Clinical Consequences of Immune Responses to Chlamydia in Men

prostatitis; male chlamydial infections halamydia trachomatis (C.t.) has been involved in variety of pathological conditions of the female and male genital tracts. Chronic female persistent infections due to this microorganism have been recently investigated, but the role of C.t. has not been completely clarified especially in acute and chronic pathologies of the male genital tract. The immunocompetency of the female and male genital tract is well documentedl,Z; the production of secretory IgA (SIgA) can take place in the fallopian tubes, uterine cervix and vagina, prostate and the epididymis, resulting in local production of SIgA by submucosal plasma cells present in a quantity greater than plasma cells producing IgM and IgG. During infections, increased numbers of these three classes of plasma cells are present. Specific SIgA against various infectious agents, such as Escherichia coli and Chlamydia trachomatis, 4'5'6 are produced in pathological conditions of the genital tract. SIgA mediates the protection of mucosal membrane by interfering with microbial adherence to mucosal surfaces and by inhibiting the penetration of potentially harmful microorganisms into muco-sal tissues. IgA occurs in serum and secretions as two subclasses that differ in amino acid sequences and glycosylation of the ot heavy chain. IgA1 predominates in serum whereas secretions may contain up to 60% IgA2. Subclass composition and response may be important parameters in understanding the host immune response, but the physiological significance of the two subclasses has not been explained. It has been postulated that IgA1 and IgA2 antibod-ies may play different protective roles: IgA1 is susceptible to bacterial IgA1 proteases; the degrading effect of the IgA1 protease from N. gonorrhoeae on anti sperm antibodies suggested a predominant local IgA1 response at least to some antigens but the actual in vivo situation has never been proved. The role of IgA1 proteases has been demonstrated in relation to dental flora: they may promote the adherence of oral streptococci to tooth surface. In 1992, a very strong SIgA protease was demonstrated to be associated with the spermatic fraction of human semen. IgA2 is protease resistant and plays a true role in mucosal defense. The subtle functional differences between IgA1 and IgA2 became recently apparent but, their biological effective role is not clarified. The appearance of elevated SIgA in seminal plasma, especially during infections, seems to be related to a pathological rather than a physiological situation of the male genital tract. The overproduction of SIgA could be theoretically explained by …