解脲支原体感染对精子质量和精液细胞因子浓度的影响

Effect of ureaplasma urealyticum infection on sperm quality and sperm cytokine concentration

目的探讨解脲支原体(Uu)感染对精子质量、一氧化氮浓度及细胞因子白细胞介素17(IL-17)、白细胞介素18(IL-18)、肿瘤坏死因子α(TNF-α)浓度的影响,从分子水平分析其在男性不育症中的作用机制.方法选取2015年9月至2017年12月在连云港市第二人民医院门诊就诊的男性不育患者53例为研究对象,根据患者是否感染Uu将其分成两组,男性不育无Uu感染组(B组)和男性不育伴Uu感染组(C组,Uu≥107 CCU/L),采用硝酸还原酶法测定精浆一氧化氮(NO)含量,采用流式细胞仪微球捕获芯片技术(CBA)检测细胞因子IL-17、IL-18、TNF-α的含量,并结合计算机辅助精液分析系统(CASA)对精液相关参数进行分析.结果男性不育伴Uu感染组的精浆NO浓度[(145.98±32.28)μmol/L]明显高于男性不育无Uu感染组[(60.93±16.62)μmol/L]和对照组[(35.92±1.73)μmol/L](F=200.987,P<0.01),男性不育伴Uu感染组的精液pH(6.09±0.14)、精子浓度[(26.64±8.34)×10^6/mL]、前向运动率(a+b)[(21.46±6.88)%]、精子存活率[(28.92±9.17)%]、精子形态正常率[(10.12±4.97)%]均明显低于男性不育无Uu感染组和对照组(均P<0.01),并且不育男性精液中NO浓度与IL-17、IL-18、TNF-α浓度呈正相关(R^2=0.9168、0.8630、0.8789,均P<0.01),IL-17和IL-18浓度呈正相关(R^2=0.9344,P<0.01).结论不育症患者感染Uu会引起NO浓度的高表达,细胞因子IL-17、IL-18、TNF-α的表达水平与NO的浓度呈正相关,各种细胞因子间的平衡失调可能是引起男性不育的原因之一.

Objective To investigate the effects of ureaplasma urealyticum(Uu)infection on male sperm quality,nitric oxide(NO)concentration and cytokine interleukin(IL)-17,IL-18 and tumor necrosis factor alpha(TNF-α)concentrations,the mechanism of its action in male infertility was analyzed at the molecular level.Methods From September 2015 to December 2017,53 male infertility patients who admitted in the outpatient clinic of the Second People's Hospital of Lianyungang were selected.According to whether the patients were infected Uu,they were divided into two groups:male infertility without Uu infection group(B group)and male infertility with Uu infection group(C group,Uu≥10^7 CCU/L).The content of NO in seminal plasma was determined by nitrate reductase method.The contents of cytokines IL-17,IL-18 and TNF-αwere detected by flow cytometry microsphere capture chip technique(CBA),and the spermate-related parameters were analyzed in conjunction with the computer-aided semen analysis system(CASA).Results The concentration of NO in the male infertility group with Uu infection group[(145.98±32.28)μmol/L]was significantly higher than that in the male infertility without Uu infection group[(60.93±16.62)μmol/L]and the control group[(35.92±1.73)μmol/L](F=200.987,P<0.01).The semen pH(6.09±0.14),sperm concentration[(26.64±8.34)×10^6/mL],and forward movement rate(a+b)[(21.46±6.88)%],sperm survival rate[(28.92±9.17)%]and sperm morphology normal rate[(10.12±4.97)%]in the male infertility group with Uu infection were significantly lower than those in the male infertility without Uu infection group and the control group(all P<0.01).And the concentration of NO in the semen of males waspositively correlated with the concentrations of IL-17,IL-18 and TNF-α(R^2=0.9168,0.8630,0.8789,all P<0.01).The concentrations of IL-17 and IL-18 were positively correlated(R^2=0.9344,P<0.01).Conclusion Uu infection in infertility patients can cause high NO concentration.The levels of cytokines IL-17,IL-18 and TNF-αare positively correlated with the concentration of NO.The imbalance of various cytokines may be one of the causes of male infertility.