CHLAMYDIAL ANTIBODIES IN SEMEN - SEARCH FOR SILENT CHLAMYDIAL INFECTIONS IN ASYMPTOMATIC ANDROLOGICAL PATIENTS

The importance of a serological diagnostic workup in male genitourinar y infections with Chlamydia trachomatis and its relevance for male inf ertility is still under debate, In a prospective study, antichlamydial serum and seminal plasma antibodies of 131 consecutive patients (mean age 31: 20-57) without evidence of acute urethritis and with negative urethral chlamydial culture were investigated, The antibody determina tion was carried out with a genus specific rELISA, In patients with po sitive seminal plasma IgA, chlamydial genome was evaluated by polymera se chain reaction (PCR), The results were associated with standard sem en parameters according to evaluated WHO guidelines, Specific serum Ig G antibodies were found in 51 patients (38.9%), IgA in in 39 (29.7%); both antibodies were present in 25 patients (19%). Seminal plasma IgG was demonstrable in seven patients (5.3%), IgA in 26 (19.9%), and five patients were positive for both antibody classes (3.8%), Of the 26 me n positive for specific seminal plasma IgA antibodies 12 did not demon strate a serum antibody reaction, Only two patients with positive IgA titers in their seminal plasma showed a positive chlamydial genome rea ction in PCR (8%), Men with antichlamydial seminal plasma IgA and/or I gG did not differ significantly in any of the standard semen sperm par ameters from men testing negative for antibodies, with the exception o f peroxidase positive leukocytes (p < 0.01), nor was there an associat ion between any of the ejaculate parameters and any of the antibody ti ters, The data of about 40% antichlamydial serum antibody findings wit hout a significant association with seminal plasma antibodies and no c linical signs of infection seem to reflect a history of urogenital inf ection, The unique presence of seminal plasma IgA in 12 of 26 cases ma y be caused by a local antibody response due to a ''silent'' infection , Thus, seminal plasma IgA was associated with signs of inflammation, whereas, there was no association with genome or pathogen demonstratio n, Therefore, it appears to be necessary to reevaluate genus-specific seminal plasma IgA antibodies with a species-specific microimmunofluor escence test and to compare these results with a genome screening usin g PCR or in situ hybridization.