ACUTE EFFECTS OF SPINAL CORD INJURY ON SPERM FUNCTION

众所周知，不育症是男性脊柱畸形的常见后遗症。 脊髓损伤（SCI）。 造成这种不孕的原因有两个--贫穷 精液质量和射精功能障碍。 射精的问题是 使用电射精已经在很大程度上解决了功能障碍。 然而，精液质量差，特别是精子活力，仍然是一个问题。 未解决的问题。 人们普遍认为， 的SCI男性也有精子发生异常。 已经 目前还没有关于精子发生，精子活力， 或精子功能的影响 我们的初步数据显示， 大鼠脊髓损伤后不久精子发生可能开始开始。 精液质量差 在男性SCI后2-4周也注意到。 临床上， 动物研究已经确定了这些机制 损伤 这项提案的广泛的长期目标是了解 SCI男性和SCI患者睾丸-附睾功能障碍的潜在机制 脊髓横断大鼠。 了解这些机制及其 时间进程对制定干预措施至关重要， SCI患者的生育能力。 调查的第一个领域是时间 精子发生和精子功能受损的过程以及 影响了老鼠和人的时间进程 鼠 中胸和骶骨脊髓横断将研究与 以下具体目标：1）量化的时间进程和严重性， 生精损伤和精子活力; 2）确定是否 生精损伤在8个月内是不可逆的; 3）确定 随着时间的推移，特定的生精细胞是最脆弱的， 横切 近期完全创伤性SCI的男性将被分为 神经节段在T6、T7 - T11或以上且骶椎完整的患者 脊髓和T12及以下，涉及骶髓，因此， 组将在他们的自主神经系统中相对同质 功能 具体目标是：1）精子发生的时间过程 通过连续测量睾丸体积，这是已知的相关 精子发生的时间进程 通过对精子浓度、活力 形态学和精子功能。 具体机制 将研究睾丸-附睾损伤。 这些包括 睾丸血流调节异常和阴囊高热 包括老鼠和人类。 在大鼠研究中，重点将放在 研究精子运输和成熟的异常， 附睾，以及支持细胞的异常功能， 是支持精子发生的睾丸体细胞。 一个 了解导致SCI患者精子质量差的机制 男性将为治疗努力提供科学依据，以改善他们的健康状况。 生育潜力 最后，即使精子质量无法维持， 在慢性SCI男性中，精子质量的保持直到SCI男性被 身体状况稳定并能进行电射精的人 重要的临床意义。 精子银行，这需要良好的 高质量的精子，然后可以提供给病人。

It is well known that infertility is a common sequela in men with spinal cord injury (SCI). There are two causes of this infertility -- poor semen quality and ejaculatory dysfunction. The problem with ejaculatory dysfunction has largely been solved with use of electroejaculation. However, poor semen quality, particularly sperm motility, continues as an unresolved problem. It is generally accepted that a significant number of SCI men have abnormalities of spermatogenesis as well. There have been no prospective clinical studies of spermatogenesis, sperm motility, or sperm function following SCI. Our preliminary data have shown that spermatogenesis may begin shortly after SCI in rats. Poor semen quality has also been noted 2-4 weeks after SCI in men. Neither clinical nor animal studies have identified mechanisms responsible for these impairments. The broad long-term aim of this proposal is to understand mechanisms underlying testicular-epididymal dysfunction in SCI men and in spinal cord transected rats. Understanding of these mechanisms and their time course is critical to development of interventions to preserve fertility in men with SCI. The first area of investigation is the time course of impaired spermatogenesis and sperm function and factors that affect this time course in both rats and men. Rats subjected to mid-thoracic and sacral spinal cord transection will be studied with the following specific aims: 1)to quantify the time course and severity of spermatogenic injury and sperm motility; 2) to determine if the spermatogenic injury is irreversible over 8 months; 3) to determine which specific spermatogenic cells are most vulnerable over time after transection. Men with recent complete traumatic SCI will be grouped into those with neurologic levels at or above T6, T7 - T11 with intact sacral cord and T12 and below with involvement of the sacral cord, so that each group will be relatively homogeneous in their autonomic nervous system function. Specific aims will be: 1) the time course of spermatogenesis by serial measurement of testicular volume, which is known to correlate well with normalcy of spermatogenesis, 2) the time course of sperm quality by serial evaluation of sperm concentration, motility, morphology, and sperm function. Specific mechanisms of testicular-epididymal injury will be investigated. These include abnormal regulation of testicular blood flow and scrotal hyperthermia in both rats and humans. In rat studies, emphasis will be placed on investigating abnormalities of spermatozoa transport and maturation in the epididymis, as well as abnormal function of the Sertoli cells, which are testicular somatic cells that support spermatogenesis. An understanding of the mechanisms contributing to poor sperm quality in SCI men will form a scientific basis for therapeutic efforts to improve their fertility potential. Finally, even if sperm quality cannot be maintained in chronic SCI men, preservation of sperm quality until SCI men are medically stable and able to undergo electroejaculation would have important clinical significance. Sperm banking, which requires good quality sperm, could then be offered to patients.