Mechanism of Mechanism of immune infertilityimmune infertility ＆＆

sterilitysterility --Anti-sperm --Anti-sperm

immunityimmunity

Group member:Group member: 赵学英，杨赵学英，杨晓艳，张珍，闵亚楠，阎娜，晓艳，张珍，闵亚楠，阎娜，

郑荣华，臧文，孟菲郑荣华，臧文，孟菲

Do you know ?Do you know ?

Definition of Immune Definition of Immune infertility and sterility:infertility and sterility:

Under normal sex actions, a Under normal sex actions, a few people can generate few people can generate immune responses against immune responses against any step of the reproductive any step of the reproductive courses ,as a result ,the courses ,as a result ,the couple fail to have a baby couple fail to have a baby within two years. within two years.

Immune infertility and Immune infertility and sterilitysterility

Anti-sperm immunityAnti-sperm immunityAnti-zona pellucida Anti-zona pellucida

immunityimmunity

Anti-sperm Anti-sperm immunityimmunity

Anti-sperm HIAnti-sperm HIAnti-sperm CMIAnti-sperm CMI

Anti-sperm immune Anti-sperm immune responseresponse

一、一、 Antigens in SemenAntigens in Semen After centrifugation, human After centrifugation, human

semen can be divided into semen can be divided into human seminal plasma human seminal plasma (HSP) and sperm. Both (HSP) and sperm. Both of them have many of them have many types of antigens.types of antigens.

HSP AgsHSP Ags Sperm AgsSperm Ags

HSP AgsHSP Ags

11 、、 blood type antigen blood type antigen In semen there are AIn semen there are A 、、 B and B and

O blood type antigens. These O blood type antigens. These antigens have no relationship antigens have no relationship with auto-sensitization.with auto-sensitization.

22 、、 HLA antigenHLA antigen HLA antigen is a type of HLA antigen is a type of

leukocyte antigen. It is widely leukocyte antigen. It is widely distributed in all tissues. So is distributed in all tissues. So is the semen.the semen.

HSP AgsHSP Ags

33 、、 Other antigens:Other antigens:

There are another 10 more There are another 10 more antigens in semen, of which most antigens in semen, of which most can be detected in serum , such can be detected in serum , such as albumin, globulin and so on.as albumin, globulin and so on.

Sperm antigenSperm antigen 11 、、 Sperm membrane antigen and Sperm membrane antigen and

sperm surface antigensperm surface antigen

It’s confirmed that some glucosyl(It’s confirmed that some glucosyl( 糖糖基基 ) on the sperm surface , such as ) on the sperm surface , such as galactosegalactose （半乳糖） （半乳糖） , N-, N-acetylgalactosamineacetylgalactosamine （（ N-N- 乙酰糖胺）乙酰糖胺） , , ect, paly a key role in recognition ect, paly a key role in recognition reaction. What’s more, they’re the reaction. What’s more, they’re the determinate cluster of sperm Ag. determinate cluster of sperm Ag. Besides, many Ag components in Besides, many Ag components in seminal plasma can adhere to sperm seminal plasma can adhere to sperm surface. surface.

Sperm antigenSperm antigen

22 、、 Ag in sperm cytoplasmaAg in sperm cytoplasma

The sperm head plasma The sperm head plasma contains sperm protein .When contains sperm protein .When the sperm is damaged, the the sperm is damaged, the sperm protein is revealed as Ag. sperm protein is revealed as Ag.

Sperm antigenSperm antigen

33 、、 Sperm nuclear Ag Sperm nuclear Ag

Sperm nuclear Ag includes the Sperm nuclear Ag includes the yujing proteinyujing protein 、、 yujing protein-2 yujing protein-2 and DNA-pol in the nucleus. It is and DNA-pol in the nucleus. It is the specific Ag of sperm. the specific Ag of sperm.

Sperm protection Sperm protection mechanism in malemechanism in male

11 、、 Natural barrierNatural barrier 1)1) blood-testis barrierblood-testis barrier :The basal part :The basal part

of adjesent supporting cells connect of adjesent supporting cells connect tightly ,which provents sperm to tightly ,which provents sperm to contact with immune system ,so that contact with immune system ,so that the lymphocyte can not come across the lymphocyte can not come across sperm.sperm.

22)blood-epididymis barrier)blood-epididymis barrier :The :The epithelium cells connect tightly to epithelium cells connect tightly to separate sperm from systemic separate sperm from systemic circulation. circulation.

Sperm protection Sperm protection mechanism in malemechanism in male

3)3)mucosal-associated lymphoid mucosal-associated lymphoid tissuetissue in testis and epididymis secret in testis and epididymis secret low level of IgG and a large amount of low level of IgG and a large amount of sIgA, as a result , pathogens can not sIgA, as a result , pathogens can not enter testis and epididymis and sperm enter testis and epididymis and sperm is protected.is protected.

Sperm protection mechanism in male• 2 、 Immunocytes• 1) Microfold cell :It exists in

reproductive tract mucosa ,which can capture and transport Ag to imunocytes , inducing immune response

• 2)MФ: in reproductive and testis interstitial tissue ,which can swallow,process and present Ag to T cells.

Sperm protection mechanism in male

3) lymphocyte barrier

T cells and B cells in testis interstitial tissue form a lymphocyte barrier

which protect sperm from immuncytes in humoral fluid

Sperm protection mechanism in male

3 、 Special cells Sertoli cell and leydig cell both exist in testis

and secret CKs such as IL-1 、 IL-6 、 INF-α 、TGF-β

Sertoli cell can also express special surface molecules FasL,it initiate immune privilege.

Sperm protection mechanism in male

4 、 Immunoglobulins : The main Ab in reproductive tract is IgA(sIgA).Low level of IgGs exist in testis fluid and epididymis fluid.

5 、 Cytokines:IL-1 IL-6 TGF TNF IFN ect. form cytokine network which regulate local immue funnction.

Sperm protection mechanism in female

1 、 Immuno-supressive material in seminal plasma

2 、 Special protein in female reproductive tract can envelop and protect sperm

3 、 only a small amount of sperm can reach uterus cavity

The mechanism of the production of AsAb in male

1 、 The destruction of blood –testis barrier

Under normal condition, the blood-testis barrier keeps the sperm Ag away from the immune system . So the anti-sperm immune reaction will not occur. But after the blood –testis barrier is destructed(such as operation ,trauma),the sperm will leak from the barrier and the macrophage will swallow and digest the spermatids. And the sperm Ag may activate the immune system, which will produce AsAb.

The mechanism of the production of AsAb in male

2 、 the chang of cellular immunity functions

The number and the activity of the inhibitory T cells reduce. It induces the production of AsAb.

3 、 The infection of reproductive tract This may be related to existence the antibody

that has the cross reaction with the sperm membrane antigen. Or it is because the infection makes the immune cells get in touch with the sperm antigen, and produce AsAb.

The mechanism of the production of AsAb in male

4 、 Inactivation of seminal plasma immuno-suppressive material(SPIM)

The infection of reproductive tract, trauma, embolism, ect, can induce anti-SPIM Abs. These Abs can affect density , mobility and the number of survival sperm.

The formation of female Anti-sperm antibody(AsAb)

Female reproductive tract contacts with millions of sperms through normal sexual activity. As for the female, sperm is not their own. But only a few sensitive females may produce AsAb. We even do not know the reason exactly.

The formation of female Anti-sperm antibody(AsAb)

1 、 Differences of individual immune reaction 2 、 Lacking of seminal plasma immuno-

suppressive material(SPIM) in husband’s semen. 3 、 Infection of reproductive tract or sexual

disease

enhance the non specific immunity 4 、 Injury of reproductive tract mucosa

sperm antigen meets B cell below epithelial by passing the injured mucosa epithelial barrier. Thus AsAb occurs .

Function of AsAb

1 、 Abs against the head of sperm They can inhibit sperm capacitation and

acrosome reaction. They can also block sperm to combine with zona pellucida and ovum membrane ,thus inhibit fertilization.

2 、 Abs against the tail of sperm can affect the mobility of sperm

3 、 Activation of complement system MAC formation and death of sperm

Function of AsAb

4 、 Fc of anti-sperm Abs can combine with specific glycoprotein in uterine mucus, thus can inhibit sperm swim through uterine mucus.

5 、 Opsonization of anti-sperm Ab can enhance phagocytosis of MФto swallow sperm.

Treatment

1 、 Isolation 2 、 Immuno-supressive therapy 3 、 Artificial insemination 4 、 GIFT and IVF( 配子输卵管内移植及体

外受精 ) 5 、 herb