Male infertility: evaluation of human sperm function and its clinical application.
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Humans↗
Biomedical subjects
A Lenzi
Publications and source records attributed to A Lenzi.
Effectiveness of the combination verapamil and chlorpromazine in the treatment of severe manic or mixed patients.
1. The authors investigated the possible antimanic properties of a Calcium channel blocker, Verapamil, in 15 in-patients admitted consecutively to the female psychiatric ward at Pisa University for a manic episode. 2. The results showed that most of the patients presented a global improvement of the manic symptoms and, in some cases, even a complete clinical remission. 3. Although it was necessary to add chlorpromazine for the severe conditions of several patients, verapamil appeared to speed the positive outcome and to lead to a faster resolution of the symptoms. In addition, the association of verapamil and chlorpromazine did not produce any relevant side-effect. These preliminary findings thus indicate that verapamil by itself does not seem to be sufficient in the treatment of a severe affective episode, but it may constitute an alternative to lithium salts in association with neuroleptics.
Adolescent↗
Study of antisperm antibodies bound to the sperm cell surface and their relationship to circulating ASA.
PROBLEM: Direct and indirect tests for antisperm antibody (ASA) detection are commonly used in laboratories for the diagnosis of male immunological infertility. Even though the two kinds of tests study the same immunological phenomena, frequently no perfect correlation is found even on large series of patients and with precise statistical models. The aim of the present investigation was to try to establish whether biological models can explain the antibody test results and if a predictive threshold can be established for expected positivity/negativity. METHOD: The data relate to 667 patients, who were screened using the Direct Immunobead test (d-IBT) for ASA bound to the sperm surface and with the gelatin and tray agglutination test (GAT and TAT) in sera for circulating ASA. Correlation were studied and cases of no correlation were further analyzed. RESULTS: The number of patients with a clinically significant positivity to d-IBT (binding percentage > or = 20%) was 134 (20.1% of total patients). The analysis of the results of direct and indirect tests shows that the discordances are due to differences in the Ig class of immunization or to the site of epitopes involved. In fact, as far the Ig class is concerned, if d-IBT shows a prevalent or exclusive IgG or IgA positivity, this results in a poor correlation between binding percentage to d-IBT and GAT-TAT titers. If both the Ig classes are involved, the level of positivity of the two kinds of test are strictly related. As far as the site of Ag-Ab reaction on the sperm surface is concerned, the wide immunization involving all the surface sperm antigens (mixed), shown by d-IBT, is related to higher indirect test titers. CONCLUSION: Local and systemic antisperm immunizations are strictly related and a predictive threshold of expectation can be established to explain even apparently discordant direct and indirect results.
Agglutination Tests↗
Glutathione treatment of dyspermia: effect on the lipoperoxidation process.
We recently introduced reduced glutathione into the therapeutic protocols in some selected cases of dyspermia. This therapy improved semen quality both in a pilot follow-up study and in a double-blind cross-over trial. This improvement was seen in patients with varicocele and germ-free genital tract inflammation, two pathologies in which production of reactive oxygen species or other toxic compounds could have a pathogenic role. Polyunsaturated fatty acids of phospholipids play a major role in membrane constitution and function and are one of the main targets of the lipoperoxidative process. Therefore, to understand the therapeutic action of reduced glutathione, we selected infertile patients and studied the modifications produced by the therapy in seminal parameters, biochemical sperm membrane parameters, and the pattern of fatty acids of phospholipids from blood serum and red blood cell membranes (a model widely accepted as representative of general cell membrane status). The results showed an improvement in both sperm parameters and cell membrane characteristics. This study suggests that biochemical modifications in membrane constitution could explain the seminal results of glutathione therapy. On the other hand, it seems likely that only subjects with systemic membrane disturbances associated with andrological pathologies express this membrane damage in spermatozoa, resulting in dyspermia. This sperm alteration can be partially reversed by glutathione therapy if the structural cell membrane damage is not too severe.
Adult↗
Social class and mood disorders: clinical features.
We examined clinical features in 877 in- and outpatients affected by depression who were enrolled in psychopharmacological trials, subdivided according to Hollingshead's method into five social classes. The results showed that social class correlated significantly with the subtypes of mood disorders, with bipolar disorder being more frequent amongst the upper than the lower social classes. Furthermore, as already reported in other countries, social class appeared to influence the psychopathological pattern of depressive symptoms: somatization and anxiety were more frequent amongst the lower social classes, while psychic and cognitive symptoms were more common amongst the upper classes.
Adult↗
Computer assisted sperm motility analysis at the moment of induced pregnancy during gonadotropin treatment for hypogonadotropic hypogonadism.
Two azoospermic patients with isolated hypogonadotropic hypogonadism (IHH) no. 1,24-year-old, and no. 2,31-year-old), never treated before, were given gonadotropin therapy (GT), (FSH, 225 IU/week, and HCG, 4000 IU/week) and followed up monthly for sperm characteristics. After 6 (no. 1) and 9 (no. 2) months of treatment, immotile spermatozoa appeared in the semen. Two months later motile spermatozoa also appeared. A motile sperm concentration sufficiently high for computer motion analysis (CASA) was achieved 1 month later 9th and 12th month, respectively. At the 13th (no. 1) and 17th (no. 2) month of GT, CASA showed a small population of spermatozoa with a very good motility pattern. In the next ovulatory cycle the patients' partners became pregnant.
Adult↗
A single electroconvulsive treatment affects platelet serotonin uptake in bipolar I patients.
We evaluated serotonin (5HT) uptake parameters in platelets of a group of bipolar I patients in both a depressive phase and a mixed state, before (t0) and after (t1) the first electroconvulsive treatment (ECT). The results showed the presence of significant changes in the number of the carrier proteins for 5HT at t1, which in most cases preceded the clinical improvement. Although other mechanisms are certainly involved, these data suggest that ECT may influence the 5HT transport through platelet membranes.
Adult↗
Serotonin syndrome-like symptoms in a patient with obsessive-compulsive disorder, following inappropriate increase in fluvoxamine dosage.
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Adult↗
Placebo-controlled, double-blind, cross-over trial of glutathione therapy in male infertility.
Glutathione therapy was used for 2 months in a placebo-controlled double-blind cross-over trial of 20 infertile patients with dyspermia associated with unilateral varicocele (VAR) or germ-free genital tract inflammation (INF). The patients received either glutathione (group 1) or placebo (group 2) for 2 months, then they crossed over to the alternative treatment for a further 2 months. The patients were randomly and blindly assigned to treatment (one i.m. injection every other day of either 600 mg glutathione or an equal volume of a placebo preparation). The standard semen analysis and the computer-assisted sperm motility analyses were carried out before treatment and during the trial. Statistical cross-over analysis, case-control study and treatment efficacy test were carried out on groups 1 and 2 and differences in the effects of therapy between VAR and INF patients with varicocele or inflammation were tested. Glutathione therapy demonstrated a statistically significant positive effect on sperm motility, in particular on the percentage of forward motility, the kinetic parameters of the computerized analysis and on sperm morphology. The findings of this study indicate that glutathione therapy could represent a possible therapeutical tool for both of the selected andrological pathologies.
Adult↗
Nicotine, cotinine, and trans-3-hydroxycotinine levels in seminal plasma of smokers: effects on sperm parameters.
Sperm samples from 44 cigarette smokers and 50 nonsmokers attending an infertility clinic were examined by high-performance liquid chromatography (HPLC) assay and HPLC-mass spectrometry for the presence of nicotine (NIC), cotinine (COT), and trans-3'-hydroxycotinine (THOC) in seminal plasma. Smokers were found to have levels of COT and THOC in seminal plasma that were similar to those found in serum. The level of NIC was significantly increased in seminal plasma compared to serum. Total motility of spermatozoa was significantly and negatively correlated to COT and THOC levels in seminal plasma. Forward motility of spermatozoa was correlated only with cotinine semen levels. On the basis of these results, we suggest that the presence of tobacco smoke constituents in seminal plasma could provide a warning of the adverse effects of cigarette smoke on the physiology of reproduction.
Adolescent↗
Immunological infertility in humans.
This review deals with some of the most controversial problems in the field of immunologic infertility and antisperm antibodies (ASA) in humans: (a) sperm antigens and their identification; (b) the aetiopathogenesis of the immune reaction and the biological effects of ASA; (c) laboratory tests set up for ASA detection, and (d) the therapy for immunologic infertility both in vivo and in vitro.
Adrenal Cortex Hormones↗
Supplementation of male inhibitory material to lipid A activated human mononuclear cell supernatants contributes to the suppression of polymorphonuclear cell phagocytosis.
Human normal peripheral blood mononuclear cells were stimulated with lipid A (LA), the biologically active moiety of bacterial lipopolysaccharides. LA-activated supernatants were able to suppress polymorphonuclear cell (PMN) phagocytosis of Candida albicans. This inhibitory activity was enhanced by the supplementation of male inhibitory material (MIM) to active supernatants. The addition of a recombinant human anti-interleukin-1 beta monoclonal antibody to activated supernatants in the absence or presence of MIM diminished or abrogated, respectively, the suppressive effect on PMN function. The mechanisms and the significance of MIM-mediated inhibition of phagocytosis under these circumstances are discussed.
Adult↗
Fertility and semen quality of workers exposed to high temperatures in the ceramics industry.
The objective of this study was to test the hypothesis that chronic occupational exposure to high temperatures may be detrimental to male reproduction. The study was based on 92 healthy ceramics oven operators with a long exposure to high temperatures, and 87 controls, recruited from the shipment department of the same industry. Interviews with all subjects provided data on sociodemographic characteristics, health status, and fertility problems. Semen analysis was carried out on 46 of the workers exposed to high temperatures, and 14 of the controls, and included evaluation of the sperm concentration, morphology, and motility, including computer-assisted sperm motion analysis (velocity, linearity, ALH, BCF). The results of the questionnaire showed that exposed individuals had a higher incidence of childlessness and of self-reported difficulty in conceiving than controls. The semen analysis showed no significant differences except in sperm velocity. Although differences in semen parameters, taken singly, were not statistically significant, the overall evaluation of the sperm parameters indicated a higher prevalence of pathologic sperm profiles among the exposed compared to the controls.
Adult↗
In vitro sperm capacitation to treat antisperm antibodies bound to the sperm surface.
Our objective was to study antisperm antibody bound to the acrosome region during in vitro capacitation and to determine whether acrosome-antibody free sperm can be obtained from previously acrosome-antibody-coated sperm. The spermatozoa from a selected series of 14 patients were tested for sperm antibodies bound to the sperm surface using d-IBT and focusing on the acrosome positivity. The tests were carried out before the incubation and after 3, 6, 9, and 12 h of incubation in Tyrode's solution with 0.5% human serum albumin as the capacitation medium. Tests to evaluate acrosome region, sperm motion parameters, and zonae binding ability were carried out. In this way we were able to evaluate sperm function during capacitation protocol. The patients were 14 subjects selected according to good seminal characteristics, good post-rise sperm parameters, and high percentage of ASA bound to the sperm surface. In all cases the results showed that antisperm antibodies bound to the acrosome region were shed prior to the acrosome reaction. During sperm capacitation in human a modification, migration, or shedding of plasma membrane molecules takes place. The presence of antibodies in such an important area of the sperm head could certainly interfere in the fertilization process. Our data indicate that in vitro capacitation could provide an in vitro therapy capable of eluting antibodies from the acrosome region.
Acrosome↗
[Metabolism and action of L-carnitine: its possible role in sperm tail function].
The authors report a review on the L-carnitine effects on the male genital tract. L-carnitine represents a cofactor in the transport of long chain fatty acids inside mitochondria and their subsequent oxidation. Therefore, its main role is that of intramitochondrial vehicle of acyl groups. In particular, the effects of L-carnitine on the male genital function seem connected mainly with the high concentration of L-carnitine in the epididymis; the uptake of the L-carnitine from the blood is an active, in part androgen-dependent, mechanism. Moreover, epididymal spermatozoa are able to concentrate L-carnitine (while they become progressively more impermeable to such a substance) during their passage from the caput to the cauda epididymis. The main function of the L-carnitine in the epididymis is to give to the spermatozoa an energetic substrate. In fact, this function should be of great importance since the epididymal spermatozoa employ fatty acid oxidation for their energy metabolism; on the contrary, the ejaculated sperm employ glycolytic process. As a consequence of the above-mentioned effects of L-carnitine the dosage of this substance in the evaluation of the integrity of the processes of maturation of the spermatozoa was proposed. Finally, there is growing interest in the use of L-carnitine as a therapeutic tool in some forms of male infertility.
Adult↗
[The management of head trauma in a general surgery department. a contribution to an epidemiological analysis].
Personal experience in the management of head injury in a General Surgery Department is reported and a series of 352 patients analysed with a view to identifying variations in the epidemiological profile of this pathology over the last decade and in order to establish indications for admission and the transfer of the patient to specialist departments.
Age Factors↗
A comparison of the direct immunobead test and other tests for sperm antibodies detection.
The authors report the results of a correlation study between the direct Immunobead Test (d-IBT) and other techniques for antisperm antibodies detection. The Gelatin Agglutination Test (GAT) and Tray Agglutination Test (TAT) were used to detect antibodies in blood serum and seminal plasma ("indirect methods"). The Direct IgG Mixed Antiglobulin Reaction Test (d-MAR test) was used to detect sperm antibodies bound to the sperm surface ("direct method"). A good concordance between the methods, measured by phi and K tests, was found and satisfactory mathematical models were established by regression analyses.
Agglutination Tests↗
Serotoninergic dysfunction in bipolar disorder.
The recent discovery of peripheral markers of central neurotransmitter systems has broadened the scope of biological research in psychiatry. Human platelets resemble presynaptic serotoninergic neurons and permit us to investigate the involvement of the serotonin system in the pathophysiology of mood disorders. In particular, platelets show an active uptake of serotonin and the related 3H-imipramine (3H-IMI), similar to cerebral binding sites. We evaluated 3H-IMI binding in a group of 30 bipolar patients as compared with healthy controls. In 20 patients, platelet 14C-5HT uptake was also measured. The results showed no difference in IMI binding parameters between bipolar patients and healthy controls. However, the patients showed a lower Vmax of 14C-5HT uptake than the controls. These findings suggest that bipolarity influences one of the main components of the 5HT transporter complex in platelets.
Adult↗