[Updated treatments for neonatal phimosis and redundant prepuce]

Phimosis and redundant prepuce, as common problems in andrology, are found in the majority of male neonates. Early treatment of neonatal phimosis and redundant prepuce has the advantages of better cost--effectiveness and higher safety, and contributes much to the prevention of childhood urinary tract infection and adult sexually transmitted diseases, as well as to the improvement of genital hygiene. Neonatal circumcision is commonly performed in some countries, but remains at a low rate in China. This article updates surgical and non-surgical treatments of neonatal phimosis and redundant prepuce, introduces the benefits of neonatal circumcision, and appeals for more attention to the management of neonatal phimosis and redundant prepuce.

[The need for high-quality training and surgical standards for adult male circumcision in China]

Although HIV is a significant problem in Africa, HIV infection rates are rising rapidly in other regions such as Asia and South America. International health organizations have recognized the need to develop effective strategies to check the worldwide transmission of HIV. Studies have demonstrated the significant reduction of HIV, HPV, HSV-2 and other STD infection rates with male circumcision (MC). Although numerous MC techniques are available, there are no standardized protocols and surgical training programs. Studies have shown that the standardization of MC techniques coupled with training programs can significantly reduce complication rates. High complication rates have been a primary obstacle to the implementation of MC services. We recommend the establishment of surgical standards and training protocols prior to the promotion of MC services in China.

[Male circumcision is an effective "surgical vaccine" for HIV prevention and reproductive health]

Recent randomized controlled clinical trials in Africa have demonstrated that adult male circumcision (MC) efficiently decreases the rate of HIV, HPV and HSV-2 infections. Many studies have clearly shown that MC is a simple, safe, and cost-effective method for the prevention of sexually transmitted diseases and urinary tract infection, and for improving genital hygiene. While a 30% MC prevalence exists worldwide, only 5% or less of the Chinese males have undergone circumcision. In this review, we report recent trends in international MC and HIV prevention efforts, as well as the potential benefits and importance of promoting MC in China. We appeal to medical and public health authorities to pay close attention to the international experience in MC and HIV prevention.

[Promoting male circumcision in China for preventing HIV infection and improving reproductive health]

The incidence of heterosexually transmitted HIV infection is rapidly increasing in China, which reached 44.7% among the HIV-positive patients in 2007. With a view to the reduction of HIV transmission and improvement of reproductive health in the Chinese population, this paper introduces the latest evidence obtained from the international epidemiological studies and randomized controlled clinical trials on the preventive effect of male circumcision (MC) on HIV transmission, and elucidates the cellular and molecular mechanisms of HIV transmission through the foreskin. Four studies published during 1997-2007 demonstrated that the mean prevalences of redundant prepuce and phimosis in 15,109 Chinese males aged 3-23 years in 4 areas of China were 43.90 and 11.55% , respectively, while the rate of MC was only 2.66%. As MC is a simple, inexpensive and highly effective technique in HIV prevention, we appeal to the policy-makers in China to conduct a practical program for promoting MC and enhancing male productive health in combination with other approaches to the prevention of HIV infection. MC for neonates, children, adolescents and adults should be included in the health insurance program, and free and timely MC should be performed for the male adults with the high risk of HIV infection and the normal ones whose wives are HIV-positive. Further investigations should be carried out on the epidemiology of redundant prepuce and phimosis, the acceptance and socio-cultural context of MC and the development of simpler and safer methods for MC.

Anti-HIV-1 activity of trichobitacin, a novel ribosome-inactivating protein

AIM

To determine whether trichobitacin, a novel ribosome-inactivating protein purified from the root tubers of Trichosanthes kirilowii, possesses the anti-HIV activity.

METHODS

The inhibition of syncytial cell formation induced by human immunodeficiency virus type 1 (HIV-1) was determined under microscope, reduction of HIV-1 p24 antigen expression level was measured by ELISA, and decrease in numbers of HIV-1 antigen positive cells in acutely and chronically infected cultures were detected by indirect immunofluorescence assay.

RESULTS

Trichobitacin was found to greatly suppress syncytial cell formation induced by HIV-1 and to markedly reduce both expression of HIV-1 p24 antigen and the number of HIV antigen positive cells in acutely but not chronically HIV-1 infected culture. The median inhibitory concentration (IC50) in inhibition of syncytial cell formation and HIV antigen positive cells were 5 micrograms.L-1 (95% confidence limits: 1.3-20 micrograms.L-1) and 0.09 mg.L-1 (95% confidence limits: 0.011-0.755 mg.L-1), respectively.

CONCLUSION

Trichobitacin is a novel ribosome-inactivating protein with anti-HIV-1 activity.

Alpha-momorcharin inhibits HIV-1 replication in acutely but not chronically infected T-lymphocytes

AIM

To identify the anti-human immunodeficiency virus type 1 (HIV-1) activities of alpha-momorcharin (alpha-MMC) from Momordica charantia in acutely and chronically infected T-lymphocytes.

METHODS

The anti-HIV activities of alpha-MMC were examined by 1) the inhibition of syncytia formation induced by HIV-1 III B; 2) reduction of p24 core antigen expression level and decrease in numbers of HIV antigen positive cells in acutely and chronically infected cultures. The cytotoxic effects of alpha-MMC was tested by trypan blue dye exclusion or colorimetric MTT assay.

RESULTS

alpha-MMC was found to obviously inhibit HIV-1 III B-inducing C8166 syncytia formation and markedly reduced both expression of p24 core antigen and the numbers of HIV antigen positive cells in acutely but not chronically HIV-1-infected culture. The median effective concentration (EC50) in these assays were 0.016, 0.07, and 0.32 mg.L-1, respectively.

CONCLUSION

alpha-MMC is a unique component of momorcharin with anti-HIV activity, and markedly inhibited HIV-1 replication in acutely but not chronically HIV-1-infected T-lymphocytes.

[The terminal monosaccharide of antigenic determinant is involved in the binding of human sperm to specific monoclonal IgA antibody]

In order to know whether terminal monosaccharide of human sperm antigen is involved in stimulating antisperm immune response (especialy IgA production) in mucosal immune system, 33 IgA, 12 IgG and 35 IgM monoclonal antibodies (MAbs) all obtained by intragastrointestinal immunization were used in the present study. The molecular weight (MW) of sperm antigens reactive with MAbs were dectected by Western blotting. The MW range of sperm antigens to the above monclonal IgA, IgM and IgG class, except 12 MAbs not reactive with blotted sperm antigen on nitrocellulose strip, is 10-89 KDa, 11-75 KDa and 12-94 KDa respectively. The sperm antigens were separately blocked and digested with 5 lectins and 4 glycosidases. After that, the capacity of human sperm antigens bind with the above antibodies were determined by ELISA. One or more terminal monosaccharides of sperm antigens are involved with the reaction of most MAbs tested. The loss of terminal alpha-fucose, alpha-N-acetylgalactosamine, alpha-N-acetylglucosamine, mannose and beta-galactose but neuraminic acid in the antigenic determinant of human sperm were found to seriously affect the IgA binding with the corresponding sperm antigen. The binding of IgG with sperm antigen was obviously damaged by the removing of terminal alpha-fucose, alpha-N-acetylgalactosamine and alpha-mannose. The results suggest that the terminal monosaccharides of the sperm antigens play an important role in stimulation of antisperm IgA and other antibodies produced by using intragastrointestinal immunization.

In vitro immunotoxicity and cytotoxicity of trichosanthin against human normal immunocytes and leukemia-lymphoma cells

Trichosanthin (TCS) is a ribosome-inactivating protein from root tubers of Trichosanthes kirilowii Maxim. In this paper, the effects of TCS on the viability of human peripheral blood immunocytes, on the proliferation of lymphocytes, and its cytotoxicity to twelve cell lines of lymphoma or leukemia had been observed. TCS at high concentration (> 12.5 micrograms/ml) affected the viability of human B lymphocytes, but not that of human peripheral blood mononuclear cells (PBMCs), T lymphocytes and granulocytes. Human peripheral blood-derived monocytes/macrophages were highly sensitive to TCS (ID50 at 1.70 micrograms/ml). TCS suppressed lymphocyte proliferation stimulated by Concanavalin A (Con A) or lipopolysaccharide (LPS). Human T cell lines and macrophage cell lines were more sensitive (ID50 < 0.9 microgram/ml) to TCS than B cell lines and myeloid lines. These results suggest that selective cytotoxicity of TCS to human macrophages/monocytes may be implicated in anti-HIV activity, and that selectively killing some leukemia-lymphoma cells by TCS merit further evaluation in treatment of some lymphoma and leukemia.

[The characteristics of monoclonal antibodies and their antigens associated with human sperm acrosome reaction. I. The induction of acrosome reaction and monoclonal antibody production]

Sperm released from the male genital tract must undergo capacitation and acrosome reaction (AR) before binding to oocyte membrane. Changes of sperm components have been found after the capacitation and AR. Based on these changes, the new contraceptive methods and the treatment of the male infertility might be approached. In the present study, in vitro capacitated human sperm were induced to undergo AR in BWW-BSA medium with calcium ionophore A 23187. The fresh human AR sperm in about 50% of sperm population assayed by triple stain technique and/or chlortetracycline fluorescence staining were used for immunization. Twenty three murine hybridomas secreting monoclonal antibodies (McAbs) to non-treated (NT) and/or AR human sperm have been obtained. Of them, 21 McAbs were classified as IgM, others as IgG1 and IgG2a. Based on the immunoreactions of 23 McAbs with NT and AR sperm, they were divided into three groups: group A reacted mainly with the AR sperm, group B with NT sperm, and group C with both AR and NT sperm. The cross reaction of these McAbs with human leukemia cell lines was detected by ELISA and the discrepant reactions were observed.

[The characteristics of monoclonal antibodies and their antigens associated with human sperm acrosome reaction. II. Effects of the monoclonal antibodies on sperm function, sperm antigen localization and immunoblotting]

By using microassay, the strong human sperm agglutination were caused by 9 of 23 monoclonal antibodies (McAbs) obtained by immunization with fresh human acrosome-reacted (AR) sperm, which was induced by ionophore A 23187, but no one of them demonstrated the ability to immobilize human sperm. In contrast to most studies reported by other laboratories, the antigens recognized by most of McAbs in the present study were located in equatorial segment and midpiece of human sperm, and no one in acrosome region of human sperm. The binding pattern of some McAbs on non-treated and AR sperm was found to be different. The human sperm proteins ranged in the size of 16-146 kDa were demonstrated to be reacted with 9 of 23 McAbs by immunoblotting. Moreover, the cross reaction of 23 McAbs with mouse and tree shrew sperm was detected by indirect immunofluorescent assay. These results suggest that AR sperm possesses peculiar immunogenic properties.

[TRBC receptor on T lymphocytes of human and macaque and its ligand are different from E2 molecule and ligands for CD2]

CD2 (E receptor, LFA-3 receptor) and E2 molecules (Bernard, 1988) on human T lymphocytes, CD58 (LFA-3, lymphocyte function associated antigen 3) on human erythrocytes and S14,S42,S110-220 molecules (Bernard, 1987) of sheep erythrocytes are involved in rosette formation of human T lymphocytes with human or sheep erythrocytes. Rosette formation of human and macaque pan-T lymphocytes with tree shrew (Tupaia belangeri) red blood cells (TRBC) (TRBC rosette) has shown different physicochemical properties from that of rosette formation with sheep red blood cells (E rosette) (Ben, 1985). CD2, CD3/TCR complex, CD5, CD6, and CD7 are not involved in TRBC rosette formation (Zheng, 1990). In order to know whether E2, LFA-3,S14,S42 and S110-220 molecules are involved in TRBC rosette formation or human and macaque T lymphocytes, rosette inhibition and antigenic modulation or co-modulation were performed with relevant monoclonal antibodies (McAbs), and hemolytic assay and slide agglutination were also conducted. TRBC rosette formation of human and rhesus monkey PBL was not blocked by E2 McAb (inhibition rate 2.8% and 2.1%, respectively). In contrast, human E rosette formation was obviously blocked at inhibition rate of 49.8% and macaque E rosette formation was slightly inhibited (13.3%). The modulation or co-modulation of E2 molecule with E2 McAb did not affect human TRBC rosette formation. Similar results were shown in rosette formation inhibition of Jurkat cells.(ABSTRACT TRUNCATED AT 250 WORDS)

[Comparative study of TRBC receptor and E receptor on T lymphocytes of human and macaque]

In 1985, rosette formation of human and macaque pan-T lymphocytes with tree shrew red blood cells (TRBC) (TRBC rosette) was first found by Ben K et al, showing different physico-chemical properties from that of rosette formation with sheep red blood cells (E-rosette). In order to approach the correlation between TRBC receptor, E receptor (CD2) and other differentiation antigens (CDs) on T lymphocytes, rosette inhibition assay and antigenic modulation or co-modulation were performed with monoclonal antibodies (McAbs) to CDs, and the distribution of TRBC receptor in other peripheral immunocytes, cell lines was also examined. TRBC rosette appeared in 88.8% of E rosette positive peripheral blood lymphocytes (E(+)-PBL) and in 4.16% of E(-)-PBL. TRBC receptor was also found on all T cell lines tested (CEM, H33 HJ-JA 1, Jurkat, MLA-144, Molt-3, Molt-4, Molt-4 clone 8, PEER) and some myeloid lines (U 937 and HL 60), but not on human granulocytes, B cell lines (Daudi, Raji and Reh) and myeloid line K 562. The modulation or co-modulation of CD 3, TCR, CD 5, CD 6 and CD 7 with McAbs OKT 3, T 108 (F 1), T 136 (F 101-15), T 149 (M-T 604) and T 152 (7 G 5) did not affect TRBC rosette formation of PBL. TRBC rosette of human and rhesus monkey PBL was not inhibited by T 11.1 McAb OKT 11 (CD 2 McAb), in contrast human and rhesus monkey E rosette formations were obviously blocked at inhibition rates of 77.9% and 49.3%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Vasectomy-induced autoimmunity: monoclonal antibodies affect sperm function and in vitro fertilization

A panel of sperm-reacted monoclonal auto-antibodies developed from spleen cells of vasectomized mice (BDF1) were characterized. Immunogenic antigens were mainly located on the acrosome, midpiece and principal piece. All of the monoclonals were IgM; three demonstrated a multispecific reaction with testis and/or epididymis antigen extracts by immunoblotting. Immunobead studies indicated that most of the antibodies were to surface molecules, a finding supported by the observation that five of the seven antibodies caused complement-mediated immobilization (although not sperm agglutination) of mouse sperm. In vitro fertilization was significantly impaired when antibodies (Vx5, 8 and 10) were added to the sperm prior to exposure to the eggs. Furthermore, passive immunization with Vx5 antibody reduced in vivo fertilization. Our findings indicate that vasectomy-generated antibodies can reduce sperm function in vitro and in vivo.