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Evaluation of granulocyte elastase as a seminal plasma marker for leukocytospermia
1Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Abstract:
To evaluate the relationship between concentrations of the granulocytic enzyme polymorphonuclear (PMN) elastase in seminal plasma and the presence of high numbers of white blood cells (WBC) in semen, specimens from 118 infertility patients were analyzed for each variable. PMN-elastase levels were determined by an enzyme-linked immunosorbent assay and WBC numbers by a recently described immunohistologic technique. PMN-elastase levels in seminal plasma correlated well with WBC numbers in semen (r = +0.755). A three-step grading system of PMN-elastase values as low/normal (less than 250 ng/ml), intermediate (250 to 1000 ng/ml) and high/pathologic (greater than 1000 ng/ml) showed a highly significant relationship to a similar WBC number grading system: low/normal, less than 10(5) WBC/ml, intermediate, 10(5) to 10(6) WBC/ml, and high/leukocytospermic, greater than 10(6) WBC/ml semen. Incubation of semen at 37 degrees C resulted in a slight continuous decrease of immunoreactive PMN-elastase at a rate of approximately 10% per 3 hours. As all 18 samples with more than 1000 ng PMN-elastase per ml seminal plasma showed more than 10(6) WBC/ml semen, PMN-elastase levels above 1000 ng/ml were diagnostic for leukocytospermia.
Insights
Polymorphonuclear (PMN) elastase in seminal plasma strongly correlates with white blood cell (WBC) counts in semen. High PMN-elastase levels above 1000 ng/ml are diagnostic for leukocytospermia, indicating elevated WBCs in infertile patients.
Area of Science:
- Reproductive Medicine
- Clinical Chemistry
- Immunology
Background:
- Seminal white blood cells (WBCs) can negatively impact male fertility.
- Polymorphonuclear (PMN) elastase is a granulocytic enzyme that may serve as a marker for WBCs in semen.
Purpose of the Study:
- To assess the correlation between seminal plasma PMN-elastase concentrations and WBC counts in semen.
- To determine if PMN-elastase levels can diagnose leukocytospermia.
Main Methods:
- Analyzed semen specimens from 118 infertility patients.
- Measured PMN-elastase using enzyme-linked immunosorbent assay (ELISA).
- Quantified WBC numbers using an immunohistologic technique.
Main Results:
- A strong positive correlation (r = +0.755) was observed between PMN-elastase levels and WBC counts.
- Established grading systems for both PMN-elastase and WBC counts showed significant agreement.
- PMN-elastase levels exceeding 1000 ng/ml consistently indicated the presence of over 10^6 WBC/ml, diagnosing leukocytospermia.
Conclusions:
- Seminal plasma PMN-elastase is a reliable indicator of WBC presence in semen.
- PMN-elastase levels >1000 ng/ml are diagnostic for leukocytospermia in infertile men.
- This assay provides a valuable tool for assessing semen quality and potential infertility factors.