无创测试以促进男性不育症的诊断

新的研究今天发表在BMC Medicine评估一个新的男我的临床表现nfertility test, based on the detection of TEX101 protein, that could help to eliminate the need for invasive diagnostic biopsies. Here author of the study, Andrei Drabovich, tells us more about this test and the function of TEX101 protein.

不育是一种常见的医疗状况,普通人群的估计患病率近15%。该疾病会影响男性和女性,而男性因素是独家或与女性异常相结合的,大约有一半的病例。

Fertility rates and sperm counts are急剧下降in many industrialized countries, presumably due to the changing lifestyles and environmental factors. In the北欧国家,目前有多达5%的儿童使用辅助生殖技术。因此,男性不育症是一个公认的问题,值得更加科学和临床关注。

Tex101蛋白质

在我们的研究中,我们关注男性不育症的类别,精子中的精子量减少。此类类别的范围从降低的精子产生到精液中完全缺乏精子的严重病例。我们先前发现,精液中低水平的Tex101(一种睾丸特异性蛋白)可能表明由于先天缺陷,遗传原因或输精管切除术程序而导致精子运输的阻塞。

精液中的Tex101(一种睾丸特异性蛋白)的低水平表明由于先天缺陷,遗传原因或输精管切除术程序而导致精子运输。

We also suggested that due to its exclusive production in male germ cells, TEX101 protein could serve as an indicator of spermatogenesis in other categories of男性不育症。这样的指标可以预测男性生育率条件的整个梯度,从完全缺乏活性精子发生(例如,对于仅Sertoli细胞综合征)到降低精子发生以及正常健康的精子发生。

We initially discovered and characterized TEX101 protein by mass spectrometry, a technique suitable for research studies but not for routine measurements in the clinical laboratories. To translate TEX101 biomarker into clinic, we thus developed a simple enzyme-linked immunosorbent assay (ELISA).

新的诊断测试应在诊所使用之前对其进行彻底评估,这是我们本研究的目的。我们在805个肥沃的,亚毛皮和不育男性的大量队列中调查了TEX101 ELISA测试的临床性能,并证实了三种不同的临床公用事业:(i)区分Azoospermia形式;(ii)通过手术检索精子的机会;(iii)评估输精管切除术成功(输精管切除术是用于男性灭菌的手术程序)。

福利Tex101测试

目前,唯一区分Azoospermia形式并预测手术精子检索的机会是初步诊断睾丸活检,其中在显微镜下提取并研究了一小部分睾丸组织。

消除对侵入性诊断活检的需求是我们的测试提供的重要优势,并将受到患者和临床医生的欢迎。因此,我们建议在泌尿科诊所接受的患者中,在初步评估不孕症的标准方案后提供TEX101测试(精液分析和测量运动,形态和生殖激素水平),但在诊断睾丸活检之前。

消除对侵入性诊断活检的需求是我们的测试提供的重要优势,并将受到患者和临床医生的欢迎。

我们的测试简单且便宜。它取代了侵入性手术程序,并可能有助于更好地计划辅助繁殖。此外,Tex101是男性生育能力必不可少的蛋白质,因此了解其功能作用并调整其活性或浓度可能有助于开发有效的男性避孕药。我们将将未来的努力集中在多个生育诊所对我们的测试验证上,并获得监管部门的批准和对Tex101生物学的更好理解。

Finally, it should also be emphasized that TEX101 may be among the first protein biomarkers discovered by proteomic technologies. Numerous studies previously attempted to discover disease biomarkers using proteomics and mass spectrometry, but were not able to develop clinically useful protein biomarkers as yet. This resulted in a lot of pessimism in the field of biomarker discovery. Our study may revive the hope to discover disease biomarkers by proteomics and motivate researchers to look for biomarkers of other diseases including major cancers.

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