Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Vấn Đề Tiên Tiến Trong Viêm Tinh Hoàn Tự Miễn
Tóm tắt
Viêm tinh hoàn tự miễn là nguyên nhân quan trọng gây giảm khả năng sinh sản ở nam giới, và được định nghĩa là sự tấn công trực tiếp vào tinh hoàn với sự hiện diện đồng thời của các kháng thể chống tinh trùng (ASA). Sự hiện diện của những kháng thể đặc hiệu này đã được quan sát thấy trong khoảng 5-12% các đối tác nam bị vô sinh. Viêm tinh hoàn tự miễn nguyên phát được định nghĩa bởi tình trạng vô sinh cô lập với ASA nhưng không có bằng chứng của bệnh lý hệ thống. Các nguyên nhân thứ phát gây viêm tinh hoàn và/hoặc viêm mạch tinh hoàn thường liên quan đến các bệnh tự miễn, chủ yếu là trong viêm mạch nguyên phát như viêm đa động mạch nút, bệnh Behçet và ban xuất huyết Henoch-Schönlein. Tần suất tổng thể của viêm tinh hoàn cấp tính và ASA trong các bệnh thấp khớp lần lượt là 2-31% và 0-50%. Bản chất bệnh sinh của viêm tinh hoàn tự miễn nguyên phát/thứ phát chưa được hiểu rõ hoàn toàn nhưng có thể liên quan đến việc tiếp cận của các tế bào miễn dịch vào môi trường vi mô của tinh hoàn do viêm, nhiễm trùng hoặc chấn thương, dẫn đến sự apoptosis của tế bào sinh tinh và tinh trùng non. Glucocorticoid và thuốc ức chế miễn dịch được chỉ định trong các bệnh tự miễn hệ thống có liên quan đến viêm tinh hoàn tự miễn. Tuy nhiên, không có các tùy chọn điều trị chuẩn hóa, và ý nghĩa thực sự của ASA ở nam giới vô sinh vẫn còn gây tranh cãi. Các công nghệ hỗ trợ sinh sản như bơm tinh trùng vào tử cung, thụ tinh trong ống nghiệm và tiêm tinh trùng vào bào tương (ICSI) là những lựa chọn điều trị cho tình trạng vô sinh ở nam giới có liên quan đến những tự kháng thể này. ICSI được coi là sự lựa chọn tốt nhất cho những bệnh nhân có tự miễn tinh trùng nặng, đặc biệt ở những nam giới có số lượng tinh trùng thấp hoặc độ di động kém.
Từ khóa
#Viêm tinh hoàn tự miễn #kháng thể chống tinh trùng #vô sinh nam #bệnh lý tự miễn #tự miễn tinh trùng #công nghệ hỗ trợ sinh sản #ICSI.Tài liệu tham khảo
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