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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Cutting-Edge Issues in Autoimmune Orchitis

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Author(s):
Silva, Clovis A. [1, 2] ; Cocuzza, Marcello [3] ; Borba, Eduardo F. [1] ; Bonfa, Eloisa [1]
Total Authors: 4
Affiliation:
[1] Univ Sao Paulo, Div Rheumatol, BR-01246903 Sao Paulo - Brazil
[2] Univ Sao Paulo, Pediat Rheumatol Unit, Dept Pediat, BR-01246903 Sao Paulo - Brazil
[3] Univ Sao Paulo, Dept Urol, BR-01246903 Sao Paulo - Brazil
Total Affiliations: 3
Document type: Review article
Source: CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY; v. 42, n. 2, p. 256-263, APR 2012.
Web of Science Citations: 15
Abstract

Autoimmune orchitis is a relevant cause of decreased fecundity in males, and it is defined as a direct aggression to the testis with the concomitant presence of anti-sperm antibodies (ASA). The presence of these specific antibodies has been observed in approximately 5-12% of infertile male partners. Primary autoimmune orchitis is defined by isolated infertility with ASA but without evidence of a systemic disease. Secondary causes of orchitis and/or testicular vasculitis are uniformly associated with autoimmune diseases, mainly in primary vasculitis such as polyarteritis nodosa, Beh double dagger et's disease, and Henoch-Schonlein purpura. The overall frequencies of acute orchitis and ASA in rheumatic diseases are 2-31% and 0-50%, respectively. The pathogenesis of primary/secondary autoimmune orchitis is not completely understood but probably involves the access of immune cells to the testicular microenvironment due to inflammation, infection or trauma, leading to apoptosis of spermatocytes and spermatids. Glucocorticoids and immunosuppressive drugs are indicated in autoimmune orchitis-associated active systemic autoimmune diseases. However, there are no standardized treatment options, and the real significance of ASA in infertile men is still controversial. Assisted reproductive technologies such as intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection (ICSI) are therapeutic options for male infertility associated with these autoantibodies. ICSI is considered to be the best choice for patients with severe sperm autoimmunity, particularly in males with low semen counts or motility. (AU)