title: Positive myeloperoxidase staining (Endtz test) as an indicator of excessive reactive oxygen species formation in semen.
abstract: OBJECTIVE
  Although the significance of leukocytospermia in semen remains controversial, evidence exists that white blood cells (WBCs) may adversely affect sperm function and act as a potential cofactor in male infertility. Nevertheless, the mechanisms by which leukocytes may alter sperm function in vitro is unknown. Recent investigations suggest that reactive oxygen species (ROS) generated by the polymorphonuclear (PMN) granulocytes could adversely affect sperm function. The objective of this study was to investigate the relationship between the presence of leukocytospermia as determined by the Endtz test and the excessive formation of ROS.
  
  
  METHODS
  The WBC concentration and ROS formation in human semen, obtained from men consulting for infertility, were assessed and compared to that of normal donors. ROS was measured by a chemiluminescence assay using luminol and a Berthold luminometer. The WBC concentration was determined with a myeloperoxidase staining technique (Endtz test). Specimens were obtained from 94 subjects (20 donors, 74 patients).
  
  
  RESULTS
  Of the 20 donors, 2 were Endtz positive and ROS positive; 18 were Endtz negative with 2 (11%) ROS positive. In the patient group (n = 74), 26 (35%) were ROS positive, and 17 were Endtz positive and found to be ROS positive. Of the 57 Endtz-negative patients, 9 (15%) were ROS positive. The positive Endtz test results correlated strongly with positive ROS formation in patients and donors (P < 0.001).
  
  
  CONCLUSIONS
  Our results indicate that the simple, cost-efficient Endtz test could be used as an indicator of excessive ROS formation in semen.
authors.affiliation: Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: M
authors.initials: M
authors.lastname: Shekarriz
authors.forename: R K
authors.initials: RK
authors.lastname: Sharma
authors.forename: A J
authors.initials: AJ
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D006801:Humans; D007248:Infertility, Male / Q000378:metabolism; D007958:Leukocyte Count; D008163:Luminescent Measurements; D008297:Male; D009195:Peroxidase / Q000032:analysis*; D017382:Reactive Oxygen Species / Q000032:analysis*; D012661:Semen / Q000737:chemistry* / Q000166:cytology; D013194:Staining and Labeling / Q000379:methods
chemical_list: D017382:Reactive Oxygen Species; D009195:Peroxidase