title: [The usefulness of elastase measurement in the sperm for the diagnosis of urogenital male inflammation and infection].
abstract: BACKGROUND
  Genital tract inflammation is a frequent cause of infertility among men, usually clinically silent with only leukocytospermia defined as the presence of white blood cells (WBC)>1.106/ml in semen. During the inflammation process, granulocytes discharge large amounts of proteases such as elastase. The elastase linked to its inhibitor in the form of a complex the elastase α1-protease inhibitor in semen is suggested as a potential marker of genital tract inflammation.
  
  
  OBJECTIVE
  To assess the measurement of elastase as a biomarker of genital tract inflammation by comparing this technique with the detection of leukocytospermia according to the WHO guidelines.
  
  
  METHODS
  This study interested 83 infertile men attending the andrology center for semen analysis. Leukocytospermia was assessed by a peroxydase test and elastase concentration by immunoassay in the seminal plasma.
  
  
  RESULTS
  An elevated elastase was found in 38% of men. A similarity was found between leukocytospermia and elastase in 79% of cases, kappa coefficient concordance with leukocytospermia is good (0.78). The sensitivity of the elastase is 100%, the specificity= 75%. The positive predictive value is 47%, the negative predictive value is 100% with a Youden index=0.75. All patients with leukocytospermia>1.106/ml had an elastase>250ng/ml, 73% of them a concentration>1000 ng/ml. In the group of patients with no leucocytospermia, 75% had elastase<250ng/ml, 21% had concentration between 250 and 1000ng/ml and 4% (3 patients) a concentration>1000ng/ml.
  
  
  CONCLUSIONS
  Seminal elastase is a more sensitive marker than leucocytospermia in the diagnosis of male urogenital inflammation and infection.
authors.forename: A
authors.initials: A
authors.lastname: Zhioua
authors.forename: S
authors.initials: S
authors.lastname: Fourati
authors.forename: H
authors.initials: H
authors.lastname: Elloumi
authors.forename: G
authors.initials: G
authors.lastname: Merdassi
authors.forename: A
authors.initials: A
authors.lastname: Chaker
authors.forename: F
authors.initials: F
authors.lastname: Zhioua
authors.forename: J C
authors.initials: JC
authors.lastname: Soufir
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007249:Inflammation / Q000175:diagnosis*; D019272:Leukocyte Elastase / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012661:Semen / Q000201:enzymology*; D014552:Urinary Tract Infections / Q000175:diagnosis*
chemical_list: D019272:Leukocyte Elastase