Helicobacter pylori infection and infertility.
OBJECTIVE
To determine (1) the prevalence of Helicobacter pylori infection in male and female patients with reproductive disorders and controls; (2) the presence of anti-H. pylori antibodies in samples of follicular fluid, vaginal secretions and sperm; and (3) the existence of a structural homology between a major spermatozoa protein, tubulin, and H. pylori proteins.


METHODS
Serum samples from 167 patients with infertility and 837 age- and gender-matched controls (blood donors) were examined by enzyme-linked immunosorbent assay (ELISA) and Western blotting to determine the seropositivity for H. pylori infection. The presence of anti-H. pylori antibodies in samples of follicular fluid, vaginal secretions and sperm was determined using the same techniques. The possible cross-reactivity with spermatozoa of anti-H. pylori hyperimmune sera and human antibodies was studied by immunofluorescence. The N-acid homology of human tubulin with the principal H. pylori proteins was assayed by the WU-blastp program available on the Internet.


RESULTS
The prevalence of infection was significantly higher in patients than controls (49.1% v. 33.5%, P < 0.001). Follicular fluids from infected patients contained specific antibodies in all cases, sperm samples in about 50% of cases, and vaginal secretions in a minority of cases. Sera to H. pylori whole antigens and VacA reacted with the tails and the pericentriolar area of human spermatozoa (which are rich in tubulin); sera to urease and heat-shock protein (Hsp) did not. Follicular fluids with anti-H. pylori antibodies immune reacted with spermatozoa. A linear homology was found between beta-tubulin and three H. pylori proteins, flagellin, VacA and CagA.


CONCLUSIONS
H. pylori infection may increase the risk of developing reproductive disorders or worsen the clinical expression of this syndrome.
Figura
N
N
Institute of Internal Medicine, University of Sienna, Sienna, Italy. figura@unisi.it
Piomboni
P
P
Ponzetto
A
A
Gambera
L
L
Lenzi
C
C
Vaira
D
D
Peris
C
C
Lotano
M R
MR
Gennari
L
L
Bianciardi
L
L
Renieri
T
T
Valensin
P E
PE
Capitani
S
S
Moretti
E
E
Colapinto
R
R
Baccetti
B
B
Gennari
C
C
D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D015153:Blotting, Western; D003429:Cross Reactions; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015571:Follicular Fluid / Q000276:immunology; D016481:Helicobacter Infections / Q000150:complications* / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007246:Infertility / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013081:Sperm Motility; D013094:Spermatozoa / Q000276:immunology; D014404:Tubulin / Q000276:immunology
D000907:Antibodies, Bacterial; D014404:Tubulin