Medical encyclopedia - agglutination. Agglutination is an insidious and dangerous pathology. Possible types of agglutination when determining blood type

The agglutination reaction is based on the specific interaction of antibodies (agglutinins) with whole microbial or other cells. As a result of this interaction, agglomerate particles are formed that precipitate (agglutinate). Bacteria, protozoa, fungi, yeast, rickettsia, erythrocytes and other cells, both living and killed, can participate in the agglutination reaction. The reaction occurs in two phases: the first is a specific combination of antigen and antibody, the second is non-specific, i.e. the formation of a visible agglutinate. Precipitation of agglutinate occurs in the presence of electrolytes, such as sodium chloride. The microorganisms in the agglutinate remain alive, but lose their mobility.

The agglutination reaction is widely used for serological diagnosis of infectious diseases and determination of the antigenic structure of isolated microbes. To determine the antigenic structure of a pathogen isolated from the body of a patient or a carrier, specific immune serum is used, obtained by immunizing animals (rabbit, donkey, sheep) with certain microorganisms. Identification of the microbe is carried out in an agglutination reaction on glass with adsorbed or monoreceptor sera or in test tubes with specific agglutinating sera. Adsorbed sera contain antibodies only to antigens specific to a given microbe, and monoreceptor sera contain antibodies only to one specific antigen of the pathogen.

Species sera contain antibodies to all antigens of a particular microbe.

The belonging of an isolated microorganism culture to a given species is determined by agglutination with a known serum to the antibody titer indicated on the label of the serum ampoule. The antibody titer of a serum is considered to be its last dilution, in which agglutination of the culture of microbes used to immunize the animal is still observed. Adsorbed and monoreceptor sera are usually used undiluted in the glass agglutination reaction.

When determining the presence of antibodies in the patient’s blood serum, it is diluted with an isotonic sodium chloride solution starting from a dilution of 1: 50 to 1: 800 or more. A suspension of live or killed microbes is added to each dilution. Preparations containing microbes killed by heat or formaldehyde are called diagnosticums. Diagnosticums obtained by heating microorganism cultures contain only somatic antigens. When using only formaldehyde, microbes retain their flagellar antigens.

In the presence of antibodies in the patient’s blood, the diagnostic test taken in the reaction sticks together and a precipitate (agglutinate) forms on two test tubes. In this case, the results of the agglutination reaction are regarded as positive. In the control tube, into which isotonic sodium chloride solution and diagnosticum are added, the suspension of microbes should be homogeneous (negative agglutination reaction).

The results of the agglutination reaction in some diseases, such as leptospirosis, are taken into account only microscopically in a dark field of view of a microscope (microagglutination). To make a serological diagnosis of a disease, the diagnostic disease is taken into account. It usually corresponds to a serum dilution of 1:100 or 1:200.

Antibodies in the patient’s blood serum can be detected using the agglutination reaction in cases of typhoid fever and paratyphoid fever (Vidal reaction), brucellosis (Wright reaction), tularemia, etc.
Castellani's reaction. With some infectious diseases or immunization with microorganisms containing group antigens, in the blood serum, in addition to antibodies specific to a given type, group antibodies also appear. In this case, related bacterial species will be agglutinated by the resulting sera.

Castellani proposed a method for the adsorption of group antibodies from immune sera, based on their removal with the help of microorganisms of related species that have group antigens but lack specific ones. A culture of such microorganisms added to the serum adsorbs nonspecific group antibodies, and after removal of the antigen-antibody complex by centrifugation, only specific immunoglobulins remain in the serum. Sera processed according to the Castellani method can be used in the agglutination reaction as highly specific.

Any fluid in the human body consists of cellular elements, blood from, leukocytes and platelets; The main components of male seminal fluid are spermatozoa. Agglutination (translated from Latin as “to stick together”) in microbiology is considered the process of gluing together cellular elements, as a result of which their mobility and functionality are lost.

Previously, this term was known only to initiates: urologists, andrologists and other specialists in this field, and infertility was considered exclusively a female inferiority. Today statistics demonstrate sad facts: male infertility in our country dominates over female infertility.

Male strength has always been associated not only with the sword and spear, but also with potency and reproductive function. There are three main types of agglutination: true (specific), false (nonspecific) and mixed.

1. With specific agglutination, tails or heads stick together. Such elements, lacking mobility and efficiency, cannot fertilize a female egg.
2. False agglutination, when sperm stick together with particles of damaged epithelial cells and other elements of the ejaculate, also losing speed of movement.
3. Mixed agglutination is very rare. With this type of pathology, spermatozoa stick together both with each other and with other elements of the seminal fluid.

In all cases, the sperm changes: it becomes thicker, sometimes the presence of lumps can be discerned with the naked eye. The result is also the same - reproductive dysfunction and infertility in men.

Development mechanism

The zone of sperm formation is the seminiferous tubules, the boundaries of which are covered with epithelium consisting of Sertoli cells. Having firmly connected to each other, these cells form a blood-testis barrier that prevents blood from contacting sperm. The fact is that due to the haploid set of sperm chromosomes, the immune system perceives them as enemies and begins an active fight against the “violators”, producing antisperm antibodies (ASAT).

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If this barrier is violated, unwanted contact still occurs, and the male body begins to produce specific proteins, this is ACAT. Antibodies combine with antigens located on the surface of the “tadpole”, their connection is very close and strong, it causes a decrease in the speed of movement and disruption of all the main functions of the sperm. As a result, such a “candidate” loses the ability to get close to the egg and fertilize it.

The body of a healthy man works like a clock; sperm are endowed with a negative electrical charge, and according to the laws of physics, they repel other cells and each other. When a well-functioning mechanism fails, sperm agglutination begins to develop and, as a result, immunological infertility in men.

Causes of agglutination

There are several main reasons for the occurrence and development of agglutination:

• The presence of inflammatory diseases: vesiculitis, orchitis, etc.
• Injury to the testicles (testicles), as a result of which the seminal canals and capillaries are damaged, the Sertoli cell barrier is disrupted.
• Uro/genital infections. Viruses, bacteria and fungal microorganisms attached to sperm membranes provoke the immune system. It, in turn, produces antibodies that affect both the pathogen and the sperm themselves.
• Hormonal imbalances in the male body.
• Some chronic diseases that call on the immune system to act.
• The use of alcohol, drugs and certain medications leads to a decrease in sperm quality.
• Unsuccessful surgical interventions in the genital area.
• Varicocele.

This pathology is dangerous not only because of reproductive dysfunction. In milder stages, there is a risk of giving birth to genetically diseased offspring; in severe cases, there is a decrease in the mobility of the genital organ and even impotence.

Agglutination should not be confused with sperm aggregation, in which sperm stick together with the mucus present in the seminal fluid. Aggregation becomes dangerous for male power only in the most severe and advanced forms.

Diagnostics of deviations

Agglutination can be diagnosed by assessing the spermogram and passing the MAR test. For the first study, it is necessary to provide ejaculate obtained by self-masturbation in a certain amount. You can collect material for analysis both in the laboratory and at home in sterilized containers. It is necessary to deliver the material for research within an hour, observing temperature conditions. This analysis allows you to evaluate the quality of sperm by color, volume, presence of mucus, white blood cells and red blood cells, liquefaction rate and the number and maneuverability of sperm.

MAR - the test determines the percentage of motile sperm with antibodies to their total number in a certain volume of seminal fluid. A portion of sperm and venous blood is taken for analysis. If the result is positive, the number of active sperm with ACAT is more than fifty percent of the total mass.

Agglutinations are indicated by crosses:

• (-) - no deviations, normozoospermia
• (+) – rare groups of stuck together “tadpoles”, up to five pieces in each
• (++) – companies from ten to twenty pieces
• (+++) – several dozen
• (++++) – a solid mass of stuck together sperm, severe degree of agglutination

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In the case of an advanced form of deviation, it is not always possible to restore fertilizing ability. The only chance to have a child for such patients is artificial insemination, ICSI or IVF.

Traditional treatment for agglutination

Before starting treatment for agglutination, the doctor determines the cause of the pathology. This pathology is not an independent disease; rather, it is a symptom or consequence of some illness.

For a detailed study of the clinical picture, the patient may be referred for additional examinations, and may have to be tested for sexually transmitted diseases, E. coli and other infections.

First of all, medications that increase immunity and a complex of vitamins are prescribed. In case of inflammatory processes - antibacterial therapy.

If the cause of the pathology is varicocele or other diseases associated with venous expansion of the pampiniform canal, surgery is prescribed together with drug treatment. Often resort to the use of Gonadotropin or Clomiphene.

• Limit physical activity
• To refuse from bad habits
• Give preference to comfortable underwear made from natural materials
• Have sex regularly to avoid sperm stagnation
• Avoid stress and

The body will definitely respond gratefully to manifestations of care for it, it simply cannot be otherwise. It is unwise to accumulate problems and the sooner measures are taken, the better and sooner the result should be expected.

Traditional medicine methods

Unfortunately, this pathology is quite common, and modern assisted conception methods are not available to everyone. Statistics and numerous patients speak positively about traditional medicine methods in this area.

The most popular and accessible of them:

1. Mumiyo in the amount of 0.2 g is taken twice a day on an empty stomach. It is better to drink the product with carrot, blackberry juice or decoctions of medicinal plants.
2. Red or tea rose syrup. It can be purchased at a pharmacy along with instructions for use.
3. Plantain seeds. 1 tbsp. pour a glass of boiling water over the spoon and leave in a water bath for about five minutes. Should be taken 2 tbsp. spoons four times a day.
4. Infusion of adonis. Infuse for at least two hours 1 tbsp. a spoonful of the plant, steamed with boiling water. Drink three times a day.
5. Bird's knotweed. Brewed and taken as tea, 1 glass per liter of water.
6. Adam's root in the amount of 2 teaspoons, pour a glass of boiling water and leave for about three hours. Drink four times a day.

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In the fight against a disease, as in war, all means are good. However, you should not self-medicate; a qualified doctor will help you quickly get rid of the pathology and experience the joy of fatherhood. Proper nutrition and a healthy lifestyle will certainly speed up the arrival of the long-awaited stork in every home.

Jul 13, 2016 Violetta Doctor

agglutination

Agglutination reaction (from lat. agglutinatio- gluing) - gluing of corpuscles (bacteria, red blood cells, etc.) by antibodies in the presence of electrolytes.

Agglutination reaction manifests itself in the form of flakes or sediment consisting of corpuscles (for example, bacteria) “glued together” by antibodies (Fig. 7.37). The agglutination reaction is used to: determine the pathogen isolated from the patient; determination of antibodies in the patient’s blood serum; determination of blood groups.

Rice. 7.37 a, b. Agglutination reaction withIgM-antibodies (a) andIgG-antibodies (b)

1. Determination of the pathogen isolated from the patient. Approximate agglutination reaction on glass (Fig. 7.38). A suspension of bacteria isolated from the patient is added to a drop of agglutinating serum (1:20 dilution). A flocculent precipitate forms.

Rice. 7.38.

An extensive agglutination reaction with a pathogen isolated from a patient (Fig. 7.39). A suspension of bacteria isolated from the patient is added to the dilutions of the agglutinating serum.

Rice. 52

2. Determination of antibodies in the patient’s blood serum
Detailed agglutination reaction with the patient’s blood serum (Fig. 7.39). Diagnosticum is added to dilutions of the patient's serum.
- Agglutination with O-diagnosticum (bacteria killed by heat, retaining O-antigen) occurs in the form of fine-grained agglutination.
- Agglutination with H-diagnosticum (bacteria killed by formaldehyde, retaining the flagellar H-antigen) is large and occurs faster.
3. Agglutination reaction for determining blood groups The agglutination reaction to determine blood groups is used to establish the ABO system (Table b) using agglutination of erythrocytes with immune serum antibodies against blood group antigens A (I), B (III). The control is: serum that does not contain antibodies, i.e. serum AB (IV) blood group; antigens contained in red blood cells of groups A (II), B (III). The negative control does not contain antigens, i.e., group O (I) erythrocytes are used.

Table 7.6. Determination of ABO blood groups

Agglutination is the process of adhesion of cells that are under the influence of agglutinins found in the blood plasma.

Sperm agglutination, first of all, is indicated by a pathology of the reproductive system of a young man. In this case, the cells stick together, and do not repel, under the influence of negatively charged particles, as happens in the normal and planned state.

It is this condition that can contribute to fertilization. With agglutination, this process does not occur.

It is customary to divide agglutination into true and false.

What is true agglutination? True agglutination is the process by which sperm stick together. And with false agglutination, cells can only stick together with destroyed particles or antibodies of their own body.

Main causes of agglutination

There are several reasons why agglutination may occur and it is worth considering them in a little more detail.

• First of all, these are injuries to the testicles, which can damage the seminal canals.
• Most often these are viral infections. They have the ability to attach to the sperm membrane. By doing this, of course, they greatly injure the immune system, and it, in turn, tends to produce antibodies.
• The next cause may be various inflammatory diseases, such as prostatitis, orchitis, vesiculitis.
• Certain surgical operations on the genital organs, which are not performed entirely successfully, can also contribute to the development of such a disease.
• Hormonal problems in the male body.
• Chronic diseases that can contribute to the development of such a disease.
• Use of drugs, alcohol, use of medications. All this can contribute to poor sperm quality.

It is worth noting

Most people confuse the concepts of agglutination and aggregation and put them on an equal footing. But this should not be done, because they are completely different.

If, during agglutination, sperm stick together with each other, then during aggregation, sperm can stick together not only with each other, but also with any other cells of the seminal fluid. Thus, aggregation is less destructive and dangerous than agglutination.

This kind of pathology cannot lead to impaired organ mobility and infertility. This can only happen if this process is at an advanced stage and is strongly expressed.

What should be done when sperm agglutination is detected?

Only a qualified specialist should treat and prescribe the entire course of drugs and medications. Moreover, he should do this only when he has all the tests on the man’s health in hand. Only after this can the specialist begin drawing conclusions and treatment.

In the process of deciphering the results and based on the spermogram, therapy for the inflammatory process is carried out from the very beginning. Such diseases may include prostatitis, orchitis, vesiculitis and others. All these diseases must be treated. Only in some cases, with a favorable outcome of treatment, agglutination may disappear.

Most often, an inflammatory process is excluded, but there are clearly significant deviations from the norm. In this case, the man cannot conceive a child on his own. And even then you can use modern reproductive technologies for fertilization.

The degree of sperm agglutination: what does it mean?

It is worth mentioning that it is customary to distinguish only four degrees of sperm agglutination.

• “+” - in this case, only a few gluing groups are distinguished, and can contain up to 5 units of sperm in a group.
• “++” - these groups can contain from 10 to 20 units of sperm.
• “+++” - such a group can contain 5 or more groups and number dozens of sperm.
• “++++” - this degree can contain a large number of groups and sperm.

Agglutination itself has the properties of reducing sperm motility. Such deposits on the very surface of the sperm reduce the likelihood of conception several times. In this case, it is recommended to carry out. It will help determine the number of sperm that are and remain motile. And on the surface of which antisperm antibodies are present.

Treatment of agglutination will consist of eliminating those factors that influenced the development of such a pathology. In cases where conservative therapy has no effect, assisted methods of conception are usually resorted to.

It is also worth saying that there are several tips that can improve the degree of sperm agglutination.

1. You should not stay in very stuffy and warm rooms for a long time. Wear only underwear that makes you comfortable. These factors can cause sperm quality to deteriorate.
2. Do not overload your body with physical activity. Of course, you need to adhere to a healthy lifestyle and exercise, but everything should be within reasonable limits.
3. The quality of sperm is primarily affected by diseases that are sexually transmitted. Therefore, you need to be regularly examined by specialists.
4. It is worth paying attention to the quality of underwear fabrics. It is best if these are natural materials.
5. Give up all harmful and harmful habits that destroy your body. There is no need to get too involved in alcoholic beverages, cigarettes and drugs. It's no secret that cigarettes have a negative effect on erection, and most importantly, they can also affect the DNA of the fetus.
6. And the last thing is regular sexual intercourse, which improves sperm quality. You need to have sex every day.