Testicular Sertoli cell function in male systemic lupus erythematosus.
OBJECTIVE
To assess the testicular Sertoli cell function in male SLE patients.


METHODS
Thirty-four consecutive patients were prospectively selected to evaluate serum inhibin B. Clinical features, treatment, semen analysis, urological evaluation, testicular ultrasound, hormones and anti-sperm antibodies were determined.


RESULTS
Patients were subdivided into two groups: low serum inhibin B (Group 1, n = 8) and normal levels (Group 2, n = 26). The median sperm concentration (P = 0.024), total sperm count (P = 0.023) and total motile sperm count (P = 0.025) were lower in Group 1. Inhibin B levels were positively correlated with sperm concentration (r = 0.343), total motile sperm count (r = 0.357), and negatively correlated with follicule-stimulating hormone (FSH) (r = 0.699) and luteinizing hormone (r = 0.397). The median serum inhibin B was lower in SLE patients treated with intravenous cyclophosphamide (IVCYC) compared with those without this therapy (P = 0.031). Further evaluation of the 26 SLE patients with normal inhibin B and FSH levels revealed that medians of inhibin B/FSH ratio were lower in SLE patients with oligozoospermia compared with normozoospermia (P = 0.004). This ratio was also lower in SLE patients treated with IVCYC than those without this therapy (P = 0.04). In contrast, inhibin B serum level alone did not discriminate the later group of patients (P = 0.12).


CONCLUSIONS
This is the first study to identify a high frequency of testicular Sertoli cell dysfunction in male SLE associated with semen abnormalities. Further prospective studies are necessary to determine if inhibin levels and inhibin B/FSH ratio will be an earlier and useful marker of IVCYC toxicity in these patients.
Suehiro
R M
RM
Division of Rheumatology, Department of Pediatrics, University of São Paulo, SP, Brazil.
Borba
E F
EF
Bonfa
E
E
Okay
T S
TS
Cocuzza
M
M
Soares
P M F
PM
Silva
C A A
CA
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D016009:Chi-Square Distribution; D003520:Cyclophosphamide / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007265:Inhibins / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012708:Sertoli Cells / Q000378:metabolism / Q000473:pathology / Q000502:physiology*; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000276:immunology; D018709:Statistics, Nonparametric; D013737:Testis / Q000000981:diagnostic imaging; D014463:Ultrasonography
D001323:Autoantibodies; D007166:Immunosuppressive Agents; C422364:inhibin B; D007265:Inhibins; D003520:Cyclophosphamide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone