Showing papers by "S. La Vignera published in 2011"

Male accessory gland infection and sperm parameters (review).

Abstract: Summary Male accessory gland infection (MAGI) has been identified among those diagnostic categories which have a negative impact on the reproductive function and fertility in males (Rowe et al., World Health Organization Manual for the Standardised Investigation and Diagnosis of the Infertile Couple, Cambridge University Press, Cambridge, 1993). MAGI is a hypernym which groups the following different clinical categories: prostatitis, prostate-vesiculitis and prostate-vesiculo-epididymitis. Some of the characteristics they share are: common diseases, mainly have a chronic course, rarely cause obstruction of the seminal pathways, can have an unpredictable intracanicular spread to one or more sexual accessory glands of the reproductive tract, as well as to one or both sides. In this review, we show that all components involving the inflammatory response (from the agents which first trigger it to each component of the inflammatory response dynamic) can deteriorate conventional and/or non-conventional sperm parameters arising from one or more of the following mechanisms: altered secretory function of the epididymis, seminal vesicles, and prostate which reduce the antioxidant properties or scavenging role of the seminal plasma; deterioration of spermatogenesis; and (unilateral or bilateral) organic or functional sub-obstruction of the seminal tract.

Effects of myoinositol on sperm mitochondrial function in-vitro.

Abstract: Background and Objectives: Inositol is a component of the vitamin B com - plex. Myo-inositol (MYO) is the most biologically important form in nature. It is involved in several systemic processes and in mechanisms of sig - nal transduction in the plasma membrane as precursor of second messengers. On the male reproductive function, MYO appears to regulate seminal plasma osmolarity and volume; the ex - pression of proteins essential for embryogenetic development and sperm chemiotaxis; and sperm motility, capacitation, and acrosome reaction. Recently, a seminal antioxidant action has also been suggested. Aim of the Study: To evaluate the effects of MYO on sperm mitochondrial function and apop - tosis. Materials and Methods: Spermatozoa isolat - ed from 5 normozoospermic men and from 7 pa - tients with oligo-astheno-teratozoospermia (OAT) were incubated in-vitro with 2 mg/ml of MYO or placebo (control) for 2 hours. After this incubation period, the following sperm parame - ters were evaluated by flow cytometry: mito - chondrial membrane potential (MMP) by JC-1 staining; phosphatidylserine (PS) externalization by annexin V and propidium iodide double stain - ing; and chromatin compactness following pro - pidium iodide staining. Results: MYO did not affect the mitochondrial function of spermatozoa isolated from normo - zoospermic men, whereas it increased signifi - cantly the number of spermatozoa with high MMP and decreased significantly the number of those with low MMP in OAT patients. No effect of MYO was observed on PS externalization and chromatin compactness in both normozoosper - mic men and OAT patients. Conclusion: The data suggest that MYO is able to ameliorate mitochondrial function in OAT patients. We conclude that this compound may be useful for the treatment of male infertility.

Environmental car exhaust pollution damages human sperm chromatin and DNA

Abstract: Objective: The adverse role of traffic pollutants on male fertility is well known. Aim of this study was to evaluate their effects on sperm chromatin/DNA integrity. Methods: To accomplish this, 36 men working at motorway tollgates and 32 unexposed healthy men (controls) were enrolled. All of them were interviewed about their lifestyle. Hormone, semen samples, and environmental and biological markers of pollution were evaluated. Sperm chromatin and DNA integrity were evaluated by flow cytometry following propidium iodide staining and TUNEL assay, respectively. Results: LH, FSH, and testosterone serum levels were within the normal range in tollgate workers. Sperm concentration, total sperm count, total and progressive motility, and normal forms were significantly lower in these men compared with controls. Motorway tollgate workers had a significantly higher percentage of spermatozoa with damaged chromatin and DNA fragmentation, a late sign of apoptosis, compared with controls. A significant direct correlation was found between spermatozoa with damaged chromatin or fragmented DNA and the length of occupational exposure, suggesting a time-dependent relationship. Conclusion: This study showed that car exhaust exposure has a genotoxic effect on human spermatozoa. This may be of relevant importance not only for the reproductive performance of the men exposed, but also for the offspring health.

Obesity is associated with a higher level of pro-inflammatory cytokines in follicular fluid of women undergoing medically assisted procreation (PMA) programs.

Abstract: Introduction: Cytokines are glycoproteins that modulate reproductive func- tion through a series of various mechanisms (by both conditioning gonadal steroidogenesis and contributing to the preservation of an inflamma- tory microenvironment). Aim of the Study: To evaluate the impact of certain clinical variables (i.e., age, obesity, in- sulin resistance index, serum antithyroid anti- bodies serum levels) on the serum concentra- tions of cytokines TNF-alpha, IL-6, and IL-10 in the follicular fluid of women undergoing a med- ically assisted procreation (PMA) cycle. Materials and Methods: A total of 40 female patients undergoing an intracytoplasmic sperm in- jection (ICSI) in oocytes, following ovarian stimula- tion by purified FSH and hCG carried out after sup- pression of ovarian function. The follicular fluid, obtained by surgical ultrasonography-guided with- drawal, was stored at -30 degrees C. Subsequently the cytokines were assayed by ELISA technique. Results: Women suffering from class II obesity showed follicular levels of TNF-alpha significantly higher (p 2.5. Women clinically present- ing with concomitant obesity and high serum lev- els of antithyroid antibodies were found to have higher follicular levels of TNF-alpha and IL-6 (p <0.05) in comparison with women suffering from obesity only or low antithyroid antibodies levels only, or from both these conditions. Conclusion: Obesity is a common clinical condition associated with a higher concentra- tion of inflammatory substances in the follicular fluid of infertile women. It is not understood, as yet, the possible pejorative role exerted by the presence of other clinical conditions, such as in- sulin resistance and high levels of antithyroid antibodies, that are conditions frequently en- countered in the clinical practice.

Hypertrophic-congestive and fibro-sclerotic ultrasound variants of male accessory gland infection have different sperm output.

Abstract: Introduction: Male accessory gland infection (MAGI) exerts a negative influence on male fertility which depends upon its extension. Indeed, we have shown that patients with MAGI involving prostate, seminal vesicles and epididymis have worse sperm parameters compared with patients with prostatitis alone or prostate-vesiculitis. Similarly, MAGI extending bilaterally is associated with a worse sperm output. The aims of this study were to evaluate the prevalence of two different additional ultrasound (US) findings (hypertrophic-congestive and a fibro-sclerotic US form) and to evaluate their semen quality. Materials and methods: One hundred infertile patients with MAGI, diagnosed according to the World Health Organization (WHO) 1993 criteria, were evaluated by scrotal and transrectal ultrasound scans. The control group consisted of 100 healthy, age-matched men. Results: The ultrasound examination confirms two separate US variants of MAGI: a hypertrophic-congestive (prevalence of 56%) and a fibro-sclerotic form (prevalence of 29%). Patients with hypertrophic-congestive MAGI showed higher sperm concentration, motility and normal forms, but also higher sperm leukocytes concentration and seminal reactive oxygen species compared to patients with fibro-sclerotic MAGI. However, all these parameters were significantly worse than those observed in the control group. Discussion: Infertile patients with hypertrophic-congestive MAGI have a better sperm quality compared with patients with fibrosclerotic MAGI; however, they showed higher oxidative stress in semen.

Endothelial apoptosis decrease following tadalafil administration in patients with arterial ED does not last after its discontinuation

Abstract: Although it is well known that phosphodiesterase V inhibitors, used to treat patients with ED, can improve the endothelial dysfunction in organic vascular forms, few studies have explored the duration of their effect on the endothelium after discontinuation. Therefore, the purpose of this study was to evaluate the serum concentrations of apoptotic endothelial microparticles (EMPa), selected as a marker of endothelial damage, in patients with arterial ED at baseline, during tadalafil administration and 3 and 6 months after its discontinuation. In all, 50 patients with arterial ED were evaluated at baseline and 1 week after administration of tadalafil 5 mg once daily for 90 days. Clinical (International Index of Erectile Function-5 score), instrumental (dynamic penile echo color Doppler) and flow-cytometric (serum EMPa concentrations) analyses were performed before (T0) and 1 week (T1), 3 months (T2) and 6 months (T3) after tadalafil discontinuation. The events CD45neg/CD144pos/annexinVpos were defined as EMPa. At T0, patients with arterial ED had serum EMPa concentration significantly higher than 20 healthy men (controls). At T1, patients with arterial ED showed a serum EMPa concentration significantly lower than T0. The significant difference was maintained, though reduced, at T2 and completely lost at T3. In conclusion, the administration of tadalafil decreased serum EMPa concentration in patients with arterial ED. This positive effect on the endothelial dysfunction disappeared 6 months after tadalafil discontinuation.

Effects of anti-neoplastic treatment on sperm aneuploidy rate in patients with testicular tumor: a longitudinal study

Abstract: Objective: The adjuvant radio/chemotherapy, usually employed after orchidectomy in patients with testicular tumors, allows a long-term survival with a consequent increased request for fertility. However, little is known about the effects of the anti-neoplastic treatment on sperm cytogenetic asset. Therefore, this prospective, longitudinal study was designed to evaluate the effects of radio- and/or chemotherapyon sperm chromosome. Methods: Eleven patients with testicular tumor were enrolled and underwent sperm aneuploidy rate evaluation before and after 3, 6, 9, 12, 18, 24, and 36 months from radio- and/or chemo-therapy ending. A double and triple multicolor fluorescence in-situ hybridizations for chromosomes 8, 12, 18, X and Y were used to evaluate the sperm aneuploidy rate. To define normal sperm aneuploidy rate, 18 healthy, normozoospermic men were selected as controls. Results: Before treatment, testicular tumor patients had a higher total sperm aneuploidy rate compared with normal men. Total sperm aneuploidy rate showed a slight, but statistically significant increase 6 months after anti-neoplastic treatment. This increase was mainly related to the high sperm aneuploidy rate found in 2 patients which remained elevated up to 12 months in both of them. Conclusion: These results showed that anti-neoplastic treatment caused only slight and transient sperm malsegregation events in patients with testicular tumor. However, since a subset of them had an elevated sperm aneuploidy rate for about 1 yr, we suggest to counsel them to refrain from fatherhood for this length of time.

Arterial erectile dysfunction: reliability of new markers of endothelial dysfunction.

Abstract: Objective: Blood endothelial progenitor cells (EPC) and microparticles (EMP) have been proposed as markers of endothelial dysfunction. Aim of this study was to evaluate a new immunophenotype of EPC and EMP in patients with arterial erectile dysfunction (AED) compared to psychogenic erectile dysfunction (PED). Materials and methods: One hundred patients (63.2±2.6 yr) with AED were enrolled in this study. Their EPC and EMP concentrations were compared to those of 40 patients with PED (64.2±2.7 yr). EPC (CD45neg/CD34pos/CD144pos) and EMP (CD45neg/CD144pos/AnnexinVpos) blood concentrations were evaluated by flow cytometry. Results: Patients with AED had significantly higher blood pressure, triglyc-erides, homeostasis model assessment index of insulin resistance, and cavernous artery acceleration time and intima-media thickness than PED; whereas international index of erectile function 5 score, HDL-cholesterol, and cavernous artery peak systolic velocity was lower than PED. Both EPC and EMP were significantly higher in patients with AED compared to patients with PED. Conclusions: Patients with AED showed worse metabolic parameters, cavernous artery parameters, and higher EPC and EMP compared to patients with PED. This suggests that AED is an expression of endothelial dysfunction and that EPC and EMP may be considered predictors of endothelial dysfunction in patients with AED.

Understanding polycystic ovarian syndrome pathogenesis: An updated of its genetic aspects

Abstract: Polycystic ovary syndrome (PCOS) is the most frequent cause of female infertility It is also characterized by metabolic defects that raise the risk for cardiovascular disease Despite the progress in the definition of the clinical aspects of the syndrome, only very few definite data are available about the ethiopathogenetic mechanisms that subtend PCOS It is likely that the PCOS phenotype derives from the interaction between environmental and genetic factors While environmental factors have easily been investigated, the individuation of the genetic factors seem to be more complex Indeed, PCOS appears to be inherited as a complex, polygenic trait Several family studies have been conducted with the aim to clarify the genetic aspects of PCOS, but their findings are often conflicting and not conclusiveMoreover, it is difficult to establish with certainty which genes are involved and their effective role in the development of the syndrome because in PCOS, genetic analysis is hampered by low fecundity, lack of a male phenotype, absence of an animal model, and dissimilarity of the diagnostic criteria used to select the patients Since multiple biochemical pathways are implicated in PCOS pathogenesis, genes of steroid hormone metabolism, gonadotropin release and action, insulin secretion and action, adipose tissue metabolism and others have been investigated Nevertheless, none of them seems to play a key role in the ethiopathogenesis of PCOS This article reviews the large body of literature generated to support the presence of genetic abnormalities in PCOS women by taking in consideration the most important studies regarding PCOS candidate genes

Increased expression of endothelial-platelet dysfunctional pathway in patients with arterial erectile dysfunction.

Abstract: Aim Pathophysiological externalization of specific substances belonging to the vessel wall (after endothelial injury), usually not in contact with the blood (subintimal area) is the signal which is captured by surface receptor platelet's results in their adhesion. There are no studies that have so far examined the expression of these receptors in patients with arterial erectile dysfunction (ED). The aim of this study was to assess by flow cytometry, serum concentration of apoptotic endothelial microparticles (EMPa) and vitronectin receptor (VR) in a selected series of patients with arterial ED and without apparent other sistemic arterial involvement. Methods Evaluated consecutively 50 selected patients with arterial ED-based (mean IIEF-5 score of 6.3±0.3 and mean peak systolic velocity of 24.5±0.6 cm/s). Evaluation of EMPa and VR was conducted using a flow cytometer. The events CD45neg-CD144pos-annexinVpos were defined EMPa, while events CD51pos-CD61pos-CD41neg were defined VR. Results Patients with arterial ED had a serum baseline concentrations of circulating EMPa (12.2±2.2% vs. 1.8±0.4%) and VR (7.4±1.2% vs. 1.2±0.2%) significantly higher than control group. Conclusion The present study shows that patients with arterial ED had an increased expression of endothelial apoptosis and initial platelet adhesion.

New immunophenotype of circulating endothelial progenitor cells and endothelial microparticles in patients with erectile dysfunction and metabolic syndrome: effects of tadalafil administration.

Abstract: Aim Circulating endothelial progenitor cells (EPCs) and endothelial microparticles (EMPs) increase, respectively, in the attempt to repair the damaged endothelium and in response to endothelial dysfunction Erectile dysfunction (ED) of arterial origin recognizes endothelial dysfunction as one of its main determinants and shares risk factors and physiopathological evolution with the metabolic syndrome (MetS) Tadalafil, selective inhibitor of phosphodiesterase V, long half-life, is used to treat erectile dysfunction, and several studies have already documented the beneficial effects on endothelial dysfunction The aim of this paper was to evaluate the concentrations of EPCs and EMPs in patients with arterial ED and MetS, before and after tadalafil administration, and in healthy men Methods Thirty patients (47-54 years) with ED and MetS (ATP III 1999 criteria) and 17 healthy men (44-57 years) were selected EPCs (CD45neg/CD34pos/CD144pos) and EMPs (CD45neg/CD34neg/CD144pos) blood concentrations were evaluated by flow cytometry before and after administration of tadalafil (20 mg) on demand for 3 months After treatment, the patients were divided into responders and poor responders, according to their IIEF-5 score Main outcome measures Blood EPCs and EMPs Results Before treatment, the percentage of EPCs and EMPs was significantly higher in patients with ED and MetS compared to healthy men Treatment with tadalafil increased significantly EPCs in both responders and poor responders The latter had significantly higher EPCs compared to responders, both before and after tadalafil Before tadalafil, EMPs were higher, but not significantly, in poor responders vs responders No significant change occurred after tadalafil administration in both responders and poor responders A significant positive correlation was found between EPCs and age, Body Mass Index (BMI), acceleration time, IMT and EDV; whereas a negative correlation was found with IIEF-5 score, PSV and resistance index EMPs correlated positively with BMI, acceleration time and IMT and negatively with the IIEF-5 score Conclusion Tadalafil increased the percentage of EPCs in both responders and poor responders, suggesting the persistence of an adequate bone marrow response The unchanged EMP concentrations after tadalafil suggest a reduction of the dysfunctional mechanism