Seminal vesicles: a source of trophoblast lymphocyte cross-reactive antigen

Update on the impact of Chlamydia trachomatis infection on male fertility

With approximately 90 million cases annually, infection with Chlamydia trachomatis is the most prevalent sexually transmitted bacterial disease in the world. Considering that these infections are often asymptomatic and cause major complications like acute pelvic inflammatory disease, ectopic pregnancy, infertility or infant pneumonia, the estimated costs for diagnosis and treatment in the USA amounts to 2.2 million US dollars for each 500 cases. Therefore, there is a high need for correct, quick and cost-effective diagnosis and treatment of this urogenital tract infection. New innovative therapies provide good results with regard to efficacy and patients' compliance. The success rates of treatments are at least 95%. However, the occurrence of antibiotic resistance should not be ignored and new treatment schemes must be developed. The state-of-the-art of diagnosis and treatment of chlamydial infections as well as the pathophysiology is discussed in this review. In conclusion, infections with C. trachomatis is an important public health problem, especially in third world and developing countries, and more socio-economic studies linking secondary prevention of chlamydial infections, infertility and adverse pregnancy outcome are needed to understand more of its aetiology. In addition, diagnosis and treatment should be improved. Data in men revealed that past infections but not present infections are more related to male infertility. There is still controversial results. In future studies, function of the seminal vesicles and evaluation of the antioxidant capacity should be taken into account when role of C. trachomatis infection on male fertility is assessed.

Immunomodulatory effects of extracellular secretory vesicles isolated from bovine semen

We demonstrate that extracellular secretory vesicles isolated from bovine seminal plasma have immunomodulatory properties. They inhibit mitogen induced proliferation of bovine and human peripheral blood lymphocytes in a dose dependent fashion. They also inhibit phagocytosis of latex particles by bovine neutrophils. Phagocytosis of opsonised Staphylococcus aureus however was not affected. Furthermore phorbol ester and chemotactic peptide induced superoxide production was decreased especially when a suboptimal dose of stimulants was used. We suggest that extracellular secretory vesicles may preserve sperm survival in the female reproductive tract.

Pregnancy, immunosuppression and reactivation of latent toxoplasmosis

Toxoplasmosis is a chronic, latent infection which can be reactivated in the presence of immunosuppression. The critical question in obstetrics is whether toxoplasmosis may be reactivated in the presence of the physiological "immunosuppression" of pregnancy. Standard in vitro tests, done in 24 healthy pregnant women and compared with the literature, show no significant changes in humoral and cellular immunity during pregnancy. However, the fact that some infections occur more frequently and more severely than in non-pregnant women (e.g. those due to cytomegalovirus (CMV) and human papilloma virus (HPV) points to a degree of pregnancy-associated immunosuppression. Non-rejection of the semiallogenic fetus is achieved in presence of maternal immunocompetence and is explained mainly by local changes in immune function, mediated by inhibitors of decidual, placental and fetal origin, and by the absence of class II histocompatibility antigens at the fetomaternal interface. Immune status allowing reactivation of toxoplasmosis was studied in a selected group of (predominantly male) AIDS patients from the Swiss HIV Cohort study. Shortly before (cerebral) reactivation of toxoplasmosis, 92% of these patients had very low CD4 lymphocyte counts (mean 50 cells/microliters, i.e. lower than ever recorded in a normal uncomplicated pregnancy). In a larger population of 48 women receiving immunosuppressive therapy after organ transplantation, not a single case of cerebral toxoplasmosis was observed during pregnancy, while in the 105 HIV-positive women in the Swiss HIV and Pregnancy study, there was only one case of cerebral toxoplasmosis during pregnancy and the puerperium (20 CD4/microliters), even though some 17% of those sampled (18/105) had CD4 levels below 200 cells/microliters on at least one occasion during pregnancy. These findings explain why latent toxoplasmosis is not reactivated in normal pregnancy, and why it is only likely in an immunosuppressed mother when her CD4 lymphocyte count is very low (< 200 cells/microliters). In such cases, a prophylactic treatment to prevent maternal reactivation and vertical transmission of toxoplasmosis may be useful.

Alloantibody responses to antigens recognized by rabbit antitrophoblast antisera in trophoblast and mononuclear cell (MNC) membranes by primary aborting women before and after paternal leukocyte immunization

PROBLEM

Because shared allogeneic antigens are expressed on peripheral blood lymphocytes, as well as trophoblasts, it has been proposed that lymphocyte transfusions may appropriately sensitize recurrent spontaneous aborters (RSA) to trophoblast and lead to pregnancy conservation. The degree to which these responses are affected by this treatment, however, has not been defined.

METHOD

SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analyses were used to study the alloantibody responses in RSA patients both before and after immunization with paternal leukocytes (MNC) against membrane proteins isolated from peripheral blood mononuclear cells (MNC), first trimester and full term chorionic villi (CV).

RESULTS

A distinct set of antigens with apparent molecular weights of 32, 36, 41, 63, 65, and 85 kDa was identified in both MNC and trophoblast membranes by rabbit anti-trophoblast antisera. In addition, a 55 kDa protein was recognized by MNC membranes. Thirty-eight percent of primary RSA sera recognized this 55 kDa protein. After paternal MNC immunization, all primary RSA samples displayed increased reactivity or produced antibodies to this 55 kDa protein when compared with preimmunization sera. The protein was identified as MCP using a rabbit polyclonal anti-MCP antisera. In contrast, reactivity to the other antigens present in the membrane preparations decreased after paternal MNC immunization.

CONCLUSION

Changes in immune reactivity in RSA patients after paternal MNC immunization suggest that immunization alters serum immune reactivity to MNC and trophoblast shared antigens.

Expression of a common secretory granule specific protein as a marker for the extracellular organelles (prostasomes) in human semen

OBJECTIVE

To further characterize prostasomes, trilamellar to multilamellar vesicles that are thought to originate from acinar cells of the human prostate and present in appreciable amounts in normal human semen. Purified prostasomes were shown to have immunosuppressive activity in vitro as measured by inhibition of mitogen-induced lymphocyte proliferation and inhibition of superoxide generation by neutrophils. A granule membrane protein, called granulophysin, has recently been identified in the membranes of platelet dense granules. Antibodies that recognize granulophysin also stain granules in different cell types including leukocytes, melanocytes, neurones, endothelial cells, and epithelial cells.

DESIGN

The presence of epitopes recognized by antigranulophysin monoclonal antibody in prostasomes was investigated using indirect immunofluorescence and subsequent cytofluorimetric analysis. The protein was also analyzed by Western blotting. Reactivity of antigranulophysin antibody with the prostate tissue was studied by immunoperoxidase staining.

RESULTS

A majority of prostasome particles specifically reacted with antigranulophysin antibody. In lysates prepared from prostasomes, a broad band of 32 to 37 kd was detected by Western blotting.

CONCLUSION

This report defines granulophysin as a constituent membrane molecule of prostasomes that may serve as a useful marker in elucidation of prostasome function.

Increase of lymphocytes expressing Fc-receptor class III (CD16) by exposure to human seminal plasma

OBJECTIVE

To characterize conditions for the seminal plasma-induced increase of lymphocytes that express immunoglobulin G-Fc receptor class III (Fc gamma RIII).

DESIGN

Peripheral blood lymphocytes were incubated in diluted seminal plasma or control media. Cells expressing Fc gamma RIII were quantified by using flow cytometry and fluorochrome-labeled monoclonal antibodies specific for Fc gamma RIII. The influence of incubation time, temperature, and seminal plasma concentration was investigated. Physical properties of the active seminal plasma substance were characterized by studying effects of dialysis and ultracentrifugation. The origin of the active seminal plasma substance was investigated by studying activity of autopsy materials from male accessory glands. Identity of cells that are influenced by seminal plasma activity was investigated by using two-color flow cytometry with monoclonal antibodies specific for Fc gamma RIII and different phenotypic markers of leukocytes.

RESULTS

Incubation of lymphocytes in seminal plasma significantly increased percentages of cells expressing Fc gamma RIII. Maximal increases were observed after seminal plasma incubation at 37 degrees C for 90 to 120 minutes and increases were significantly correlated with seminal plasma concentration. Seminal plasma activity was not altered by ultracentrifugation (100,000 x g for 30 minutes) but completely removed by dialysis (12,000 to 14,000 pore size). Fc gamma RIII-positive lymphocytes markedly increased after incubation in prostatic but not in seminal vesicle secretions. Two-color flow cytometry showed that increases of Fc gamma RIII-expressing cells occurred within the subset of CD56-positive natural killer (NK) cells.

CONCLUSIONS

Dialyzable compounds of prostatic origin induce significant increases of NK cells expressing Fc gamma RIII. These findings might reflect a novel regulatory mechanism acting on CD56-positive cells within the female reproductive tract after insemination.

Immunological studies of lactoferrin in human placentae

Lactoferrin (LF) and transferrin (Trf) are glycoproteins with strong affinities for ferric ions. Human syncytiotrophoblastic membranes analyzed by enzyme linked immunosorbent assay (ELISA) and immunoblotting were negative with monoclonal and polyclonal antibodies to LF. Immunohistological studies of 35 normal placentae showed that LF was absent from the trophoblast basement membranes, stroma and fetal stem vessel endothelium, but positive cells were occasionally noted in intervillous spaces and fetal stem vessels. In contrast, many LF-positive cells were identified within areas of immunopathology identified by the presence of T cells, HLA-DR-positive macrophages and platelets. Double-antibody experiments showed that the LF-positive cells in these areas reacted with CD15 and CD16 monoclonal antibodies (mAbs), indicating that the cells were polymorphonuclear neutrophils (PMN). PMN from peripheral blood analyzed by flow cytometry and immunocytology also showed reactivities with anti-LF, CD15 and CD16 and we consistently found that circulating PMN reacted better than placental PMN with antibodies to MHC class I antigens and gp 100, (CD67), which is a neutrophil activation marker. PMN adherent within placentae had no detectable MHC class I or CD67 antigens. These findings suggest PMN adherent to placental tissues down-regulate or alter plasma membrane markers. LF appears to play a role in placental inflammation, for LF-positive cells were significantly enriched in areas of immunopathology.

Leukocytospermia and function of the seminal vesicles on seminal quality

OBJECTIVE

To determine possible relationships between number of leukocytes, function of seminal vesicles, and seminal quality.

DESIGN

The study was carried out on men who consecutively attended an infertility clinic between June 1989 to June 1991.

SETTING

This study was conducted in a private immunological center for infertility, a tertiary care center, The Centro Immunológico-Sección Esterilidad y Reproducción.

PATIENTS

Semen samples from 280 infertility patients attending an Immunological Center for Infertility were analyzed.

MAIN OUTCOME MEASURE

We evaluated the effect of leukocytospermia in the presence of normal or abnormal function of seminal vesicles on seminal quality.

RESULTS

Sperm count, percent of motile sperm, and percent of sperm vitality were significantly reduced when both leukocytospermia and hypofunction of seminal vesicles were present (P less than 0.01). Leukocytospermic subjects with normal function of seminal vesicles showed similar seminal parameters to those nonleukocytspermics. The incidence of subjects with antisperm antibodies measured by direct immunobeads was significantly higher in leukocytospermic men with hypofunction of seminal vesicles. No differences in the incidence of antisperm antibodies with nonleukocytospermic samples were observed in those with both leukocytospermia and normal function of seminal vesicles.

CONCLUSIONS

These data provide evidence that white blood cells were deleterious for seminal quality when seminal vesicles were also affected.

The complement system in human reproduction

Regulation of the complement system in reproduction is unique inasmuch as reproductive tissues represent the only condition where allogeneic interactions occur naturally. Both allogeneic extraembryonic membranes and semen that contact and interact with maternal cells and tissues must avert complement-mediated damage to ensure reproductive success. Several regulators of complement activation exist. Membrane cofactor protein (MCP) and decay accelerating factor (DAF) inactivate C3 and C5 convertases on cell surfaces. In addition, CD59 inhibits the membrane attack complex (MAC) of the complement cascade. Strong expression of these membrane glycoproteins by trophoblast and amniotic epithelium has been observed. MCP, DAF, and CD59 likely safeguard extraembryonic tissues from complement damage originating from maternal and fetal blood or amniotic fluid. Different reproductive tract fluids vary in complement levels. With the exception of ovarian follicular fluid, these levels are generally much less than those in blood. Endometrial and cervical content of C3 appear to be regulated by hormones. These observations suggest that the effects of complement activation may vary in reproductive tissues. MCP is absent from the surfaces of oocytes. Sperm express MCP and DAF in discrete areas that would not be associated with the known complement-regulatory functions of these proteins. Seminal plasma contains MCP and the MAC inhibitor SP-40,40 but not DAF.SP-40,40 may exemplify how complement-regulatory proteins perform alternative functions as it interacts with molecules other than complement components. We have reviewed aspects of the complement system that relate to allogeneic interactions in reproduction and that suggest fruitful areas for further research.

Progesterone and estradiol suppress human mononuclear cell cytotoxicity

Fetal trophoblast is generally resistant to lysis by cytotoxic cells. We hypothesized that progesterone and estrogens secreted by the trophoblast act at the choriodecidual interface where they are present in high concentrations to provide a local, paracrine immunosuppressive effect on cellular cytotoxicity. Using peripheral blood mononuclear cells as effector cells in a cytotoxicity assay, we evaluated the effects of progesterone, estrone, estradiol and estriol, either alone or in combination, on cellular cytotoxicity. Both progesterone and estradiol suppressed cytotoxicity in a dose-dependent manner. Estrone, estriol, pregnenolone and cholesterol had no effect. A synergistic suppression of cytotoxicity was observed when estrone, estradiol, estriol and progesterone were combined. We speculate that trophoblast production of progesterone and estradiol may be an important local immunosuppressive mechanism contributing to fetal survival.

Syncytiotrophoblast brush border proteins recognized by monoclonal antibody TRA-2-10 and rabbit anti-TLX sera

Different subsets of placental trophoblast epithelium are directly exposed to the maternal immune system during pregnancy and consequently represent major elements in allogeneic interactions. It has been proposed that the trophoblast--lymphocyte cross-reactive (TLX) alloantigen system is involved in maternal allogeneic recognition during pregnancy. Monoclonal antibody TRA-2-10 putatively recognizes TLX antigens, but its reactivity with trophoblast and normal tissues has not been documented in detail. In this report, immunohistological investigations revealed that TRA-2-10 recognizes all subsets of trophoblast in addition to amniotic and seminal vesicle epithelia. Immunoblotting demonstrated reactivity with glycoproteins of 55,000 and 65,000 mol. mass under non-reducing conditions on various cell types. These proteins displayed tissue-specific size variations and individuals varied in the amounts expressed of the two species. On the basis of blocking and immunoprecipitation experiments, TRA-2-10 reactive antigens are recognized by rabbit anti-TLX sera and are potential TLX antigen candidates. However, TLX antigens are found in seminal plasma whilst TRA-2-10 reactive antigens are not. Both TLX and TRA-2-10 antigens appear related if not identical to membrane cofactor protein (MCP) by virtue of shared molecular characteristics and blocking of lymphocyte binding of monoclonals to MCP by polyclonal anti-TLX. Extra-embryonic membranes are thus richly endowed with a complement regulatory protein which could facilitate their roles in protection of the fetus by avoidance of harmful maternal immune response amplification.

Congenital aplasia of seminal vesicles: absence of trophoblast-lymphocyte cross-reactive antigens from seminal plasma

Our studies show that TLX antigens are absent from seminal plasma of a patient with bilateral aplasia of seminal vesicles. This is supportive for an origin of seminal plasma TLX antigens from seminal vesicles. The release of TLX antigens by seminal vesicles could represent a mechanism of priming mothers immunologically for normal implantation and pregnancy.

Human placentae: view from an immunological bias

Human placentae form a major part of the interface between maternal and embryonic tissues. Placentae are morphologically complex organs that are lined with a trophoblastic tissue that provides anatomical constraints over which flows maternal blood. Maternal antibodies and immune cells thus contact the lining syncytiotrophoblast, and this paper considers some of the antigens that maternal immune components might encounter. The antigens have been grouped into those of unknown function, major histocompatibility antigens, and antigens of suspected function. The paper also details certain antigens of cytotrophoblasts. We discuss consequences of maternal immune responses to extraembryonic antigens and present evidence for amplification of these responses through the activation of hemostasis and fibrinolysis within the placenta and placental bed.

Immunological role for seminal plasma in insemination and pregnancy

Insemination confronts the female with paternally derived alloantigens and represents an immunological challenge preceding fertilization and implantation. Current evidence suggests a role for seminal plasma in regulating maternal immunity for insemination and pregnancy. In vitro seminal plasma has been shown to suppress T- and B-cell proliferation, neutrophil and macrophage phagocytic activity, as well as killer cell activity. Seminal plasma interacts with complement components C1 and C3 and contains factors that specifically bind the Fc region of IgG. These in vitro findings suggest possible seminal plasma-suppressive effects on female alloimmune responses after insemination. Seminal plasma also contains allotypic TLX antigens that could prime mothers prior to fertilization. Such priming effects for pregnancy acceptance are supported by improved implantation rates in controlled clinical trials using timed vaginal exposure to semen during in vitro fertilization or gamete intrafallopian transfer treatment cycles.