Autoimmune Orchitis and Autoimmune Oophoritis

Abstract

The etiology of gonadal failure with infertility in men and women may have a genetic, environmental, or autoimmune basis. The major support for an autoimmune basis has come from studies on patients with the autoimmune polyglandular syndrome entity associated with mutation of the AIRE gene. AIRE-null mutant mice are defective in clonal deletion and regulatory T cell production—the two key tolerance mechanisms. When tolerance is disrupted, autoreactive T cells and B cells respond to self antigen and induce immunopathologic organ damage that leads to infertility. Although T cells are pivotal, antibodies are also critically involved. There has been considerable progress in the understanding of pathogenic mechanisms of autoimmune orchitis and oophoritis, as well as the immunologic sequel of vasectomy. In this review we describe both human diseases and the experimental models of autoimmune orchitis and oophoritis, highlighting many aspects, including the relevant role of lymph node-specific regulatory T cells as well as Th1 and Th17 effector cells.