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Erschienen in: Reproduktionsmedizin 5-6/2003

01.12.2003 | Andrologie

Immunologie des Hodens

Balance zwischen Immunprivileg und Entzündung

verfasst von: Prof. Dr. A. Meinhardt, H.-Ch. Schuppe

Erschienen in: Reproduktionsmedizin | Ausgabe 5-6/2003

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Zusammenfassung

Immunkompetente Zellen gehören zu den regulären Bestandteilen des interstitiellen Hodengewebes vieler Säuger, einschließlich des Menschen. Residenten Makrophagen und Mastzellen sowie den in geringerer Zahl nachweisbaren Lymphozyten werden vor allem regulatorische Funktionen zugeschrieben, die auch das sog. Immunprivileg des Hodens bedingen und zur Vermeidung keimzellspezifischer Autoimmunreaktionen notwendig sind. Jedoch ist auch eine pathologische Aktivierung des Immunsystems möglich, wie Tiermodelle zeigen, bei denen durch aktive Immunisierung oder den adoptiven Transfer spezifischer T-Lymphozyten eine Autoimmunorchitis ausgelöst werden kann. Beim Mann fanden immunpathologische Reaktionen im Hoden allerdings abgesehen von klinisch symptomatischen Orchitiden kaum Beachtung, obwohl Infektionen und Entzündungen im Genitaltrakt als wichtige ätiologische Faktoren einer eingeschränkten Fertilität gelten. Der Schlüssel zum Verständnis der Phänomene, die zur Ausbildung des Immunprivilegs oder im pathologischen Fall zu einer Schädigung der Hodenfunktion führen, könnte in der erkennbaren Überlappung von spezifisch testikulären Funktionen und immunregulatorischen Aufgaben der Zytokine im Hoden liegen. Im Gegensatz zu den bisher bekannten epidemiologischen Daten über symptomatische infektiös-bedingte Orchitiden, zeigten kürzlich erhobene Befunde bei infertilen Männern eine hohe Prävalenz von asymptomatischen entzündlichen Reaktionen im Hoden. Die meist fokal auftretenden entzündlichen Läsionen gingen mit erkennbaren Schädigungen der Hodenfunktion, meist der Spermatogenese, einher. Aus klinischer Sicht sollten Entzündungsreaktionen im Hoden als ursächlicher oder begleitender Faktor männlicher Infertilität nicht vernächlässigt werden. Von zukünftigen Untersuchungen über die zugrunde liegenden Mechanismen testikulärer Immunreaktionen erhofft man sich Anhaltspunkte, um therapeutisch gezielt in die Immunmodulation des Hodens eingreifen zu können.
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Metadaten
Titel
Immunologie des Hodens
Balance zwischen Immunprivileg und Entzündung
verfasst von
Prof. Dr. A. Meinhardt
H.-Ch. Schuppe
Publikationsdatum
01.12.2003
Verlag
Springer-Verlag
Erschienen in
Reproduktionsmedizin / Ausgabe 5-6/2003
Print ISSN: 1434-6931
Elektronische ISSN: 1434-808X
DOI
https://doi.org/10.1007/s00444-003-0418-y

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