Key Points
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Male fertility is controlled by a Zn2+-dependent short circuit of the Krebs cycle within prostate epithelial cells
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Homeostasis of the prostate epithelium is reliant on the intracellular androgen-dependent accumulation of Zn2+ and citrate
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Sperm motility requires the coordinated action of the components of the two main fluids in the human seminal plasma: the prostatic fluid, which is enriched with Zn2+, citrate and kallikreins, and the semenogelin-enriched seminal vesicle secretion
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The prostate is the direct target for a number of benign and malignant diseases that are potentially linked to impaired fertility status
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Prostatitis might be directly linked with changes in fertility
Abstract
Ejaculation is a synchronized cascade of events that has the ultimate goal of activating sperm and enabling them to reach an egg for fertilization. The seminal plasma contains a complex mixture of fluids that is secreted from the testes, epididymis and male accessory glands. The prostate gland has a pivotal role in this process, as prostatic fluid enriched in Zn2+, citrate and kallikreins is crucial for the molecular synchronization of the functional cascade triggered by ejaculatory stimuli. The prostate is the target of a number of common diseases that can affect male fertility at different ages. In both young and aged men, prostatic diseases or an unhealthy prostate can affect spermatozoa functioning and, therefore, male fertility. Consideration of prostate physiology emphasizes a number of points: the central role of Zn2+ and citrate in the regulation of prostate epithelium homeostasis and in ejaculation; the influence of bacteria-related prostatic inflammation on male fertility; and the potential role of prostatic inflammation in promoting the development of prostatic hyperplastic growth and carcinogenesis.
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P.V., T.C. and S.L. equally contributed to researching data for the article, discussion of content, writing and reviewing/editing of the manuscript under the coordination of the corresponding author.
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Verze, P., Cai, T. & Lorenzetti, S. The role of the prostate in male fertility, health and disease. Nat Rev Urol 13, 379–386 (2016). https://doi.org/10.1038/nrurol.2016.89
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DOI: https://doi.org/10.1038/nrurol.2016.89
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