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Title: Lymphocyte subsets and macrophages in the male genital tract in health and disease
Author: El-Demiry, Mostafa Ibrahim Metwally
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1987
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The ability of sperm cells to induce specific auto- and iso-immunity was reported as early as the turn of the century. However the mechanism controlling autoreactivity to sperm is not well known. As lymphocytes constitute the major cellular components of the immune system, determination of their anatomical location within the tissues of the male genital tract may be of considerable importance in understanding immunological infertility and other urogenital disorders. A series of monoclonal antibodies that react with human lymphoreticular cells was therefore used in an indirect immunoperoxidase technique to study their distribution throughout the male genital tract. The normal human tissues investigated were: testis, epididymis, vas deferens, prostate and seminal vesicles obtained from multiorgan transplant donors. The clinical specimens examined included surgical biopsies of testis, epididymis and prostate obtained during surgical procedures directed at the investigation and treatment of subfertile males and other patients. All normal tissues, apart from the testis, were found to contain appreciable numbers of T-lymphocytes (leu 4+). T-cells of the suppressor/cytotoxic phenotype (leu 2a+) were more abundant in the intraepithelial compartment while T-cells of the helper/inducer phenotye (leu 3a+) were more common in the interstitial areas. With the exception of the prostate, very few B-cells were observed. Macrophages (leu M3+) were identified within normal testicular tissues as well as the rest of the male genital tract. HLA-DR+ cells were also identified and the HLA-DR antigens were normally expressed on the lining epithelium of the rete testis, epididymis and vas deferens. Derangement of this pattern was observed in clinical specimens. Testicular biopsies from patients with testicular obstruction showed marked infiltration with lymphocytes mainly of the T-cell type. Biopsies from patients with benign prostatic hyperplasia showed increased infiltration with the helper/inducer T-cells and other cell types such as natural killer cells (leu llb+) and activated T-cells (IL2-r+). These patterns of lymphoid cells distribution could provide an insight into both normal immunohomeostatic mechanisms and pathological events within the male genital tract. The presence and distribution of lymphocyte subpopulations and macrophages within human urothelium in health and disease was also examined. T-lymphocyte subsets and macrophages were identified in normal urothelium and shown to have a similar pattern of distribution to that seen in normal epithelium of the genital tract. The existence of these cell populations may contribute to the health and protection of urothelium, particularly in resistance to infection and tumour surviellance. The presence of leucocytes and their subpopulations was also studied in the ejaculate from 69 men with an infertile marriage and 12 fertile men. Leucocytes were found in large numbers in the fertile men compared with the patients. Lymphocytes were found in 20% of the patients. There was no correlation between leucocyte counts and growth of micro-organisms. These results cast doubt on the conventional criteria of subclinical genital tract infection, namely positive culture and excess leucocyte counts.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available