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
Via A. Cecchi, 19/9
16129 – Genova (Italy)
Tel: +39.010.58.94.95
Mobil
phone: +39.335.628.34.24
e-mail: castello@tiopoietine.info