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Papillomavirus umano (HPV): ricerca e genotipizzazione su liquido seminale

  • Anna Laura Gambardella
  • Simona Marino
  • Marianna Salierno
  • Marianna Calafati
  • Attilio Rosolia
Articolo Originale
  • 109 Downloads

Riassunto

Premesse.

Il papillomavirus umano, conosciuto anche con l’acronimo HPV, è un virus a trasmissione sessuale molto frequente nella popolazione femminile e maschile. Esistono differenti genotipi di questo virus, alcuni dei quali considerati ad alto rischio oncogeno perché collegati all’insorgenza di patologie a carattere tumorale, tra le quali il carcinoma del collo dell’utero; altri, invece, sono definiti a basso rischio perché non legati a patologie oncogene, ma responsabili di lesioni cervicali, verruche e condilomi ano-genitali. L’uomo rappresenta un’importante riserva del virus e ha un ruolo significativo nella trasmissione e nella persistenza della malattia neoplastica nella donna, in particolare in rapporto al genotipo del virus infettante. Studi sperimentali dimostrano, inoltre, che l’HPV può essere causa di infertilità alterando le caratteristiche morfologiche degli spermatozoi e pregiudicandone l’innesto all’interno dell’ovocita. L’infezione genitale da HPV nell’uomo è spesso asintomatica, non sempre le lesioni sono clinicamente evidenti, ma evidenziabili solamente con peniscopia o con indagini molecolari per la ricerca del DNA virale. L’importanza della diagnosi e del trattamento delle lesioni da HPV nell’uomo è confermata dall’evidenza che il rischio più significativo per la neoplasia cervicale è la presenza della condilomatosi genitale nel partner maschile. Obiettivo di questo studio è stato la ricerca e la tipizzazione dell’HPV in campioni di liquido seminale provenienti da pazienti inclusi in protocolli di riproduzione assistita.

Metodi.

Lo studio è stato condotto su una popolazione di 56 pazienti sottoposti ad accertamenti preliminari per i trattamenti di riproduzione assistita. L’analisi molecolare per la ricerca del DNA virale è stata effettuata su acidi nucleici estratti da campioni di liquido seminale. Successivamente è stata effettuata la genotipizzazione dei principali papillomavirus mediante PCR e ibridazione inversa su striscia di nitrocellulosa (Innogenetics, Gent, Belgio).

Risultati.

Le analisi effettuate hanno evidenziato la positività al test in 17 pazienti su 56 (30,36%). Di questi, 14 sono risultati positivi a virus ad alto rischio oncogeno e 3 a basso rischio. La tipizzazione dei principali papillomavirus ha rivelato la presenza del genotipo 51 ad alto rischio in 7 pazienti su 17 (41,18%), del genotipo 11 a basso rischio in 3 pazienti (18%), mentre i restanti 7 pazienti hanno mostrato i genotipi: 16, 52, 31/53, 6/52 (alto rischio), 66 e 69/71.

Conclusioni.

Sebbene non sia completamente chiaro il ruolo dell’HPV nell’uomo, le infezioni sub-cliniche del pene sono implicate nell’infertilità e nella carcinogenesi genitale in entrambi i sessi.

Il presente studio ha mostrato una significativa percentuale (30,36%) di soggetti asintomatici risultati positivi alla ricerca del papillomavirus nel liquido seminale. Inoltre, l’82% di questi ha presentato un genotipo ad alto rischio oncogeno.

Negli uomini non si dispone di un test preciso per valutare le infezioni da HPV e l’esame citologico non trova applicazione nella sfera andrologica. La ricerca e tipizzazione del virus può condurre con certezza alla diagnosi e stima del rischio oncogeno; pertanto, è auspicabile che tale esame rientri a breve nei protocolli diagnostici.

Parole chiave

Spermatozoi Infertilità maschile Infezione virale Patologie sessualmente trasmesse 

Human papillomavirus (HPV): detection and genotyping in human sperm

Summary

Background.

Human papillomavirus (HPV) is the most common sexually transmitted diseases that can infect both females and males. Many HPV genotypes are known to infect the genital tract, some of which are considered “high oncogenic risk” and is the necessary cause of anogenital cancers as cervical cancer; and “non-oncogenic” HPV types cause genital warts and other benign lesions. Male is an important reserve of the virus and plays a significant role in the transmission and persistence of neoplastic disease in women, particularly in relation to the genotype of the infecting virus. HPV also can cause infertility, because it alters sperm morphology and ability to penetrate the oocyte. In males, infection is asymptomatic and transient, often the lesions are not clinically diagnosed, but evaluable only with peniscopy and molecular biology. The importance of diagnosis and treatment is confirmed by the evidence that the most important risk that men’s sexual behavior is a risk factor for cervical neoplasia. In this study we aimed at better understanding the presence of HPV in human sperm in relation to assisted reproduction techniques (ART).

Methods.

The study was conducted on semen samples obtained from 56 patients that are included in an assisted re production protocol. Detection of Human papillomavirus was realized with extraction of DNA from sperm, PCR protocol and reverse dot-blot with commercial kits (Innogenetics, Gent, Belgium).

Results.

The analysis conducted showed the presence of HPV-DNA on 17/56 patients (30.36%). 14 out of 17 patients were positive on high-risk oncogenic virus, and 3 to low-risk. The typing of the main papillomavirus revealed the presence of genotype as follows: 51 high-risk genotype in 7 of 17 patients (41.18%), 11 low risk genotype on 3 patients (18%). While the other 7 patients showed genotypes: 16, 52, 31/53, 6/52 (high risk), 66 and 69/71.

Conclusions.

Although it is not completely clear the role of HPV in male, penis sub-clinical infections are involved in infertility and genital carcinogenesis in both sexes. The present study showed a significant percentage (30.36%) of asymptomatic subjects positive to papillomavirus DNA in semen. 82% of these presented a high oncogenic risk genotype. In male does not exist a precise test for analysis of HPV infections and cytology is not useful. Research and typing of the virus may facilitate the diagnosis and estimation of the oncogenic risk, therefore, it is helpful that this analysis should be incorporated into diagnostic protocols.

Keywords

Spermatozoa Male infertility Sperm infection Viral sexually transmitted disease 

Notes

Conflitto di interessi

Nessuno.

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Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Anna Laura Gambardella
    • 1
  • Simona Marino
    • 1
  • Marianna Salierno
    • 1
  • Marianna Calafati
    • 1
  • Attilio Rosolia
    • 1
  1. 1.Laboratorio “Analisi Cliniche Mater Dei”PaganiItalia

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