The usefulness of elastase measurement in the sperm for the diagnosis of urogenital male inflammation and infection

Abstract

Backgroun: Genital tract inflammation is a frequent cause of infertility among men, usually clinically silent with only leukocytospermia defined as the presence of white blood cells (WBC)>1.106/ml in semen. During the inflammation process, granulocytes discharge large amounts of proteases such as elastase. The elastase linked to its inhibitor in the form of a complex the elastase α1-protease inhibitor in semen is suggested as a potential marker of genital tract inflammation.
aim: To assess the measurement of elastase as a biomarker of genital tract inflammation by comparing this technique with the detection of leukocytospermia according to the WHO guidelines. methods: This study interested 83 infertile men attending the andrology center for semen analysis. Leukocytospermia was
assessed by a peroxydase test and elastase concentration by immunoassay in the seminal plasma.
results: An elevated elastase was found in 38% of men. A similarity was found between leukocytospermia and elastase in 79% of cases, kappa coefficient concordance with leukocytospermia is good (0.78). The sensitivity of the elastase is 100%, the specificity= 75%. The positive predictive value is 47%, the negative predictive value is 100% with a Youden index=0.75. All patients with leukocytospermia>1.106/ml had an elastase>250ng/ml, 73% of them a concentration>1000 ng/ml. In the group of patients with no leucocytospermia, 75% had elastase<250ng/ml, 21% had concentration between 250 and 1000ng/ml and 4% (3 patients) a concentration>1000ng/ml.
Conclusion: Seminal elastase is a more sensitive marker than leucocytospermia in the diagnosis of male urogenital inflammation and infection.