infertile males out of 267 patients. The concentration of
ASA in blood of these males was higher than in those with normal leukocytic
indexes in the sperm. Concentration of leukocytes in sperm and ASA level in
blood havebeen normalized in 102 (88.7%) of patients of this category.
Conclusions
1. Content of ASA in blood of
infertile males with infectious-inflammatory processes becomes normal after
fulfillment of proper treatment.
2. Application of the novel
immunomodulating remedies (Neovir, Gluthoxim, Cycloferon, etc.) and the
physiotherapeutic means (the apparatus "Yarilo-Synchro") with complex
therapy of autoimmune infertility, favours the liquidation of etiologic agent
of inflammatory process and promotes normalization of autoimmune processes.
For more
references:
Dr. Giorgio Castello
Corso Torino, 32/6
16129 – Genova (Italy)
Tel: +39.010.58.94.95
Mobil
phone: +39.335.628.34.24
e-mail:
castello@tiopoietine.info