Semen granulocyte elastase: its relevance for the diagnosis and prognosis of silent genital tract inflammation.
Elastase-inhibitor complex was assessed by immunoassay in the seminal plasma of 312 men attending the outpatient infertility clinic. Using receiver operating characteristic (ROC) curve analysis, elastase at the cut-off value of > or =290 ng/ml was shown to be efficient (sensitivity 79.5%, specificity 74.4%) in the detection of genital tract inflammation as defined by leukocytospermia (>1x10(6) leukocytes/ml). The prevalence of increased elastase in 292 infertile men was significantly higher (34%) as compared with that (5%) observed in 20 fertile men (P: = 0.02). Moreover, high elastase concentration (> or =290 ng/ml) was observed in 66 of the 264 men (25%) without leukocytospermia. A significant positive correlation was found between elastase concentration and patient age (r = 0.202, P: < 0.0001) and the number of leukocytes (r = 0.330, P: < 0.0001). A negative correlation was found between elastase concentration and semen volume (r = -0.146, P: = 0.01) and the percentage of spermatozoa with single-stranded DNA (r = -0.194, P: = 0.024), but there was no correlation between elastase and sperm reactive oxygen species production. A higher seminal elastase concentration was significantly associated with tubal damage in female partners (P: < 0.001). After norfloxacine antibiotic therapy, decrease in elastase concentration was observed in 15 (25%) of the 60 treated patients. Tubal damage in the partner negatively affected the response to antibiotic therapy. In conclusion, granulocyte elastase is a reliable screening test for silent genital tract inflammation of the couple. The elastase-inhibitor complex may have a protective effect in reducing sperm DNA denaturation.
Zorn
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B
Andrology Centre, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia. milica.trenkic@guest.arnes.si
Virant-Klun
I
I
Meden-Vrtovec
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H
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004277:DNA, Single-Stranded / Q000032:analysis; D005184:Fallopian Tube Diseases / Q000201:enzymology; D005260:Female; D005832:Genital Diseases, Male / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007248:Infertility, Male / Q000201:enzymology* / Q000473:pathology / Q000503:physiopathology; D007249:Inflammation / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000032:analysis*; D008297:Male; D011379:Prognosis; D017382:Reactive Oxygen Species / Q000378:metabolism; D012661:Semen / Q000166:cytology / Q000201:enzymology* / Q000382:microbiology; D013076:Sperm Count; D013081:Sperm Motility
D000900:Anti-Bacterial Agents; D004277:DNA, Single-Stranded; D017382:Reactive Oxygen Species; D019272:Leukocyte Elastase