Th1/Th2细胞因子与自身抗体在特发性少弱精子症患者血清中的表达及意义

Expressions of Th1/Th2 cytokines and autoantibodies in the serum of males with idiopathic oligoasthenozoospermia and their significance

目的:探讨特发性少弱精子症(IO)患者血清中Th1/Th2细胞因子和自身抗体表达水平及意义。方法:2017年11月至2020年4月期间,用酶联免疫吸附法(ELISA)检测48例轻、中度IO患者,48例重度IO患者和72例精液常规在正常范围的男性血清中细胞因子(IL-2、IL-4、IL-10、IL-21、TNF-α和IFN-γ)水平及抗人绒毛膜促性腺激素抗体(AhCGAb)、抗精子抗体(AsAb)、抗心磷脂抗体(AcAb)水平,并比较组间差异,构建Logistic回归模型进行回归分析。结果:与对照组比较,轻、中度IO组患者血清IL-10、IL-21和IFN-γ的含量,AhCGAb、AsAb和AcAb阳性表达率显著增高(P<0.05),重度IO组患者血清中6种细胞因子含量及3种自身抗体阳性表达率均显著增高(P<0.05);与轻、中度IO组比较,重度IO组患者血清中IL-2、IL-4、IL-21和TNF-α水平,AhCGAb和AsAb阳性表达率明显增加(P<0.05)。Logistic多元回归分析显示,IL-21/IL-10比值增加[OR (95%CI):1.694 (0.319~4.035),P<0.05]、AhCGAb阳性表达[OR (95%CI):4.357 (1.204~9.426),P<0.05]和AsAb阳性[OR (95%CI):2.135 (1.902~5.429),P<0.05]是IO发生的危险因素。结论:特发性少弱精子症男性血清中细胞因子IL-2、IL-4、IL-10、IL-21、TNF-α、IFN-γ和抗体AhCGAb、AsAb、AcAb的表达水平均显著不同于精液参数正常的男性对照,定量分析患者血清中的细胞因子和抗体,对于探索男性不育的致病机制具有一定价值。

Objective: To investigate the expressions of Th1/Th2 cytokines and autoantibodies in the serum of the patients with idiopathic oligoasthenozoospermia(IO) and their significance. Methods: From November 2017 to April 2020, we examined the levels of Th1/Th2 cytokines(IL-2, IL-4, IL-10, IL-21, TNF-α, IFN-γ) and the expressions of AhCGAb, AsAb and AcAb in the serum of 48 infertile men with mild or moderate IO, 48 with severe IO and another 72 males with normal semen parameters by ELISA. We compared the results of detection among the three groups and analyzed them with the logistic regression model. Results: Compared with the normal controls, the patients with mild or moderate IO showed significant increases in the levels of IL-10, IL-21 and IFN-γ and the expressions of AhCGAb, AsAb and AcAb(P < 0.05), and so were those of the severe IO group in the levels of all the six cytokines and the expressions of the three autoantibodies(P < 0.05). The levels of IL-2, IL-4, IL-21 and TNF-α and the expressions of AhCGAb and AsAb were even higher in the patients with severe IO than in those with mild or moderate IO(P < 0.05). Multivariate logistic regression analysis showed that the increased levels of IL-21/IL-10(OR = 1.694, 95% CI: 0.319-4.035, P < 0.05) and positive expressions of AhCGAb(OR = 4.357, 95% CI: 1.204-9.426, P < 0.05) and AsAb(OR = 2.135, 95% CI: 1.902-5.429, P < 0.05) were the risk factors for IO. Conclusion: The levels of the cytokines IL-2, IL-4, IL-10, IL-21, TNF-α and IFN-γ and the expressions of the autoantibodies AhCGAb, AsAb and AoAb are significantly higher in IO patients than in normal healthy males. Quantitative analysis of cytokines and autoantibodies in the serum of IO patients may provide some valuable information for studies of the pathogenesis of male infertility.