Biomedical subjects

G Barba

Publications and source records attributed to G Barba.

71 records · Page 4Linked to original sources

PubMedDate not supplied

The use of three different therapeutic protocols according to the immunologic pathology present in three women with recurrent spontaneous abortion and fetal death for immunologic reasons: flucortolone and salicylates; high-dose intravenous gammaglobulins; subcutaneous heparin.

The authors report three cases of immunologic spontaneous abortions and fetal death. In the first patient there was lupus-like anticoagulant activity with a diagnosis of sub-clinical autoimmune disease; the second showed inadequate blocking factor activity, while the third subject presented excessive lymphocytotoxicity. In these cases three different therapeutic protocols were successfully used: flucortolone and salicylates, high-dose intravenous gammaglobulins and subcutaneous heparin.

Abortion, Habitual↗

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New perspectives for the therapeutic management of recurrent immunological abortion.

Up to now the only effective therapy for recurrent abortion syndrome due to the absence of the so-called blocking-factor has been active immunotherapy with partner or third-party donor mononucleates. The Authors report their in vivo and in vitro experience with high-dose intravenous gammaglobulin (i IV Ig) in order to treat women with recurrent abortion syndrome. In the Authors opinion there are sufficient experimental reasons for continuing this research with IV Ig obtained from multiparous women plasma pools.

Abortion, Habitual↗

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Immunological problems in the recurrent abortion syndrome.

The recurrent abortion syndrome has been considered a serious obstetrical problem, since it was not possible to diagnose the causes in over 40% of the cases. Great progress has now been made with the knowledge of the immunological mechanisms involved in the maintenance of pregnancy. The disorders of such immunological mechanisms, both due to auto- or alloimmune problems, are demonstrated in about 40% of the cases of recurrent abortions. The Authors have studied a group of 56 patients with recurrent abortion syndrome in a complex diagnostic work-up involving: 1) The research of an autoimmune cause; 2) The research of the presence of the Blocking-factors by means of one-way mixed lymphocyte cultures; 3) The research of an altered antipaternal lymphocytotoxic activity or of an excessive HLA-sharing. According to the results of the investigations, several forms of therapeutic management have been used: 1) Steroids-aspirin-calcic heparin for Autoimmune cases. 2) Active immunotherapy for the cases due to the lack of blocking factors. 3) Calcic heparin for the altered antipaternal lymphocytotoxic activity. At the moment it is difficult to evaluate the results of pregnancy rate with this type of therapeutic management because of the too short follow-up.

Abortion, Habitual↗

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The effect of female serum antisperm antibodies on in vitro fertilization and embryo transfer.

Twenty-nine women with serum antisperm antibodies underwent in vitro fertilization and embryo transfer. Half the oocytes from each patient were treated with patient-serum-supplemented medium with antibodies (medium A), and the other half with donor-serum-supplemented medium without antibodies (medium B). In 9 cases the antibodies were against the sperm head and these showed a significant difference in the number of embryos obtained between the two media (p = 0.001): 10.5% of fertilization of type 3 and/or 4 oocytes with medium A and 81.2% with medium B. A lower rate resulted also when the antibodies were against the middle and main portion of the tail, but fertilization did not seem to be affected when they were directed against the tail tip. No definite conclusions are possible, however, since the number of cases studied was too small.

Adult↗

PubMedDate not supplied

Direct intraperitoneal insemination (DIPI) for the treatment of refractory infertility unrelated to female organic pelvic disease.

344 couples with infertility unrelated to female organic pelvic disease underwent Direct Intraperitoneal Insemination (DIPI) for a total of a 429 DIPI cycles. Pregnancy per couple was 16.5% and per DIPI cycle 13.2%. DIPI was particularly effective in cases of infertility due to cervical mucus insufficiency and unexplained infertility with results respectively of 33.7% and 30.4% per couple and 30.7% and 28.7% per DIPI cycle. On the contrary, the results regarding male subfertility were 12.5% per couple and 10.5% per DIPI cycle. A significant difference was found (X2 A = 16.48, p less than 0.001) between these results and those of the group composed of cases of cervical mucus insufficiency and unexplained infertility. In cases of antisperm iso- and autoimmunization the results were on the whole poor, and were in any case influenced by corticosteroid pretreatment. The Pellet Swim-up Test (PST) proved to be a good prognostic sign for success of DIPI, since a significant difference was found between the PST group greater than or equal to 1.5 X 10(6)/ml (pregnancy per couple was 19.7% and per DIPI cycle 17.2%) and PST group less than 1.5 X 10(6)/ml (pregnancy per couple was 6.8% and per DIPI cycle was 4.5%) (X2 = 11.4. P less than 0.001).

Autoimmune Diseases↗

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Immuno-bead test (IgG-IgA-IBT) in cervical mucus for the diagnosis of antisperm isoimmunization in female infertile patients with negative or doubtful PCT.

57 infertile women belonging to infertile couples with negative or doubtful PCT underwent the following tests: Sperm Cervical Mucus Contacts Test (SCMC-Test), IgG-IgA-Immuno-Bead Test (IgG-IgA-IBT) in cervical mucus, Micro Sperm Immobilizing Test (Micro-SIT) in cervical mucus and Sperm Immobilizing Test (SIT) in serum. Et least one of the tests gave a positive result in 49.1% of the patients examined and there was a significant difference between the SCMC-Test and the IgG-IgA-IBT: the former was positive in 26 out of 45 patients (57.7%), while the latter was positive in 13 cases (28.8%), (chi 2 = 6.48, p less than 0.05). On the other hand, there was no significant difference between the cervical mucus IgG-IgA-IBT, cervical mucus Micro-SIT and serum SIT; these were positive in respectively 14 (24.5%), 18 (31.5%) and 17 (29.8%) in the 57 patients who underwent all the tests at the same time. Three of the four cases with a mildly positive result of the cervical mucus IgG-IgA-IBT, where the beads were located at the tail-tip, showed negative results to all the other tests performed. Cervical mucus IgG-IgA-IBT is therefore a fairly specific method for the determination of antisperm isoantibodies in the cervical mucus as long as the assessment of those cases with low positivity and beads located mainly at the tail-tip is performed carefully. It is advisable in these patients to take into consideration the results of more classical tests such as cervical mucus Micro-SIT.

Adult↗

PubMedDate not supplied

Indirect immuno-bead test in the seminal plasma and in the serum for the diagnosis of antisperm autoimmunization in male infertile patients.

125 male subjects belonging to infertile couples with negative or doubtful PCT underwent the following tests: IgG MAR Test, seminal TAT, indirect IgG-IgA-IgM-IBT in the seminal plasma, serum TAT, serum SIT, serum IgG-IgA-IgM-IBT. There was no significant difference in the incidence of autoimmunized patients and those resulting from classical testing methods (IgG MAR Test, seminal and serum TAT, serum SIT) (16%), and the results of the indirect IBT in the seminal plasma and in the serum (16.8%). The IBT showed an increase which was not, however, statistically significant in subjects with concomitant local and general autoimmunization, compared to the classical methods, (13.6% in the subjects examined versus 10.4%). There was a statistical significant difference between the results of the indirect IgA-IBT in the seminal plasma and those of the IgG MAR Test, (19 versus 12 positive patients, chi2 = 6.05, p less than 0.05). Furthermore, in 88.2% of the cases with concomitant positivity, the indirect IgA-IBT in the seminal plasma showed higher values than the indirect IgG-IBT in the seminal plasma. There was no significant difference between the results of the classical methods and the serum IBT, whereas both in the semen and in the serum the beads adhered mainly to the tail plus the tail up considering only the nemaspermic portion with the highest relative rate of adhered beads.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Evaluation of sperm immobilizing and sperm agglutinating seric activity in male subjects with or without positive IgG M.A.R.-test belonging to sub-fertile couples with negative or doubtful P.C.T.

In this study we have compared the results of autoagglutination, IgM M.A.R.-test, seric S.I.T. and seric T.A.T. in 75 men with normal seminal parameters belonging to sub-fertile couples in whom the only evident anomaly was the presence of negative or doubtful P.C.T. We compared a tight correlation between IgG M.A.R.-test and autoagglutination (IgG M.A.R.-test clinically positive in 82.8% of subjects with positive spermagglutination); between seric S.I.T. and IgG M.A.R.-test (S.I.T. positive in 58.3% of subjects with IgG M.A.R.-test clinically positive); between seric T.A.T. and IgM M.A.R.-test (T.A.T. positive in 69.4% of subjects with positive IgG M.A.R.-test). Such results proved the reliability of IgG M.A.R.-test as a screening test in the determination of male autoimmunization. Moreover, the possibility that they were the cases in which only the local antisperm activity was shown, underlines the necessity not to limit immunological research to only seric antibody titrations. The analyses of the types of mixed agglutination present in cases of positive IgG M.A.R.-test make us suspect that a quota of the agglutination type emh was due to the impossibility with such type of test to specify adequately the zones of G.R. sperm interaction involved in the formation of mixed agglutinates.

Adult↗

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In vitro sperm capacitation and intrauterine insemination (IVC-Insem): a simple technique for the treatment of refractory infertility unrelated to female organic pelvic disease. Clinical results and immunological effects: a preliminary report.

12 couples, with infertility due to male subfertility, female antisperm isoimmunization, male antisperm autoimmunization, cervical mucus insufficiency or unexplained infertility underwent intrauterine A.I.H. with capacitated sperm and controlled ovarian stimulation. The pregnancy percentage was of 41.6% per woman treated and of 31.2% per treatment cycle; five pregnancies were obtained, of which two resulted in abortions. Five cases of oligoasthenospermia were treated, three severe and two moderate; two pregnancies occurred in the former and one in the latter. S.I.T. and S.I.T.-cap. were performed on the serum, and Micro-S.I.T. and Micro-S.I.T.-cap. on the cervical mucus in order to exclude the possibility that intrauterine A.I.H. with capacitated sperm might have caused capacitated or non-capacitated antisperm immunization. Intrauterine A.I.H. would seem to be a useful alternative to G.I.F.T. and to I.V.F./E.T. or at least a technique which should be performed before these two in cases of infertility not caused by female organic pelvic disease; it is cheap, simple and extremely well-accepted by the patient.

Adult↗

PubMedDate not supplied

An ELISA for antisperm antibody detection in serum: comparison with TAT and SIT in serum, with MAR-test, immunobead-test and TAT in semen and with micro-SIT in cervical mucus.

16 couples belonging to couples with negative or doubtful PCT were selected according to the presence of antisperm immunization. 12 patients, 5 male and 7 female, showed both localized and generalized immunization. The former was diagnosed by means of a positive IgG MAR-Test, direct IgG Immunobead-Test, direct IgG Immunobead-Test and seminal TAT in the male patients, and Micro-SIT in the cervical mucus of the female patients, while for the latter there was simultaneous positivity of both serum TAT and SIT, except for two cases, in which the SIT only was positive. The 4 remaining patients, 2 male and 2 female, did not show any signs of antisperm immunization. The evaluation of the antisperm antibodies by means of the ZER ELISA Antisperm Kit in the serum of the 16 patients examined showed that there were no significant statistical differences between the serum TAT and the SIT. The former showed agreement of the results in 93.75% of the cases, and the latter in 81.25%. A strict correlation was observed between the ELISA for serum antisperm antibodies (ELISA-AS-Abs) and the local immunitary situation, with agreement in 93.75% of the cases. The ELISA-AS-Abs seems to bring the advantage of eliminating the need for fresh semen for antibody titration and also means that there is no subjective interference with the evaluation of the results.

Adult↗

PubMedDate not supplied

Effects of in-vitro capacitation of human spermatozoa on the action of the sperm-immobilizing and sperm-agglutinating antibodies. Possible therapeutic applications on female antisperm isoimmunization.

In 51 serum samples (31 originating from infertile women, 20 from infertile men) with significant sperm immobilizing activity (S.I.T. with S.I.V. greater than 2) we carried out the following tests using semen from three proven fertile donors with excellent semenological characteristics: repetition of S.I.T.; carrying out of S.I.T. with sperm previously subjected to in vitro capacitation (S.I.T.-cap.); carrying out of T.A.T.; carrying out T.A.T. with sperm previously subjected to in-vitro capacitation (T.A.T.-cap.). Nor was there statistically significant difference evident in the results of the tests in relation to the use of the semen of the three different donors. In all 51 samples the repetition of S.I.T. involved the confirmation of sperm-immobilizing activity, while the result of such activity was constantly negative when it was carried out with S.I.T.-cap. In female subjects the comparison of the results of S.I.T. and S.I.T.-cap. showed a statistically significant difference (p less than 0.001). 38 out of the 51 serum samples examined showed positive T.A.T. with variant titers from 1:32 to 1:512 and with different types of agglutination (H, T, tip, M). In all the serum examined, T.A.T.-cap. resulted positive with a titer of 1:512 and agglutination of type H. The results of S.I.T.-cap. seem to underline the advantages linked to the use of capacitated semen in A.I.H. and in G.I.F.T. The evaluation of the results of T.A.T.-cap. make us suspect that they are not linked with the presence of antibodies in tested sera.

Agglutination Tests↗

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The role of Micro-S.I.T. in the evaluation of antisperm immunization in infertile women.

We tested the women of 45 infertile couples with negative or dubious P.C.T. and without any other evident reason for infertility. The presence of female immunization was discovered in 57,7% of the couples examined by S.C.M.C.-Test, Micro-S.I.T. at cervical level and S.I.T. in the sera. 100% of immunized women showed topical immunization (S.C.M.C.-Test and/or Micro-S.I.T. positive), and 28,8% of immunized women showed seric immunization. We found that in the 84,6% with topical immunization the positive results were exactly the same in S.C.M.C.-test and Micro-S.I.T.

Antibodies↗

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The M.A.R. test role for a rapid detection of antisperm autoimmunization in infertile men.

We examined 44 men from couples with negative or dubious P.C.T. which had not been caused by cervical pathology (infection, malformative pathology or insufficient mucus production) or seminal pathology (no infection present, normal seminal liquid and in some cases at the most a slight asthenospermia). 40,9% of the men were classified as immunized. This was established by the results of seric T.A.T. and other tests. The M.A.R. test has proved to be a good method for the screening of immunization in those with a low sperm-motility; in fact results proved either positive or strongly positive in 83,3% of immunized subjects. Considering as positive the M.A.R. tests which were "doubtfully positive", the final results proved positive in 94,4% of immunized subjects.

Adult↗

PubMedDate not supplied