ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2415

Increased Sperm DNA Fragmentation in Male Systemic LUPUS Erythematosus Patients

Bruno C Tiseo1, Clovis A Silva2, Eduardo Ferreira Borba3, Gabriela A Munhoz3, Miguel Srougi1, Eloisa Bonfa4 and Marcello Cocuzza1, 1Discipline of Urology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil, 2Pediatric Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil, 3Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil, 4Rheumatology Division, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Tuesday, October 23, 2018

Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Gonadal dysfunction may affect male systemic lupus erythematosus (SLE) patients. Recently, sperm DNA integrity analysis has shown better diagnostic and prognostic performance for predicting male reproductive potential. In fact, conventional semen analysis, which focus on sperm concentration, motility and morphology, has been demonstrated to be a poor indicator of fertility and pregnancy outcome. There are, however, no studies assessing sperm DNA fragmentation and in male non-azoospermic SLE patients. Therefore the objective of the present study was to evaluate sperm DNA fragmentation analysis concomitantly with a global gonadal assessment in non-azoospermic male SLE patients.

Methods: Twenty-eight consecutive male SLE patients (ACR criteria) and 34 healthy controls were evaluated for demographicand exposures data, urologic evaluation and hormone.Semen analysis was performed according to the World Health Organization guidelines and sperm DNA fragmentation by alkaline comet assay in both groups. Clinical features, disease activity/damage scores and treatment were also evaluated in SLE patients.

Results: The median age [33 (20-52) vs. 36.5 (25-54) years, p=0.329] and frequency of varicocele (25% vs. 32%, p=0.183) were similar in SLE patients and healthy controls. Sperm DNA fragmentation showed significantly higher levels of cells class III [44 (9-88) vs. 16.5 (0-80)%, p=0.001] and cell class IV [10.5 (3-86) vs. 7 (0-36)%, p=0.039] in SLE patients compared to healthy controls. Sperm DNA fragmentation index was also significantly higher in SLE patients [62 (31-97) vs. 25.5 (0-100)%, p<0.001]. Conventional sperm parameters (including sperm count, motility and morphology) were similar in both groups (p>0.05). In SLE patients no correlations were observed between sperm DNA fragmentation index and age, disease duration, body mass index, SLEDAI-2K and SLICC/ACR-DI scores, and cumulative dose of prednisone, hydroxychloroquine, methotrexate, azathioprine, mycophenolate mofetil and intravenous cyclophosphamide (IVCYC) (p>0.05). Further analysis of SLE patients treated with and without IVCYC showed that total sperm motility was significantly lower in the former group [64 (15-83) vs. 72 (57-86)%, p=0.024]. Sperm DNA fragmentation index was alike in both groups [52.5 (31-95) vs. 67.5 (34-97)%, p=0.185].

Conclusion: To our knowledge, this was the first report that male non-azoospermic SLE patients have increased sperm DNA fragmentation without evident gonadal dysfunction. IVCYC does not seem to be a major determinant for this abnormality.Future prospective study is necessary to determine the impact of this alteration in these patients’ fertility.

Disclosure: B. C. Tiseo, None; C. A. Silva, Fundação de Amparo à Pesquisa do Estado de São Paulo, 2; E. F. Borba, None; G. A. Munhoz, None; M. Srougi, None; E. Bonfa, Fundação de Amparo à Pesquisa do Estado de São Paulo, 2,Conselho Nacional de Desenvolvimento Científico e Tecnológico, 2; M. Cocuzza, None.

To cite this abstract in AMA style:

Tiseo BC, Silva CA, Borba EF, Munhoz GA, Srougi M, Bonfa E, Cocuzza M. Increased Sperm DNA Fragmentation in Male Systemic LUPUS Erythematosus Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/increased-sperm-dna-fragmentation-in-male-systemic-lupus-erythematosus-patients/. Accessed .

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