Antisperm antibodies (ASA) are thought to be a predominate cause of immune infertility by interfering with various aspects of sperm function in both the male and the female reproductive tracts. The precise mechanism by which these antibodies contribute to infertility, as well as their etiology, remains to be established. ASA are present in a variety of biological substrates, such as genital tract secretions, and the blood sera of both males and females. Although not all ASA underly infertility, a substantial body of research suggests that certain ASA, referred to as sperm immobilizing antibodies (SI-Abs) and sperm agglutinating antibodies, significantly impair sperm transportation in the female reproductive tract. High titers of sperm agglutinating or sperm immobilizing antibodies have been associated with reproductive failure. CD52g is a GPI anchored glycoprotein found on mature sperm and in seminal plasma (SP). Antibodies against a male reproductive tract-specific epitope of CD52g are known to readily agglutinate sperm. The current study sought to develop an ELISA to quantify the prevalence of CD52g antibodies in the sera of male and female patients with infertility, and to determine if there was a correlation between the prevalence of CD52g antibodies and the prevalence of sperm agglutinating antibodies in the sera of these patients. Ultimately, CD52g antibodies were only detected in the sera of patients (21%) with sperm agglutinating antibodies. While detecting CD52g antibodies in sera via an ELISA proved challenging, the results of this study corroborate research demonstrating that CD52g antibodies have a remarkable capacity to agglutinate sperm. Elucidation of the mechanisms underlying this immune response would advance our understanding of immune modulation in human reproductive tracts, further the diagnosis of immune infertility, and are currently providing the basis for the development of a potent dual purpose immunocontraceptive, that both prevents unintended pregnancy, and prevents the transmission of sexually transmitted infections (STIs).

Master of Science / Department of Clinical Sciences / Maria S. Ferrer / Presence of anti-sperm antibodies (ASA) is associated with infertility in many species, including bulls but there is no standardized direct technique that allows detection of ASA bound to the sperm surface. The overall objective was to standardize a flow cytometric technique for detection of IgG and IgA directly attached to bovine sperm. The effects of fixation using phosphate buffer solution (PBS) or diluted formalin buffer solution (dFBS), exclusion of dead cells from the analysis, and aliquot variability were assessed using healthy bulls classified as Satisfactory Potential Breeders (SPB, n=9) and bulls with experimentally induced ASA (n=4) (Experiment1). The effect of freezing on the percentage of IgG- and IgA- bound sperm was assessed in samples from immunized bulls (n=4) (Experiment 2). Anti-sperm antibodies on the sperm surface were induced in yearling bulls by intramuscular injection of autologous semen and an adjuvant. Fixation of sperm cells did not affect the percentage of IgG- or IgA-bound sperm in any group of bulls. Exclusion of dead cell from the analysis did not affect the percentage of IgG-bound sperm (p= 0.0922 and p= 0.1525 for immunized and reproductively normal bulls, respectively). The exclusion of dead cells significantly increased the percentage of IgA-bound sperm in semen samples from immunized bulls (p= 0.0152) and significantly decreased the percentage of IgA- bound sperm in semen samples from reproductively normal bulls (p= 0.0012). Variability was < 10% in samples from immunized and reproductively normal bulls for percentage of IgG- and IgA-bound sperm. Freezing did not affect the percentage of IgG- (p=0.1287) or IgA-bound sperm (p=0.4175). Based on these results, fixation is neither necessary nor detrimental for analysis, and the percentage of antibody-bound cell should be calculated gated on the population of live cells only, especially when evaluating IgA binding. The percentage of ASA-bound sperm can be assessed on frozen-thawed samples. The development of this technique allows for further studies on ASA-bound sperm in populations of normal and abnormal bulls.

INTRODUÇÃO: A Região Metropolitana de São Paulo é a mais populosa do Brasil. A grande frota veicular contribui para uma maior concentração de poluentes atmosféricos. Diversos poluentes podem interferir na fertilidade humana, alterando os principais parâmetros seminais. Este estudo teve como objetivo avaliar a influência dos níveis atuais de poluição atmosférica de origem veicular nos parâmetros seminais em controladores de tráfego. MÉTODOS: Foram realizadas anamnese e avaliação clínica urológica (volume testicular, presença de varicocele, criptorquidia, má formações) em 62 controladores de tráfego da CET (grupo exposto) e 210 homens comprovadamente férteis do grupo de pré-vasectomia do ambulatório da urologia do HC-FMUSP (grupo controle). Os parâmetros seminais avaliados foram concentração, motilidade (quantitativa e qualitativa), morfologia pelos critérios da OMS e critério estrito de Kruger, teste para detecção de leucócitos e testes de função espermática, CK, ROS e anticorpo anti-espermatozóide. Parâmetros hormonais também foram avaliados. Avaliação de exposição à poluição foi realizada através da dispersão de poluentes registrado pela Cetesb, gerada pelo software SURFER 8.0. RESULTADOS: Os controladores de tráfego apresentaram volume testicular maior em relação ao grupo pré-vasectomia (p<0,001). Quanto aos níveis de Estradiol (p=0,119), LH (p=0,644), FSH (p=0,140) e Testosterona total (p=0,365), ambos os grupos apresentaram valores dentro da normalidade. A concentração espermática apresentou-se homogênea nos grupos (p= 0,395); os controladores de tráfego apresentaram média de 124,9 x 106/ml e os pré-vasectomia 110,1 x 106/ml. Os controladores de tráfego apresentaram motilidade quantitativa (total) reduzida (60%) em relação aos prévasectomia (65%) (p= 0,047). A motilidade qualitativa (progressiva) também se apresentou diminuída no grupo exposto (p<0,001). As morfologias espermáticas tanto pelo critério da OMS (grupo exposto = 12%; grupo controle = 20%), quanto pelo critério estrito de Kruger (grupo exposto = 3%; grupo controle = 6%) estavam significativamente diminuídas no grupo exposto em relação ao controle (p<0,001). O marcador de maturidade Creatina Quinase apresentou-se dentro da normalidade em ambos os grupos, porém maior no grupo controle (p<0,001). Anticorpos anti-espermatozóides estavam elevados nos dois grupos, porém não foi significativo (p=0,382). Radicais livres de oxigênio apresentaram-se em altas concentrações nos dois grupos, porém não foi significativo (p=0,141). CONCLUSÕES: A análise dos dados obtidos nessa pesquisa sugere que a poluição atmosférica exerce uma influência negativa sobre os parâmetros seminais motilidade e morfologia. Causa elevação dos níveis de ROS em todos os indivíduos, indicando perda da função espermática. Ainda demonstrou-se a elevação em todos os indivíduos dos níveis de anticorpos anti-espermatozóides, sugerindo que os poluentes teriam transposto a barreira hemato-testicular. O volume testicular do grupo exposto à poluição veicular apresentar-se maior em relação ao volume testicular do grupo controle nos leva a supor que isto se deva a uma reação inflamatória aos agentes poluidores. Apesar da diferença significativa na concentração de poluentes entre os grupos, uma correlação direta com parâmetros seminais não pôde ser demonstrada / Metropolitan Region of Sao Paulo is the most populous of Brazil. The huge number of vehicles contributes for a higher concentration of air pollutants. Various pollutants can interfere in human fertility, altering the main seminal parameters. The aim of this study was to evaluate the influence of air pollution of vehicular origin on seminal parameters of traffic controllers. Clinical history and urological evaluation (testicular volume, presence of varicocele, cryptorchidism, bad formations) were carried out in 62 traffic controllers (exposed group) and 210 proven fertile men from the pre-vasectomy group of urologic clinic at Hospital of Clinics University of Sao Paulo (control group). Seminal parameters evaluated were concentration, motility (quantitative and qualitative), morphology by WHO´s criteria and Kruger´s strict criteria, test for detection of leukocytes and tests of sperm function, CK, ROS and antisperm antibody. Hormonal parameters also were evaluated. Exposition to air pollution was analyzed through the dispersion of pollutants recorded by Cetesb, generated in the software SURFER 8.0. Traffic controllers presented bigger testicular volume than prevasectomy group (p<0,001). Hormonal levels were at normal range in both groups; Estradiol (p=0,119), LH (p=0,644), FSH (p=0,140) and Total Testosterone (p=0,365). Sperm concentration was homogeneous in both groups (p= 0,395); traffic controllers presented mean of 124.9x106/ml and pre vasectomy group 110.1x106/ml. The exposed group presented quantitative (total) motility (60%) diminished than control group (65%) (p=0,047). The qualitative (progressive) motility was also diminished in the exposed group (p <0,001). The sperm morphologies as by WHO´s criteria (exposed group = 12%; control group = 20%), as by Kruger´s strict criteria (exposed group = 3%; control group = 6%) were significantly diminished in the exposed group (p<0,001). The sperm maturity marker Creatine Kinase was at normal range at both groups, but higher in the control one (p<0,001). Antisperm antibodies was elevated in both groups, however it was not significant (p=0,382). ROS presented higher concentrations in both groups, however it was not significant (p=0,141). The facts presented in this study suggest that air pollution exercises negative effects on the seminal parameters motility and morphology. It causes elevation of ROS levels in all individuals, indicating loss of sperm function. It also showed, elevation of antisperm antibodies levels, suggesting that pollutants would have transposed the blood-testis barrier. The testicular volume in the exposed group was higher than the testicular volume of the control group; we can suppose that it must occur due to an inflammatory reaction against the polluting agents. Although the significant difference in pollutants concentrations between groups, no direct correlation to seminal parameters could be demonstrated

INTRODUÇÃO: A Região Metropolitana de São Paulo é a mais populosa do Brasil. A grande frota veicular contribui para uma maior concentração de poluentes atmosféricos. Diversos poluentes podem interferir na fertilidade humana, alterando os principais parâmetros seminais. Este estudo teve como objetivo avaliar a influência dos níveis atuais de poluição atmosférica de origem veicular nos parâmetros seminais em controladores de tráfego. MÉTODOS: Foram realizadas anamnese e avaliação clínica urológica (volume testicular, presença de varicocele, criptorquidia, má formações) em 62 controladores de tráfego da CET (grupo exposto) e 210 homens comprovadamente férteis do grupo de pré-vasectomia do ambulatório da urologia do HC-FMUSP (grupo controle). Os parâmetros seminais avaliados foram concentração, motilidade (quantitativa e qualitativa), morfologia pelos critérios da OMS e critério estrito de Kruger, teste para detecção de leucócitos e testes de função espermática, CK, ROS e anticorpo anti-espermatozóide. Parâmetros hormonais também foram avaliados. Avaliação de exposição à poluição foi realizada através da dispersão de poluentes registrado pela Cetesb, gerada pelo software SURFER 8.0. RESULTADOS: Os controladores de tráfego apresentaram volume testicular maior em relação ao grupo pré-vasectomia (p<0,001). Quanto aos níveis de Estradiol (p=0,119), LH (p=0,644), FSH (p=0,140) e Testosterona total (p=0,365), ambos os grupos apresentaram valores dentro da normalidade. A concentração espermática apresentou-se homogênea nos grupos (p= 0,395); os controladores de tráfego apresentaram média de 124,9 x 106/ml e os pré-vasectomia 110,1 x 106/ml. Os controladores de tráfego apresentaram motilidade quantitativa (total) reduzida (60%) em relação aos prévasectomia (65%) (p= 0,047). A motilidade qualitativa (progressiva) também se apresentou diminuída no grupo exposto (p<0,001). As morfologias espermáticas tanto pelo critério da OMS (grupo exposto = 12%; grupo controle = 20%), quanto pelo critério estrito de Kruger (grupo exposto = 3%; grupo controle = 6%) estavam significativamente diminuídas no grupo exposto em relação ao controle (p<0,001). O marcador de maturidade Creatina Quinase apresentou-se dentro da normalidade em ambos os grupos, porém maior no grupo controle (p<0,001). Anticorpos anti-espermatozóides estavam elevados nos dois grupos, porém não foi significativo (p=0,382). Radicais livres de oxigênio apresentaram-se em altas concentrações nos dois grupos, porém não foi significativo (p=0,141). CONCLUSÕES: A análise dos dados obtidos nessa pesquisa sugere que a poluição atmosférica exerce uma influência negativa sobre os parâmetros seminais motilidade e morfologia. Causa elevação dos níveis de ROS em todos os indivíduos, indicando perda da função espermática. Ainda demonstrou-se a elevação em todos os indivíduos dos níveis de anticorpos anti-espermatozóides, sugerindo que os poluentes teriam transposto a barreira hemato-testicular. O volume testicular do grupo exposto à poluição veicular apresentar-se maior em relação ao volume testicular do grupo controle nos leva a supor que isto se deva a uma reação inflamatória aos agentes poluidores. Apesar da diferença significativa na concentração de poluentes entre os grupos, uma correlação direta com parâmetros seminais não pôde ser demonstrada / Metropolitan Region of Sao Paulo is the most populous of Brazil. The huge number of vehicles contributes for a higher concentration of air pollutants. Various pollutants can interfere in human fertility, altering the main seminal parameters. The aim of this study was to evaluate the influence of air pollution of vehicular origin on seminal parameters of traffic controllers. Clinical history and urological evaluation (testicular volume, presence of varicocele, cryptorchidism, bad formations) were carried out in 62 traffic controllers (exposed group) and 210 proven fertile men from the pre-vasectomy group of urologic clinic at Hospital of Clinics University of Sao Paulo (control group). Seminal parameters evaluated were concentration, motility (quantitative and qualitative), morphology by WHO´s criteria and Kruger´s strict criteria, test for detection of leukocytes and tests of sperm function, CK, ROS and antisperm antibody. Hormonal parameters also were evaluated. Exposition to air pollution was analyzed through the dispersion of pollutants recorded by Cetesb, generated in the software SURFER 8.0. Traffic controllers presented bigger testicular volume than prevasectomy group (p<0,001). Hormonal levels were at normal range in both groups; Estradiol (p=0,119), LH (p=0,644), FSH (p=0,140) and Total Testosterone (p=0,365). Sperm concentration was homogeneous in both groups (p= 0,395); traffic controllers presented mean of 124.9x106/ml and pre vasectomy group 110.1x106/ml. The exposed group presented quantitative (total) motility (60%) diminished than control group (65%) (p=0,047). The qualitative (progressive) motility was also diminished in the exposed group (p <0,001). The sperm morphologies as by WHO´s criteria (exposed group = 12%; control group = 20%), as by Kruger´s strict criteria (exposed group = 3%; control group = 6%) were significantly diminished in the exposed group (p<0,001). The sperm maturity marker Creatine Kinase was at normal range at both groups, but higher in the control one (p<0,001). Antisperm antibodies was elevated in both groups, however it was not significant (p=0,382). ROS presented higher concentrations in both groups, however it was not significant (p=0,141). The facts presented in this study suggest that air pollution exercises negative effects on the seminal parameters motility and morphology. It causes elevation of ROS levels in all individuals, indicating loss of sperm function. It also showed, elevation of antisperm antibodies levels, suggesting that pollutants would have transposed the blood-testis barrier. The testicular volume in the exposed group was higher than the testicular volume of the control group; we can suppose that it must occur due to an inflammatory reaction against the polluting agents. Although the significant difference in pollutants concentrations between groups, no direct correlation to seminal parameters could be demonstrated

INTRODUÇÃO. A síndrome antifiosfolípide (SAF) é uma condição trombofílica autoimune associada a títulos elevados e persistentes de anticorpos antifosfolípides. Caracteriza-se por tromboses em diversos órgãos, incluindo os testículos. OBJETIVO. Realizar uma avaliação global da função gonadal em pacientes masculinos com SAF primária (SAFP) e SAF associada ao lúpus eritematoso sistêmico (SAF-LES). MÉTODOS. Estudo transversal realizado em 22 pacientes (12 com SAFP e 10 com SAF-LES) e 20 controles saudáveis pareados por sexo e idade. Os pacientes foram avaliados em relação a dados demográficos, exame urológico, ultrassonografia testicular, perfil hormonal, análise do sêmen, anticorpos antiespermatozóides e características clínicas e laboratoriais. RESULTADOS. A mediana da idade atual foi semelhante nos pacientes com SAFP e controles (p=0,27), assim como naqueles com SAF-LES e controles (p=0,31). Disfunção erétil foi significantemente maior nos pacientes com SAFP comparado aos controles (25% vs. 0%, p=0,044), e nos SAF-LES comparado aos controles (30% vs. 0%, p=0,029). Com relação à antropometria do pênis, a análise dos subgrupos de pacientes com (n=7) e sem (n=5) tromboses arteriais prévias demonstrou que a mediana da circunferência do pênis foi significantemente menor em SAFP com trombose arterial versus sem trombose arterial [8,1 (6-10) vs. 10,2 (10-11) cm, p=0,007], bem como também observado em pacientes com SAF-LES com (n=2) e sem (n=8) eventos arteriais prévios [7,5 (7-8) vs. 9,18 (8-10,5) cm, p=0,039]. A mediana da circunferência do pênis foi significantemente menor nos pacientes com SAFP com disfunção erétil versus sem essa alteração [7,5 (6-9,5) vs. 9,5 (7,5-11) cm, p=0,039], assim como no grupo de SAF-LES [8,17 (8-8,5) vs. 9,14 (7-10,5) cm, p=0,0397]. Com relação à avaliação da função testicular, todos os parâmetros foram semelhantes nos pacientes com SAFP e controles (p>0,05). Por sua vez, as medianas de concentração e de mobilidade dos espermatozóides foram significantemente menores nos pacientes com SAF-LES comparado aos controles [41,1 (0-145) vs. 120,06 (34,5-329) x 106/mL, p=0,003; 47,25 (0-87,5) vs. 65,42 (43-82)%, p=0,047; respectivamente], assim como a frequência de oligo/azoopermia (40% vs. 0%, p=0,007). A análise dos pacientes com SAF-LES mostrou que as medianas da concentração e da contagem total de espermatozóides foram significantemente menores nos que usaram ciclofosfamida endovenosa versus os que não usaram tal medicação [6,87 (0-23,5) vs. 63,9 (7,5-145) x 106/mL, p=0,04; 16,12 (0-55,5) vs. 226,25 (8,5-471) x 106, p=0,035; respectivamente]. CONCLUSÕES. Diminuição do tamanho peniano nos pacientes com SAFP e SAF-LES com disfunção erétil associada foi evidenciada, além de disfunção testicular secundária ao uso de agentes alquilantes nos pacientes com SAF-LES / INTRODUCTION. Antiphospholipid syndrome (APS) is an autoimmune thrombophilic condition associated with persistent high titers of antiphospholipid antibodies. It is characterized by thrombosis in various organs including the testes. OBJECTIVE. To perform a global testicular assessment in male primary antiphospholipid syndrome (PAPS) and secondary systemic lupus erythematosus-APS (SLE-APS) patients, and healthy controls. METHODS. A cross-sectional study was conducted in 22 APS (12 PAPS and 10 SLE-APS) male patients, and 20 healthy controls. They were assessed by demographic data, systematic urological examination, testicular ultrasound, hormone profile, sperm analysis, antisperm antibodies, clinical features and treatment. RESULTS. The median of current age was similar in PAPS patients and controls (p=0.27), likewise in SLE-APS and controls (p=0.31). Erectile dysfunction was significantly higher in PAPS patients compared than controls (25% vs. 0%, p=0.044), and in SLE-APS and controls (30% vs. 0%, p=0.029). Regarding the penile anthropometry, the analysis of subgroups of PAPS patients with (n=7) and without (n=5) previous arterial thrombosis demonstrated that the median circumference penis was significantly lower in PAPS with arterial thrombosis versus without [8.1 (6-10) vs. 10.2 (10-11) cm, p=0.007], as also observed in SLE-APS patients with (n=2) and without (n=8) previous arterial events [7.5 (7-8) vs. 9.18 (8-10.5) cm, p=0.039]. In addition, the median penis circumference was significantly lower in PAPS patients with erectile dysfunction versus without this alteration [7.5 (6-9.5) vs. 9.5 (7.5-11) cm, p=0.039], likewise in SLE-APS patients [8.17 (8-8.5) vs. 9.14 (7-10.5) cm, p=0.0397]. Regarding gonadal evaluation, these parameters were uniformly normal in PAPS versus controls (p>0.05). In contrast, the median of sperm concentration and sperm motility were significantly lower in SLE-APS patients compared to controls [41.1 (0-145) vs. 120.06 (34.5-329) x 106/mL, p=0.003; 47.25 (0-87.5) vs. 65.42 (43-82)%, p=0.047; respectively], likewise the frequency of oligo/azoopermia (40% vs. 0%, p=0.007).The analysis of SLE-APS patients showed that the median of sperm concentration and total sperm count were significantly lower in SLE-APS patients treated with intravenous cyclophosphamide versus untreated [6.87 (0-23.5) vs. 63.9 (7.5-145) x 106/mL, p=0.04; 16.12 (0-55.5) vs. 226.25 (8.5-471) x 106, p=0.035; respectively]. CONCLUSIONS. We have identified reduced penile size in PAPS and SLE-APS patients with deleterious erectile function, and testicular dysfunction due to alkylating agents in SLE-APS patients

INTRODUÇÃO. A síndrome antifiosfolípide (SAF) é uma condição trombofílica autoimune associada a títulos elevados e persistentes de anticorpos antifosfolípides. Caracteriza-se por tromboses em diversos órgãos, incluindo os testículos. OBJETIVO. Realizar uma avaliação global da função gonadal em pacientes masculinos com SAF primária (SAFP) e SAF associada ao lúpus eritematoso sistêmico (SAF-LES). MÉTODOS. Estudo transversal realizado em 22 pacientes (12 com SAFP e 10 com SAF-LES) e 20 controles saudáveis pareados por sexo e idade. Os pacientes foram avaliados em relação a dados demográficos, exame urológico, ultrassonografia testicular, perfil hormonal, análise do sêmen, anticorpos antiespermatozóides e características clínicas e laboratoriais. RESULTADOS. A mediana da idade atual foi semelhante nos pacientes com SAFP e controles (p=0,27), assim como naqueles com SAF-LES e controles (p=0,31). Disfunção erétil foi significantemente maior nos pacientes com SAFP comparado aos controles (25% vs. 0%, p=0,044), e nos SAF-LES comparado aos controles (30% vs. 0%, p=0,029). Com relação à antropometria do pênis, a análise dos subgrupos de pacientes com (n=7) e sem (n=5) tromboses arteriais prévias demonstrou que a mediana da circunferência do pênis foi significantemente menor em SAFP com trombose arterial versus sem trombose arterial [8,1 (6-10) vs. 10,2 (10-11) cm, p=0,007], bem como também observado em pacientes com SAF-LES com (n=2) e sem (n=8) eventos arteriais prévios [7,5 (7-8) vs. 9,18 (8-10,5) cm, p=0,039]. A mediana da circunferência do pênis foi significantemente menor nos pacientes com SAFP com disfunção erétil versus sem essa alteração [7,5 (6-9,5) vs. 9,5 (7,5-11) cm, p=0,039], assim como no grupo de SAF-LES [8,17 (8-8,5) vs. 9,14 (7-10,5) cm, p=0,0397]. Com relação à avaliação da função testicular, todos os parâmetros foram semelhantes nos pacientes com SAFP e controles (p>0,05). Por sua vez, as medianas de concentração e de mobilidade dos espermatozóides foram significantemente menores nos pacientes com SAF-LES comparado aos controles [41,1 (0-145) vs. 120,06 (34,5-329) x 106/mL, p=0,003; 47,25 (0-87,5) vs. 65,42 (43-82)%, p=0,047; respectivamente], assim como a frequência de oligo/azoopermia (40% vs. 0%, p=0,007). A análise dos pacientes com SAF-LES mostrou que as medianas da concentração e da contagem total de espermatozóides foram significantemente menores nos que usaram ciclofosfamida endovenosa versus os que não usaram tal medicação [6,87 (0-23,5) vs. 63,9 (7,5-145) x 106/mL, p=0,04; 16,12 (0-55,5) vs. 226,25 (8,5-471) x 106, p=0,035; respectivamente]. CONCLUSÕES. Diminuição do tamanho peniano nos pacientes com SAFP e SAF-LES com disfunção erétil associada foi evidenciada, além de disfunção testicular secundária ao uso de agentes alquilantes nos pacientes com SAF-LES / INTRODUCTION. Antiphospholipid syndrome (APS) is an autoimmune thrombophilic condition associated with persistent high titers of antiphospholipid antibodies. It is characterized by thrombosis in various organs including the testes. OBJECTIVE. To perform a global testicular assessment in male primary antiphospholipid syndrome (PAPS) and secondary systemic lupus erythematosus-APS (SLE-APS) patients, and healthy controls. METHODS. A cross-sectional study was conducted in 22 APS (12 PAPS and 10 SLE-APS) male patients, and 20 healthy controls. They were assessed by demographic data, systematic urological examination, testicular ultrasound, hormone profile, sperm analysis, antisperm antibodies, clinical features and treatment. RESULTS. The median of current age was similar in PAPS patients and controls (p=0.27), likewise in SLE-APS and controls (p=0.31). Erectile dysfunction was significantly higher in PAPS patients compared than controls (25% vs. 0%, p=0.044), and in SLE-APS and controls (30% vs. 0%, p=0.029). Regarding the penile anthropometry, the analysis of subgroups of PAPS patients with (n=7) and without (n=5) previous arterial thrombosis demonstrated that the median circumference penis was significantly lower in PAPS with arterial thrombosis versus without [8.1 (6-10) vs. 10.2 (10-11) cm, p=0.007], as also observed in SLE-APS patients with (n=2) and without (n=8) previous arterial events [7.5 (7-8) vs. 9.18 (8-10.5) cm, p=0.039]. In addition, the median penis circumference was significantly lower in PAPS patients with erectile dysfunction versus without this alteration [7.5 (6-9.5) vs. 9.5 (7.5-11) cm, p=0.039], likewise in SLE-APS patients [8.17 (8-8.5) vs. 9.14 (7-10.5) cm, p=0.0397]. Regarding gonadal evaluation, these parameters were uniformly normal in PAPS versus controls (p>0.05). In contrast, the median of sperm concentration and sperm motility were significantly lower in SLE-APS patients compared to controls [41.1 (0-145) vs. 120.06 (34.5-329) x 106/mL, p=0.003; 47.25 (0-87.5) vs. 65.42 (43-82)%, p=0.047; respectively], likewise the frequency of oligo/azoopermia (40% vs. 0%, p=0.007).The analysis of SLE-APS patients showed that the median of sperm concentration and total sperm count were significantly lower in SLE-APS patients treated with intravenous cyclophosphamide versus untreated [6.87 (0-23.5) vs. 63.9 (7.5-145) x 106/mL, p=0.04; 16.12 (0-55.5) vs. 226.25 (8.5-471) x 106, p=0.035; respectively]. CONCLUSIONS. We have identified reduced penile size in PAPS and SLE-APS patients with deleterious erectile function, and testicular dysfunction due to alkylating agents in SLE-APS patients

<p>Prostasomes are extracellularly occurring organelles which are secreted in human semen by the prostate gland. Prostasomes have several known biological activities, but their physiological function is still unclear. In this thesis some new aspects were studied on the biological role of the prostasomes. </p><p>The motility-stimulatory effect of prostasomes on cryopreserved spermatozoa was further studied by supplementing the swim-up medium with seminal prostasomes, and with prostasomes purified from a PC-3 prostate cancer cell line (PC-3 prostasomes), on fresh spermatozoa. The recovery of motile spermatozoa after swim-up increased by 50% when the swim-up medium was supplemented with prostasomes. The PC-3 prostasomes bore a functional resemblance to seminal prostasomes as regards various expressions of sperm motility promotion. </p><p>Prostasomes proved to have potent antibacterial effects. The effects were not strictly confined to Bacillus megaterium since a few other bacteria were also sensitive. The high percentage of patients with anti-prostasome antibodies showed that prostasomes could be one of the major targets for antisperm antibodies (ASA). The results demonstrate that ASA in serum of infertile men and women recognise prostasomes as antigens, and that polyclonal antibodies raised against prostasomes agglutinate human spermatozoa. This suggests that prostasomes contribute at least partly to immunological infertility. Three types of prostasomes (seminal-, native- and metastasis-derived prostasomes) demonstrated similarities regarding a high cholesterol/phospholipid ratio and some marker enzymes. The conclusion is that prostasomes have a common and exclusive prostatic origin in man and that they are internalised in storage vesicles of the secretory cells and released in toto by an ordinary exocytotic event.</p>

Prostasomes are extracellularly occurring organelles which are secreted in human semen by the prostate gland. Prostasomes have several known biological activities, but their physiological function is still unclear. In this thesis some new aspects were studied on the biological role of the prostasomes. The motility-stimulatory effect of prostasomes on cryopreserved spermatozoa was further studied by supplementing the swim-up medium with seminal prostasomes, and with prostasomes purified from a PC-3 prostate cancer cell line (PC-3 prostasomes), on fresh spermatozoa. The recovery of motile spermatozoa after swim-up increased by 50% when the swim-up medium was supplemented with prostasomes. The PC-3 prostasomes bore a functional resemblance to seminal prostasomes as regards various expressions of sperm motility promotion. Prostasomes proved to have potent antibacterial effects. The effects were not strictly confined to Bacillus megaterium since a few other bacteria were also sensitive. The high percentage of patients with anti-prostasome antibodies showed that prostasomes could be one of the major targets for antisperm antibodies (ASA). The results demonstrate that ASA in serum of infertile men and women recognise prostasomes as antigens, and that polyclonal antibodies raised against prostasomes agglutinate human spermatozoa. This suggests that prostasomes contribute at least partly to immunological infertility. Three types of prostasomes (seminal-, native- and metastasis-derived prostasomes) demonstrated similarities regarding a high cholesterol/phospholipid ratio and some marker enzymes. The conclusion is that prostasomes have a common and exclusive prostatic origin in man and that they are internalised in storage vesicles of the secretory cells and released in toto by an ordinary exocytotic event.