Maturation phenotype of sertoli cells in testicular biopsies of infertile azoospeermic men

ABSTRACT

The involvement of abnormal Sertoli cell differentiation in different spermatogenic impairments has been studied by an immunohistochemical technique using cytokeratin-18 [CK-18] and anti-vimentin antibody. CK-18 is used as a marker for immature Sertoli cells as it is expressed only in Sertoli cells during prenatal and pre-pubertal differentiation and is normally lost at puberty. Forty two azoospermic men were included in the current study. These included 9 cases with obstructive azoospermia, 8 cases with pure [congenital] type of Sertoli cell only syndrome [SCOS], 12 with secondary type syndrome [SCOS], and 13 with spermatogenic maturation arrest. Vimentin was ubiquitous immunohistochemical marker associated with both normal and impaired spermatogenesis. CK-18 expression was associated with various stages of spermatogenic arrest an[l secondary type of Sertoli cell only syndrome [SCOS]. The expression of CK-18 may be a manifestation of de-differentiation of Sertoli cells or persistence of immature cells. Moreover, useful criteria to predict the absence of spermatozoa in cases of pure Sertoli-cell only syndrome can be obtained by a definite recognition of the typical histological patterns and refined by CK-18 immunostaining aid, especially in difficult cases