ANTISPERM ANTIBODIES IN PREPUBERTAL BOYS TREATED WITH CHEMOTHERAPY FOR MALIGNANT OR NONMALIGNANT DISEASES AND IN BOYS WITH GENITAL-TRACT ABNORMALITIES

In several childhood diseases which have the ensuing risk of infertili ty in adult life because of direct hypothalamic-pituitary-testicular a xis involvement, or as a consequence of therapeutic toxicity, the role of antisperm antibodies (ASA) is rarely addressed. The aim of this st udy was to investigate the occurrence of ASA in a large prepubertal ma le population (aged 1.2-13 years) consisting of three groups: Group I, 52 patients affected by malignant diseases (lymphoblastic leukaemia, malignant lymphoma, or Wilm's tumour, n = 42), or by nephrotic syndrom e (n = 10); Group II, 212 patients with either genital tract abnormali ties (cryptorchidism, inguinal hernia, funicular torsion or hypospadia s, n = 202), or cystic fibrosis (n = 10); Group III: 100 age-matched n ormal boys. Group I and II patients were investigated at diagnosis and during or after treatment (drug, radiation or surgical therapy). Grou p III was used as controls. ASA were detected in sera by the Tray Aggl utination Test (TAT) and indirect IgG, IgA and IgM immunobead tests (i IBT). All normal boys were ASA-nsgative using both tests. Twenty-six o ut of the 264 patients (9.8%) in Groups I and II were ASA-positive: 23 (8.7%) patients had a positive TAT with a titre of 1:32 to 1.128, whi lst 14 (5.3%) had IgG-ASA after iIBT. Eleven patients (4.1%) were ASA- positive in both tests. Of the 26 ASA-positive boys, 24 had genital tr act abnormalities (cryptorchidism, testicular torsion, hypospadias) an d two had leukaemia with testicular infiltration. Treatment did not mo dify antibody positivity. Our data confirm that ASR call occur in prep ubertal boys, mostly among cases with urogenital pathology, but that i t is rare among other cases. Therefore autoimmune reaction against spe rmatozoa is another factor that should be considered in the evaluation of several conditions in childhood involving reproductive tract alter ation and potential impairment of the blood testis (Sertoli cell) barr ier.