Indicators of oxidative-nitrosative stress in men with idiopathic infertility and infertility associated with rheumatoid arthritis

Infertility is a worldwide problem affecting 15% of couples. About 30% cases of male infertility are considered idiopathic associated with factors not limited to testicular dysfunction. Male infertility and rheumatoid arthritis are often associated and patients with rheumatoid arthritis have a lower fertility rate. The exact relationship between rheumatoid arthritis and male infertility has yet to be revealed. The aim of the study is to assess the MDA level and the activity of NO-synthase isoforms and arginase in men with idiopathic infertility and infertility associated with rheumatoid arthritis. Patients were divided into 2 groups: group 1 – 73 patients with idiopathic infertility; group 2 – 68 infertile men with a systemic autoimmune disease (rheumatoid arthritis). The MDA level in blood plasma of patients with idiopathic infertility and infertile men with rheumatoid arthritis was significantly higher than in the control group (fertile men). The cNOS activity in seminal plasma and blood lymphocytes decreased in men with idiopathic infertility and infertility associated with rheumatoid arthritis compared to the control group. The decrease in cNOS activity was accompanied by drastic increase in iNOS activity. The iNOS/cNOS ratio increased in men with idiopathic infertility and men with infertility associated with rheumatoid arthritis. Similar, but more drastic changes in iNOS/cNOS ratio were found in blood lymphocytes. The arginase activity in seminal plasma was decreased in patients with idiopathic infertility compared to the healthy controls. However enzyme activity in men with infertility associated with rheumatoid arthritis had a tendency to increase, but these changes are not significant. Similar changes were observed in blood lymphocytes. It was found that idiopathic infertility is associated with a decrease in the activity of non-oxidative, arginase metabolism and the dominance of NO-synthase, which leads to the hyperproduction of nitric oxide. In men with infertility associated with rheumatoid arthritis an increase in the arginase/NOS ratio in lymphocytes is noted, which is largely explained by the sharp activation of arginase activity in blood lymphocytes. The arginase/NOS balance and iNOS/cNOS ratio may can be used as indicators of oxidative-nitrosative stress in men with idiopathic infertility and infertility associated with rheumatoid arthritis.