[Posted by new forum member, "yasienhossam", representing medical researchers who sign this posted letter. Emailed Letter addressed to Dr. Marcel Waldinger]
Dear Prof Waldinger,
It has given us great honor when the editors of F1000 Research had told us that you will be one of the reviewers of our paper but we were astonished when we read your response which said that you refused our work that was accepted (with reservation) by the other 3 referees. We think and feel that it was not fair enough.
Actually we respect your own opinion but we are surprised!; how it comes to reject a case report of POIS (the rare disease) and say that you encourage publication in that topic?!. Is it related to what you think that; the idea of atopy may be a precipitating factor for POIS is yours and not ours ?!. We think that this is not true. This is because we discovered our case by the end of 2009 and at that time you have only one publication in 2002- in which you didn't refer at all to atopy. We have found that our patient is atopic and in addition to the cognitive and body pains he feels post orgasmic; his atopy flares up eye irritation with severe body itching. By December 2009 and after preparing the report and before its publication we sent you 3 e-mails with about one week intervals, by the full length paper to ask you your experience as the only reporter of this syndrome - at that time - but sadly enough we didn't receive any reply. Please, return back to your archive. Moreover; in 2010; we shared the ISSM forum by this case report also before you mention at all any relation of POIS to atopy - you mentioned it only in your publication at 2011 - and many of our colleagues who are ISSM members shared by comments and discussion ; we remember that one of them was Prof. David Goldmeier. Please go back to the ISSM Forum 2010. This case report was presented as a poster in the 20th World Congress for Sexual Health, held in June 12- 16, 2011, Glasgow, UK , and published in its proceedings . For the before mentioned reasons we think that; it is ours and not yours that; atopy may be a precipitating factor for POIS and we must ask about and check for it in any of POIS cases.
Our Dear Dr Waldinger, in your reply one of the reasons for which you refused our case report -as you stated - is that we mentioned that; NSAIDs, tramadol and SSRIs may help and you didn't find any response to these drugs. We want to remind you that this is not our findings but the references mentioned and our patient didn?t get any benefit from trying these drugs; please you can read our case report again !.
What we feel very important and we want to discuss is the skin prick test as a diagnostic test for allergy. Do you think that it is a reliable one in this regard? is it enough to reach the final conclusion that POIS patients are allergic to their own semen and that this is the cause of POIS?. Basically; we know - and it is scientifically proved - that this test has many false positive and negative results. Moreover; we as andrologists ; knew - and it is scientifically proved as well that; our semen is foreign for our body and our immune system. Immunologic tolerance to it is not present as it formed only after our puberty where the immune system didn't identify it in utero. For this reason our God totally separated it from our immune system by what is well known now as the very competent Blood Testis barrier that is formed by the highly efficient Sertoli Sertoli cell junctional complex. It is not - as you mentioned on you tube - a hypothetical membrane. Only in certain known pathologic conditions this barrier may be broken. If occurred we form auto-antibodies against our semen. So; when we inject our own semen intradermaly we will react positively to it as it is a foreign antigen for us. Please try to apply this very simple prick test for you and your assistants using your own semen; mostly you will get a positive reaction without having POIS. Moreover; if we suppose that; allergy to the patient's own semen is the cause of POIS; it was mandatory to measure serum and seminal plasma anti-sperm antibodies; IgA, IgG and IgM, to do immuno bead and MAR testing and to report on the patient's seminogram changes as in such cases ? if this is true - POIS patients will be mostly infertile as well. So; as you depended only upon the unreliable skin prick test and for the afore mentioned scientific facts, we - and we think that we will be shared by anyone who is interested in andrology - think that; your conclusion is not right and we can't scientifically accept that the cause of POIS is allergy to own semen.
Dear Prof, we are surprised; how it comes that; only from two patients ? without placebo control ? wants us to accept that; hyposensitization using the patient's own semen is the treatment of POIS!. Although your last two papers are published in a highly respectable journal we are sorry to say that; this is not right from the scientific facts mentioned above and they are only two patients. We think that; any benefit if any is not more than placebo.
Thanks,
Prof. Dr Abdalla attia & Dr Hossam Yasien
Andrology Unit,
Faculty of Medicine,
Minoufiya University,
Egypt
= = = = = = = = = = = = = = = = = = = = = = = = =
yasienhossam, thank you for your excellent questioning!
I hope Waldinger will respond.
Best regards,
Demo
ps - contact info
Prof. dr. Marcel D. Waldinger
dr.m.d.waldinger@gmail.com
[The above was edited from the original below. Edits mostly include "?" for ' and in some cases ? were removed. My apology if I inadvertently altered any original meaning by the author - demo]
Dear Prof Waldinger,
It has given us great honor when the editors of F1000 Research had told us that you will be one of the reviewers of our paper but we were astonished when we read your response which said that you refused our work that was accepted (with reservation) by the other 3 refrees. We think and feel that it was not fare enough.
Actually we respect your own opinion but we are surprised!; how it comes to reject a case report of POIS (the rare disease) and say that you encourage publication in that topic?!. Is it related to what you think that; the idea of atopy may be a precipitating factor for POIS is yours and not ours ?!. We think that this is not true. This is because we discovered our case by the end of 2009 and at that time you have only one publication ? 2002- in which you didn?t refer at all to atopy. We have found that our patient is atopic and in addition to the cognitive and body pains he feels post orgasmic; his atopy flares up ? eye irritation with severe body itching. By December 2009 and after preparing the report and before its publication we send you 3 e-mails with about one week intervals, by the full length paper to ask you your experience? as the only reporter of this syndrome - at that time - but sadly enough we didn?t receive any reply. Please, return back to your archive. Moreover; in 2010; we shared the ISSM forum by this case report ? also before you mention at all any relation of POIS to atopy - you mentioned it only in your publication at 2011 - and many of our colleagues who are ISSM members shared by comments and discussion ; we remember that one of them was Prof. David Goldmeier. Please go back to the ISSM Forum 2010. This case report was presented as a poster in the 20th World Congress for Sexual Health, held in June 12- 16, 2011, Glasgow, UK , and published in its proceedings . For the before mentioned reasons we think that; it is ours and not yours that; atopy may be a precipitating factor for POIS and we must ask about and check for it in any of POIS cases.
Our Dear Dr Waldinger, in your reply one of the reasons for which you refused our case report -as you stated - is that we mentioned that; NSAIDs, tramadol and SSRIs may help and you didn?t find any response to these drugs. We want to remind you that this is not our findings but the references mentioned and our patient didn?t get any benefit from trying these drugs; please you can read our case report again !.
What we feel very important and we want to discuss is the skin prick test as a diagnostic test for allergy. Do you think that it is a reliable one in this regard? is it enough to reach the final conclusion that POIS patients are allergic to their own semen and that this is the cause of POIS?. Basically; we know - and it is scientifically proved - that this test has many false positive and negative results. Moreover; we as andrologists ; knew - and it is scientifically proved as well ?that; our semen is foreign for our body and our immune system. Immunologic tolerance to it is not present as it formed only after our puberty where the immune system didn?t identify it in utero. For this reason our God totally separated it from our immune system by what is well known now as the very competent Blood ? Testis barrier that is formed by the highly efficient Sertoli ? Sertoli cell junctional complex. It is not - as you mentioned on you tube - a hypothetical membrane. Only in certain known pathologic conditions this barrier may be broken. If occurred we form auto-antibodies against our semen. So; when we inject our own semen intradermaly we will react positively to it as it is a foreign antigen for us. Please try to apply this very simple prick test for you and your assistants using your own semen; mostly you will get a positive reaction without having POIS. Moreover; if we suppose that; allergy to the patient?s own semen is the cause of POIS; it was mandatory to measure serum and seminal plasma anti-sperm antibodies; IgA, IgG and IgM, to do immuno bead and MAR testing and to report on the patint?s seminogram changes as in such cases ? if this is true - POIS patients will be mostly infertile as well. So; as you depended only upon the unreliable skin prick test and for the afore mentioned scientific facts, we - and we think that we will be shared by anyone who is interested in andrology - think that; your conclusion is not right and we can?t scientifically accept that the cause of POIS is allergy to own semen.
Dear Prof, we are surprised; how it comes that; only from two patients ? without placebo control ? wants us to accept that; hyposensitization using the patient?s own semen is the treatment of POIS?!. Although your last two papers are published in a highly respectable journal we are sorry to say that; this is not right from the scientific facts mentioned above and they are only two patients. We think that; any benefit ? if any ? is not more than placebo.
Thanks,
Prof. Dr Abdalla attia & Dr Hossam Yasien
Andrology Unit,
Faculty of Medicine,
Minoufiya University,
Egypt
