Evaluation of granulocyte elastase as a seminal plasma marker for leukocytospermia.

To evaluate the relationship between concentrations of the granulocytic enzyme polymorphonuclear (PMN) elastase in seminal plasma and the presence of high numbers of white blood cells (WBC) in semen, specimens from 118 infertility patients were analyzed for each variable. PMN-elastase levels were determined by an enzyme-linked immunosorbent assay and WBC numbers by a recently described immunohistologic technique. PMN-elastase levels in seminal plasma correlated well with WBC numbers in semen (r = +0.755). A three-step grading system of PMN-elastase values as low/normal (less than 250 ng/ml), intermediate (250 to 1000 ng/ml) and high/pathologic (greater than 1000 ng/ml) showed a highly significant relationship to a similar WBC number grading system: low/normal, less than 10(5) WBC/ml, intermediate, 10(5) to 10(6) WBC/ml, and high/leukocytospermic, greater than 10(6) WBC/ml semen. Incubation of semen at 37 degrees C resulted in a slight continuous decrease of immunoreactive PMN-elastase at a rate of approximately 10% per 3 hours. As all 18 samples with more than 1000 ng PMN-elastase per ml seminal plasma showed more than 10(6) WBC/ml semen, PMN-elastase levels above 1000 ng/ml were diagnostic for leukocytospermia.