Chlamydia trachomatis genotypes A and B from urogenital specimens of patients in Spain: molecular characterization

OBJECTIVES

Chlamydia trachomatis ompA genotypes A and B, primarily associated with trachoma, were unexpectedly detected in urogenital samples of patients in Spain, a trachoma-free country. In this study, we aimed to explain this finding using analysis of organotropism-related genes and a multilocus sequence typing (MLST) technique.

METHODS

C. trachomatis genotypes A or B were detected in 8/930 (0.9%) infection episodes between 2006 and 2012. In these strains, organotropism-related genes (polymorphic membrane protein gene H, tryptophan synthase gene A, CTA0934, and cytotoxin) were studied. Further, the strains were analysed by MLST, using a polymerase chain reaction that amplifies five highly variable genomic loci (hctB, CT058, CT144, CT172, and pbpB). Amplicons were sequenced and phylogenetic analysis was conducted.

RESULTS

Seven strains were detected in the eight infection episodes (in one patient, an identical strain being found in two episodes). Analysis of organotropism-related genes showed that these strains shared genetic features characteristic of genitotropic genotypes but not of trachoma strains. Three strains of genotype A showed a unique and new MLST-sequence type (ST551, allele profile 8-8-2-27-69). The four strains of genotype B belonged to ST138.

CONCLUSIONS

C. trachomatis ompA genotypes A and B associated with trachoma, but detected sporadically in urogenital samples in trachoma-free countries, may be the result of recombination between strains adapted to trachoma and strains adapted to sexual transmission.

Minimum spread of the new Swedish variant of Chlamydia trachomatis and distribution of C. trachomatis ompA genotypes in three geographically distant areas of Spain, 2011-2012

PURPOSE

The aim of this study was to determine the presence of the new Swedish Chlamydia trachomatis (C. trachomatis) variant (nvCT) and the distribution of C. trachomatis ompA genotypes in three geographically distant regions of Spain.

METHODS

The genotypes of strains causing 624 episodes of infection (January 2011-September 2012) were studied using a nested PCR that amplifies a fragment of the ompA gene, followed by sequencing. To detect nvCT, a real-time PCR was used that amplifies a fragment of the cryptic plasmid with a 377 base pair deletion, which identifies the nvCT.

RESULTS AND CONCLUSION

The ompA genotype was identified in 565 (90.5%) episodes. Eleven genotypes were detected, of which nine were found in all three regions. Only one nvCT strain was detected (0.4%), despite the predominance of genotype E (41%). Other frequent genotypes were genotypes D (19%), F (13%), G (11 %), and J (7%). Genotype L2b, causing lymphogranuloma venereum, was detected in men who have sex with men (MSM) in all three regions. Genotypes E and F were more frequent in women and heterosexual men, and genotypes D, G, J and L2b in MSM. In men, the main factor causing differences in the distribution of C. trachomatis was sexual behavior (MSM versus heterosexual men), while the distribution of C. trachomatis genotypes was similar in women and heterosexual men.

Measles genotypes D4 and G3 reintroduced by multiple foci after 15 years without measles virus circulation, Gipuzkoa, the Basque Country, Spain, March to June 2011

During a three-month period in spring 2011, 23 cases of measles occurred in seven independent outbreaks in a region in Spain with around 700,000 inhabitants, where the disease had been eliminated since 1997. High vaccination coverage and rapid diagnosis allowed implementation of containment measures and this prevented spread of the disease. Except for the first outbreak which affected 10 cases, each of the other six outbreaks caused a maximum of three secondary cases.

Human parechoviruses in infants with systemic infection

Human parechoviruses (HPeVs) are RNA viruses related to neonatal sepsis, meningoencephalitis and other infections in young children. Little clinical and epidemiological information is available on these viruses. HPeVs were sought in cerebrospinal fluid from 397 infants aged less than 12 months from whom a sample was obtained to exclude meningitis or encephalitis from 2006 to 2009. HPeV infections were also tested in stool samples from 271 children aged less than 3 years old with gastroenteritis from November 2008 to March 2009. HPeV detection was by real-time polymerase chain reaction assay (region 5'UTR), followed by genotyping (region VP3/VP1). HPeVs were detected in the cerebrospinal fluid of nine infants (2.3%), one aged 6 months and eight aged 14-55 days old. All were admitted to hospital for febrile syndrome with abrupt clinical deterioration and suspected systemic infection without clear laboratory signs of meningeal inflammation. The same virus was detected in all the available nasopharyngeal aspirates, stool, and/or serum samples from each patient. At least eight of the nine cases were caused by HPeV3. HPeVs were detected in stool samples from 17 children (6.3%), the most prevalent types being types 1 and 3. In conclusion, HPeV infection is common in the Basque Country (Spain) and HPeV3 is a significant cause of hospital admission due to systemic infection in the first few months of life. In these patients, HPeVs should be investigated as part of routine tests for enterovirus.

Residual immunity in older people against the influenza A(H1N1)--recent experience in northern Spain

The 2009 pandemic influenza A(H1N1) virus has a higher incidence in children and young adults, a pattern that has also been reported in seasonal influenza caused by the influenza A(H1N1)virus. We analysed age at infection in symptomatic patients with influenza in the Basque Country (northern Spain), reported through the sentinel influenza surveillance system which monitors 2.2-2.5%of the population. Between September 1999 and August 2009,influenza A(H3N2) or seasonal influenza A(H1N1) was detected in 941 patients, and from April to August 2009, pandemic influenza A(H1N1) was detected in 112 patients. The H3/H1 seasonal influenza ratio was between 3.3 and 3.4 in the under 60 year olds,but 9.8 in older individuals, suggesting that people born before 1950 have residual immunity against the influenza A H1N1 subtype (both seasonal and pandemic).

[Tracheal intubation guided by fibrobronchoscopy in patients with difficult airway. Predictive factors of the outcome]

INTRODUCTION AND OBJECTIVE

Tracheal intubation (TI) guided by fibrobronchoscopy (FB) is one of the essential techniques in the approach to the difficult airway (DAW). Few works have been published on the possible causes of TI failure with this procedure. This study aims to discover which factors could predict TI failure with FB.

MATERIAL AND METHODS

An observational and retrospective study in which the last 122 consecutive TIs guided by FB (between January 2000 and April 2008) performed by our group were included. A multivariate analysis of the factors that could influence in the outcome was conducted: cause of the DAW, TI pathway, type of endotracheal tube, elective or urgent indication of the procedure, sedation level and experience of the bronchoscopist.

RESULTS

Tracheal intubation in individuals who are going to undergo surgical interventions accounts for 92.6% of the total. The most frequent indications of TI by FB were: limitation of neck movement (60 cases), airway stenosis (24), increase of soft tissues (13), narrow oral aperture (9), airway compression (6), and vocal cord paralysis (6). In 10 (8.2%) cases, TI by FB was not possible. The variables that best predicted IT failure in the multivariate analysis were profound sedation/ general anesthesia (OR = 12.2; 95% CI, 1.8-84; p = 0.01) and limited experience of the bronchoscopist (OR = 25.3; 95% CI, 3.5-181.8; p = 0.001).

CONCLUSIONS

TI guided by FB performed by bronchoscopist is successful in more than 90% of the cases with DAW. The skill and experience of the bronchoscopist is one of the primary determining factors of success of the procedure. Profound sedation may condition TI guided by FB failure.

A swimming pool-related outbreak of pharyngoconjunctival fever in children due to adenovirus type 4, Gipuzkoa, Spain, 2008

An outbreak of pharyngoconjunctival fever affecting 59 children was detected in a municipality of northern Spain in July 2008. The outbreak was related to insufficient doses of water disinfectant in the municipal swimming pool. Adenovirus was detected in the pharyngeal swabs of five of six affected children and the four strains that were sequenced were all Adenovirus type 4.

Transbronchial Needle Aspiration of Diseased Mediastinal Lymph Nodes: Predictors of Positive Findings

OBJECTIVE

To assess the factors that may determine the effectiveness of transbronchial needle aspiration through a flexible bronchoscope in the diagnosis of diseased mediastinal lymph nodes in patients with lung or extrapulmonary tumors.

METHODS

Prospective study carried out at 2 hospitals between 1998 and 2004 that included all transbronchial needle aspirations performed on patients who had diseased mediastinal lymph nodes larger than 10 mm and nonlymphoid neoplasms. Univariate and multivariate analysis of the diagnostic results of transbronchial needle aspiration were performed according to the type and location of the primary neoplasm and the lymph node station biopsied, the diameter of the affected node, endoscopic findings, and the results of other bronchoscopic techniques.

RESULTS

The study evaluated the transbronchial needle aspiration of 230 lymph node stations in 207 patients. Histologic examination revealed 151 cases (72.9%) of non-small cell lung cancer, 42 cases (20.3%) of small cell lung cancer, and 14 cases (6.8%) of extrapulmonary cancer. The best predictors of obtaining a diagnostic sample were a diameter of the diseased node greater than 20 mm in diameter (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.7; P=.01) and a histologic diagnosis of small cell lung cancer (OR, 2.7; 95% CI, 0.9-8.2; P=.07).

CONCLUSIONS

The size of the diseased node and the tumor type are the best predictors of obtaining a diagnostic sample with transbronchial needle aspiration of diseased mediastinal lymph nodes in patients with lung or extrapulmonary tumors.

The influence of risk factors on the severity of anti-tuberculosis drug-induced hepatotoxicity

BACKGROUND

Hepatotoxicity is one of the most serious adverse effects of anti-tuberculosis drugs (ATD). Although many risk factors have been associated with ATD-induced hepatotoxicity, their influence on hepatitis severity has not been studied systematically.

OBJECTIVES

To evaluate whether the presence of hepatotoxicity risk factors (advanced age, chronic liver disease, abuse of alcohol or other drugs or malnutrition) influences the severity of ATD-induced hepatotoxicity.

DESIGN

A prospective cohort study of 471 active tuberculosis patients treated with isoniazid, rifampicin and pyrazinamide and followed in a tuberculosis clinic between January 1998 and July 2002. Incidence of hepatotoxicity and its severity according to the presence or absence of ATD-induced hepatitis risk factors was evaluated.

RESULTS

The incidence of ATD-induced hepatotoxicity (serum transaminase > 3 x the upper limit of normal [ULN]) was 18.2% (42/231 patients) in the risk factor group and 5.8% (14/240 patients) in the non-risk factor group (OR 3.5; 95% CI 1.9-6.7; P < 0.001). Severe hepatotoxicity (transaminase > 10 x ULN) occurred in 6.9% (16/231) of the risk factor group and in 0.4% (1/240) (OR 17.7; 95% CI 2.3-135; P < 0.001) of the group without risk factors.

CONCLUSIONS

ATD-induced hepatitis is significantly more frequent and more severe in patients with hepatotoxicity risk factors.

Conservation of purified protein derivative RT-23 tuberculin

OBJECTIVE

Recommendations that purified protein derivative (PPD) RT-23 tuberculin should not be kept and used more than 24 to 48 hours after opening are rarely complied with. The aim of this study was to determine whether using PPD RT-23 tuberculin from vials that had been open for a longer time could affect results of tuberculin tests and whether the solution could become contaminated.

METHODS

A prospective cross-sectional study was carried out. Two tuberculin tests were simultaneously administered, one in each forearm, to adult contacts of patients with active tuberculosis, one test using a recently opened vial of tuberculin (control) and the other using tuberculin that had been opened a week before (first phase) or a month before (second phase) (study tuberculin). Leftover tuberculin from several of the vials was cultured.

RESULTS

For the 127 patients in the first group (tuberculin opened 1 week), the mean (SD) diameter of the induration was 6.2 (6.9) mm for the study tuberculin and 6.3 (6.9) mm for the control (P=.3). For the 83 patients in the second group (tuberculin opened 1 month), the mean diameter of the induration was 5.5 (7.3) mm for the study tuberculin and 5.7 (7.3) mm for the control (P=.5). There were no differences between the number of positive tests found. None of the cultured tuberculins produced bacterial growth.

CONCLUSIONS

PPD RT-23 tuberculin does not appear to lose potency or sterility when vials have been opened for a week or a month.

[Class 1 integrons in Enterobacteriaceae and its association with multidrug resistance and conjugative plasmids]

The prevalence of antimicrobial resistance genes is a cause of concern. The combination of antimicrobial resistance genes and mobile genetic elements leads to their widespread presence in different bacterial species, in which integrons are a new and important element. We studied the presence of integrons in 123 unrelated enterobacteria and identified them in 20.3% of the strains. The combination of integrons and multidrug resistance was shown to be statistically significant (p <0.001). Integron-positive isolates were statistically (p <0.05) more likely to be resistant to amoxicillin-clavulanic acid, quinolones and trimethoprim-sulfamethoxazole. All the integrons were identified in conjugative plasmids. The prevalence of integrons increased from 21.2% in 1992-1994 to 72% in 1995-1997 (p <0.001). The aacC1 and aacC2 genes were identified in 80% of the integrons. The relationship between integrons and conjugative plasmids is a matter of concern because it could contribute to the dissemination of antimicrobial resistance genes among different bacterial populations.

Lack of relationship between infection by Helicobacter pylori and vomiting that usually occurs during pregnancy, although possible relationship with severe forms of emesis

OBJECTIVE

It has been reported that infection by Helicobacter pylori may cause severe vomiting during pregnancy (hyperemesis gravidarum). Two studies were carried out in order to examine the relationship between this infection and less severe vomiting.

DESIGN AND METHODS

The first study was a retrospective study involving 3438 women who required admission to the hospital during pregnancy. In 178 women, vomiting was recorded as one of the diagnoses at the time of discharge. In 162 of these women, a serum specimen was available to study the presence of anti-Helicobacter pylori antibodies (anti-HP Ab). The second study examined the presence of vomiting and anti-HP Ab in an additional 250 pregnant women who were admitted to the Maternity Ward for childbirth. In this study, the duration and intensity of emesis during the previous months was recorded.

RESULTS

In the first study, no significant difference was found between the prevalence of anti-HP Ab in the 162 women in the study and a control group of women without emesis (43.2 vs 42.9%, p = NS). In the second study, there was no significant difference in seroprevalence between the women with emesis and the control group without vomiting, with the exception of the more severe cases (anti-HP Ab 77.8%, p < 0.05).

CONCLUSION

The results of this study do not show that there is a relationship between infection by Helicobacter pylori and less severe vomiting during pregnancy. Nevertheless, we believe that additional studies should carried out in order to determine the relationship between the more severe cases of emesis during pregnancy and this treatable infection.

Fat embolism and related effects during reamed and unreamed intramedullary nailing in a pig model

OBJECTIVES

To determine whether reamed or unreamed femoral intramedullary nailing is more adverse to pulmonary function, the authors compared three populations of healthy pigs, analyzing the biochemical and hemodynamic effects related to fat embolism. Likewise, the authors histologically evaluated the presence of bone marrow fat embolism in lungs, heart, kidney, brain, and retina.

DESIGN

Randomized, experimental model.

SETTING

Laboratory.

PARTICIPANTS

Twenty-five male Duroc Jersey adult healthy pigs divided in three groups.

INTERVENTION

Reamed and unreamed intramedullary nailing.

OUTCOME MEASUREMENTS

Biochemical, hemodinamical, and histologic analysis.

METHODS

In the first group of ten pigs, a reamed nail was inserted; in the second group of ten specimens, the authors placed an unreamed nail; and in the third group of five animals (control), only the surgical approach was made without opening the medullary cavity.

RESULTS

The authors did not find statistically significant differences in pulmonary function between the reamed and unreamed group in the hemodynamic, biochemical, and histopathologic parameters evaluated. The histologic analysis of the lung tissue revealed a statistically significant difference between the nailed groups and the control (P < 0.04).

CONCLUSIONS

In this animal model, the results indicate that pulmonary changes and fat embolization during intramedullary nailing occur to the same degree in reamed and in unreamed femurs.

High proportion of pharyngeal carriers of commensal streptococci resistant to erythromycin in Spanish adults

The presence of erythromycin-resistant (ErR) commensal streptococci in the throat of 110 healthy subjects and 87 patients with pharyngitis was investigated. The resistance determinants were studied by PCR using the primers for mef and erm genes, followed by hybridization and sequencing analysis. Overall, 94.4% of the subjects carried one or more ErR strains in their pharynx. A total of 253 ErR strains was studied: 127 (50.2%) showed constitutive or inducible resistance to clindamycin (MLS(B) phenotype) and 126 (49.8%) were susceptible to clindamycin (M phenotype). In 50 subjects (25.4%) both phenotypes were detected. The ermB gene was predominant among the MLS(B) phenotype strains (97.6%). The mefA (mefA/mefE) gene was detected in 100% of the strains with the M phenotype. One Streptococcus oralis strain bearing the MLS(B) phenotype carried both mefA and ermB genes. The mefA gene from clinical isolates of Streptococcus mitis and S. oralis was transferred by conjugation to an erythromycin-susceptible Streptococcus pneumoniae strain.

Disseminated infection and colonization by Scedosporium prolificans: a review of 18 cases, 1990-1999

Scedosporium prolificans infection was analyzed in 18 patients from whom the fungus was isolated during the period 1990-1999. Of these 18 patients, 12 had some predisposing factor and either unconfirmed infection or colonization, and 6 patients had confirmed disseminated infection: 4 patients with leukemia died, 1 patient with breast cancer who underwent autologous bone marrow transplantation survived, and 1 patient with advanced acquired immunodeficiency syndrome died, although the fungal infection did not seem to affect his clinical symptoms.

[Hematogenous meningitis caused by Staphylococcus aureus with sacro-iliitis and multiple abscesses. An infrequent association]

INTRODUCTION

Meningitis due to Staphylococcus aureus (MSA) is an uncommon infectious condition. It forms from 1-9% of all cases of bacterial meningitis, and is characterized by a high morbidity and mortality. Ever since the first publications dealing with this type of meningitis, two basic mechanism have been described for the development of this infection: post-neurosurgical and hematogenous, also known as spontaneous.

CLINICAL CASE

Our objective is to present the case of a 65 year old woman who developed hematogenous Staphylococcus aureus meningitis, without any predisposing factors. During clinical investigation, the meningeal infection was seen to be associated with septic arthritis of the right sacro-iliac joint (shown on isotope studies) and with retro-peritoneal and gluteal abscesses (shown on computerized tomography). In this patient the pathological findings were: MSA, retroperitoneal and gluteal abscesses, and unilateral sacro-ileitis. To date such a combination has not been described (Medline search from January 1982 up to june 1996).

CONCLUSIONS

After analysis of the pathogenic findings of the MSA directly involved in this case we conclude by emphasizing the following points: 1. It is very important to make a thorough search for a primary infectious focus responsible for MSA, completing the physical examination of the patient with imaging techniques (conventional radiology, CT, isotope studies, etc.). 2. Depending on the primary focus found in an MSA, antibiotic treatment may sometimes have to be complemented by other methods of treatment to avoid subsequent complications.

Allogeneic blood cell transplantation without posttransplant colony-stimulating factors in patients with hematopoietic neoplasm: a phase II study

PURPOSE

There is limited experience with allogeneic blood cell transplantation (BCT). In an earlier pilot study, the combination of bone marrow and blood did not produce severe acute graft-versus-host disease (GVHD). We now report the results of a phase II study using blood stem cells alone in 19 patients.

PATIENTS AND METHODS

The median age was 40 years. All patients had hematopoietic malignancies and received transplants from HLA-identical sibling donors. GVHD prophylaxis consisted of cyclosporine plus prednisone. Posttransplant colony-stimulating factors were not administered. Donors were mobilized with subcutaneous granulocyte colony-stimulating factor (G-CSF; 16 microg/kg/d) for 5 days. Apheresis was performed on 2 consecutive days.

RESULTS

The median cell content of the two apheresis was 11.9 x 10(8) WBC/kg, 3.2 x 10(8) CD3/kg, and 8.3 x 10(6) CD34/kg. The median time to achieve an absolute neutrophil count (ANC) > or = 500/microL was 13 days, and 14 days to a platelet count > or = 50,000/microL. All patients engrafted. Platelet recovery was faster in marrow historic control groups. Blood cells in all tested cases contained more than 95% donor cells on day 30. The actuarial incidence of acute GVHD was 37%, and 13% for grade II-IV GVHD. Limited, corticosteroid responsive, chronic GVHD developed in 33% of assessable patients. At a median follow-up of 192 days, actuarial survival was 75%.

CONCLUSION

Transplantation of a high number of stem cells may lead to rapid engraftment without the use of posttransplant colony-stimulating factors. GVHD does not appear to be more severe than in similarly treated patients undergoing bone marrow transplantation. For allogeneic transplantation, mobilized blood cell collections are an alternative to bone marrow collections.

Allogeneic transplantation combining mobilized blood and bone marrow in patients with refractory hematologic malignancies

BACKGROUND

Mobilized blood stem cells have been used successfully in autologous transplant recipients to reduce the complications of pancytopenia due to dose-intensive chemotherapy. Reports of cytokine-mobilized blood progenitor cells in allogeneic transplant recipients are rare.

STUDY DESIGN AND METHODS

This is a pilot trial of six patients. Patients with advanced hematologic malignancy received bone marrow (median total 2.6 x 10(8) mononuclear cells/kg) followed by four daily transfusions of blood (median total 9.5 x 10(8) mononuclear cells/kg) from HLA-matched sibling donors who were mobilized with recombinant human granulocyte-colony-stimulating factor (5 micrograms/kg/day subcutaneously for 5 days). All patients received cyclosporine and prednisone for graft-versus-host disease (GVHD) prophylaxis.

RESULTS

An absolute neutrophil count greater than 500 per mm3 was achieved on Day 12, and platelet transfusion independence was achieved on Day 16. The median day of hospital discharge was Day 23 after transplant. All patients achieved 100-percent donor cell engraftment. Acute > or = Grade III GVHD did not develop in any patients, but all patients developed Grade I (n = 4) or Grade II (n = 2) acute GVHD. Chronic extensive GVHD developed in four of six patients. One patient died of pneumonia 263 days after transplant while undergoing immune-suppressive therapy for chronic GVHD.

CONCLUSION

The transfusion of blood stem cells in patients undergoing allogeneic bone marrow transplant is well tolerated soon after transplant, but the development of chronic GVHD may limit the general usage of unmanipulated blood stem cells.

Further characterization of a model system for the study of human epididymal physiology and its relation to sperm maturation

Some preliminary speculations about the possible participation of epididymal antigens in sperm function may be supported by the above data. On the one hand, the reduction in the amount of antigens and their abnormal localization on spermatozoa from infertile patients may be coincident with our view about participation of epididymal antigens in the development of zona pellucida binding ability and fertilizing capacity by spermatozoa during maturation. This hypothesis is derived from experiments showing that immature hamster spermatozoa gain their ability to recognize and bind to zona pellucida and to penetrate homologous oocytes when exposed to preparations enriched in androgen-dependent epididymal secretory proteins or preincubated in conditions that favor their interaction with these proteins. Supporting our viewpoint for such a role in humans is evidence showing the progressive development of the ability to interact with hamster denuded oocytes as human spermatozoa pass along the epididymis. On the other hand, the apparent correlation between the loss of epididymal antigens during capacitation and the increased fertilization of human oocytes in vitro may be reminiscent of the removal of a decapacitation or acrosome stabilizing factor known to occur in many species and that must be removed prior to fertilization. Pending further understanding of their physiological role, the androgen-dependent epididymal proteins may become a useful marker of epididymal function and/or of sperm capacitation in humans. Within this context, we wish to stress the potential value of the model system that we have developed for the study of human epididymal physiology.

Identification of androgen-induced proteins in human epididymis

Androgenic stimulation (0.1 microM testosterone or 5 alpha-dihydrotestosterone in the medium) of cultured human epididymal tubules increased the synthesis of five proteins, identified by their mobility relative to albumin (Ra) in polyacrylamide gels as 0.31, 0.43, 0.67, 0.81 and 1.01. This effect was inhibited by the simultaneous presence of 10 microM cyproterone acetate in the medium. The caput epididymidis was the most active region in the production of these proteins and a gradient of decreasing activity was found in successive segments. The appearance of induced proteins in the culture medium suggests their secretory nature, while some data indicate that androgens may also affect the secretory process. Bands corresponding to Ra 0.31, 0.43, 0.68 and 1.01 were found in caput and cauda epididymidis fluids, while bands coincident with Ra 0.31 and 0.43 were consistently found in extracts (0.5 M NaCl) of caudal spermatozoa. Preliminary determinations of molecular weight and isoelectric point for the different bands yielded the following results: Ra 0.31, 38,000 and 5.8; Ra 0.43, 21,000 and 6.2; Ra 0.68, 69,000 and 5.1; Ra 0.81, 13,900 and 6.8; and Ra 1.01, 29,000 and 6.8.

Addition of an androgen-free epididymal protein extract increases the ability of immature hamster spermatozoa to fertilize in vivo and in vitro

The fertility of spermatozoa from the different epididymal segments of hamsters was tested by in-vivo insemination. Caput and proximal corpus spermatozoa were non-fertile; spermatozoa from the distal corpus epididymidis fertilized 13% (38/290) oocytes and those from the proximal and distal cauda epididymidis 71 and 87%, respectively. When tested by in-vitro insemination, distal corpus spermatozoa penetrated 44% of oocytes while those from the distal cauda fertilized 87% of oocytes. Spermatozoa from the distal corpus recovered in Medium BMOC fertilized 13% (28/219) of oocytes in vivo, while those mixed with an epididymal protein preparation (0.8 mg protein/ml) fertilized 24% (49/204; P less than 0.01) of oocytes. When distal corpus spermatozoa were inseminated in vivo with 0.8 mg epididymal protein preparation 34% (31/90) oocytes were fertilized and only 22% (23/103; P less than 0.05) oocytes were fertilized when the proteins were obtained from epididymides of animals castrated for 30 days. When distal corpus spermatozoa were preincubated for 5 h in medium without (control) or with protein preparation (0.8 or 1.6 mg protein/ml), a significant increase in in-vitro oocyte penetration was found (25 compared with 45%; P less than 0.05) when the protein was present at 1.6 mg/ml. These results confirm and extend previous observations suggesting a role for androgen-dependent glycoproteins secreted by the epididymis in the acquisition of fertilizing ability that occurs during sperm maturation.

Epididymal proteins mimic the androgenic effect on zona pellucida recognition by immature hamster spermatozoa

The increase in zona pellucida binding caused by the exposure of cultured proximal corpus epididymidis to 2 microM-5 alpha-DHT (0.87 and 4.29 spermatozoa/egg for control and 5 alpha-DHT group respectively) was lost when 20 microM-cycloheximide was also added to the medium (0.72 spermatozoa/egg). These results were interpreted as meaning that de-novo protein synthesis was required to obtain the effect of androgens. When a fraction enriched in epididymal glycoproteins EP2-EP6 (18% total protein in epididymal cytosol and 30% in enriched fraction) and depleted of androgens (less than 120 pg testosterone + DHT/ml) was added to the cultured epididymal tubules, the zona pellucida-binding ability of the contained spermatozoa increased from 0.55 in controls to 2.73 spermatozoa/egg in the extract-treated group (P less than 0.02). When the enriched fraction was prepared from epididymides of 30-day castrates, the stimulatory effect was lost (1.04 spermatozoa/egg). We suggest that proteins synthesized in the epididymis are required to obtain the effect of androgens and that the glycoproteins EP2-EP6 may be involved.

Androgen-controlled synthesis of specific proteins in the rat epididymis

Previous investigations have established the production of specific epididymal proteins (SEP) in the rat which become attached to the sperm surface as these cells pass along the duct. The present study is concerned with the regulation of SEP synthesis by androgens. For this purpose, we determined the concentrations of SEP and protein DE, one of its main components (40%), during sexual maturation, after castration with and without androgen administration, and after ligation of the efferent ductuli in rats. SEP were first detectable at 25 days of age and attained adult values at 60-90 days of age. Protein DE behaved similarly. Castration of the adult rat led to a decrease in SEP and DE concentrations. The fall was more rapid and marked in the caput than in the caudal segments. SEP synthesis seemed to stop promptly after castration; the different rates of decrease of SEP in caput and cauda may reflect different rates of exit of spermatozoa from those segments. SEP and DE concentrations in castrated rats were increased by the administration of testosterone (100 micrograms/day). The SEP concentration was increased after 4 days and restored to control values after 11 days of treatment. Testosterone and 5 alpha-dihydrotestosterone were equipotent in inducing SEP and DE synthesis, while 5 alpha-androstandiols were less potent. The effects of androgens were significantly reduced by the simultaneous administration of cyproterone acetate. We propose that SEP is a suitable marker for following the action of androgens in the epididymis.