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Khirurgii

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Year 2019 Vol. 27 No 6

UROLOGY

Y.A. NAKONECHNYI 1, A.M. HAVRYLYUK 1, A.Y. NAKONECHNYI 1, V.V. CHOPYAK 1, M.Ì. KURPISZ 2

IMMUNOPATHOGENETIC PROGNOSTIC MARKERS OF THE FERTILE POTENTIAL IN MEN WITH LEFT-SIDED VARICOCELE

Danylo Halytsky Lviv National Medical University 1, Lviv,
Ukraine,
Institute of Human Genetics Polish Academy of Sciences 2, Poznan,
Poland

Objective. To determine immunopathogenetic prognostic markers of the fertile potential in men with varicocele by the nature of changes in the induces of congenital and acquired immunity, to assess their trends after varicocelectomy in the context of maintaining the risk of infertility development.
Methods. 36 patients with the left-sided varicocele grade II-III and 25 patients after laparoscopic varicocelectomy underwent an immunological study. The control group consisted of 23 healthy men. The participants’ age was 19-33 years. The cytokines concentration in the blood and seminal fluid were determined by ELISA. Flow cytometry was used for immunophenotyping of peripheral blood lymphocytes (absolute and relative numbers).
Results. In patients with the left-sided varicocele grade II-III concentration of cytokines in the peripheral blood and seminal fluid significantly differed from the subjects of the control group. Statistically significant differences were found in the concentration of various cytokines and quantitative indicators of the cellular level of acquired immunity in comparison to practically healthy men. Levels of the most cytokines in the serum of the peripheral blood and seminal fluid, quantitative indicators of lymphocyte populations, subpopulations of T-lymphocytes and their activation markers in the peripheral blood normalized three months after laparoscopic varicocelectomy.
ROC analysis of cytokine levels in the peripheral blood serum and seminal fluid in patients with varicocele grade II-III revealed a number of patterns. Significant immunopathogenetic prognostic markers of the fertile potential could be an increase of IFN-γ levels more than 12.4 pg/ml in the peripheral blood serum, as well as levels of interleukins in the seminal fluid: for spIL-1β 50.4 pg/ml and less, for spIL-6 more than 49.5 pg/ml.
Conclusions. Cytokine regulation changes in the reproductive and immune systems, determined by the imbalance in concentrations of the pro/anti-inflammatory cytokines at the local and peripheral levels, synthesized by T-lymphocytes and macrophages is a crucial immunopathogenetic factor in the development of immune-depended infertility in patients with varicocele.

Keywords: varicocele, varicocelectomy, infertility, immunophenotyping, cytokines
p. 662-673 of the original issue
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Address for correspondence:
79010, Ukraine,
Lviv, Pekarskaya Str., 69,
Danylo Halytsky Lviv National
Medical University,
Department of Urology
Of the Post-Graduate Education Faculty.
Tel. mobile +38 097 633-57-27,
e-mail: nyosyf@ukr.net,
Yosyf A. Nakonechnyi
Information about the authors:
Nakonechnyi Yosyf A., Post-Graduate Student of the Department of Urology of the Post-Graduate Education Faculty, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0002-6872-1889
Havrylyuk Anna M., MD, Associate Professor of the Department of Clinical Immunology and Allergology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
http://orcid.org/0000-0001-9808-8896
Nakonechnyi Andrii I., MD, Professor of the Pediatric Surgery Department, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
http://orcid.org/0000-0003-1402-6642
Chopyak Valentyna V., MD, Professor, Head of the Department of Clinical Immunology and Allergology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
http://orcid.org/0000-0003-3127-2028
Kurpisz Maciej M., MD, Professor, Head of the Department of Immunobiology, Reproduction and Stem Cells, Institute of Human Genetics Polish Academy of Sciences, Poznan, Republic of Poland.
http://orcid.org/0000-0003-3275-3245
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