Author Topic: Intralymphatic Immunotherapy With Autologous Semen in a Korean Man With POIS  (Read 1561 times)


Muon

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Poiscenter member Disaster stated he had a low IgG3 level as well.
''I have low IgG subclasses 1 and 3, normal 2 and 4.'' Comment #22: http://poiscenter.com/forums/index.php?topic=305.15

Quantum

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Here is a post form member Ciccio, who had created another thread shortly after this one. This will regroup here the conversation about this article:

Here : https://www.sciencedirect.com/science/article/pii/S2050116118300199 (Intralymphatic Immunotherapy With Autologous Semen in a Korean Man With Post-Orgasmic Illness Syndrome)

Interesting this new type of therapy, it would seem more effective. In general, according to an other study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352255/), "as few as three low dose intralymphatic allergen administrations are sufficient to effectively alleviate symptoms. Results of recent prospective and controlled trials suggest that this strategy may be an effective form of allergen immunotherapy". Even if in the Korean study, scientists say that "the pathogenesis of POIS cannot be entirely explained by allergies".

It's interesting that they observed levels of IgG3 below the normal in the patient?s serum.

Hormones were abnormal: Testosterone was too low, prolactin was too low (Weird, right? I would have thought the opposite) and estradiol was too high.
Normally, prolactin deficiency is associated with pituitary dysfunction. But following orgasm, prolactin incresease acoording to this study https://link.springer.com/article/10.1007/s11930-008-0025-6 : "Activation of the hypothalamic pituitary axis associated with orgasmic-like responses results in increased plasma levels of prolactin (but no changes in cerebral spinal fluid levels). The reason for this and the role, if any, of prolactin in orgasm is unclear."

what do you think?
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Quantum

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Hi Muon and Cicco,

Thanks to both of you for this interesting link.

What I have found the most useful and interesting in this article, is that fact that, for the first time, a scientific article acknowledge that there are more than one type of POIS, a hypothesis I have been supporting for a long time now on this forum. This is obvious here :

« Hyposensitization therapy, or AIT, can have therapeutic effects in patients with POIS in whom allergies are a dominant etiologic factor. The present patient was judged to belong to this group of patients and received ILIT, which alleviated his POIS-related symptoms »

I am so glad they had the courage to write this :)

The symptoms they had the best results with, with that new desens method, is sneezing, which is the only symptom that completely disappeared in this case report, and is clearly an allergy-like symptom  ( it is interesting to note that the technique they used was first studied in allergic rhinitis).  It also helped for some flu-like symptoms like fever, at around 80% relief at the end of treatment protocol.  However, there have been only about 30% to 50% on average for other allergy-like symptoms like burning eyes and for the relief for other types of symptoms like neuropsychiatric symptoms.  There was no relief at all for local inflammation symptoms like weak stream and voiding difficulties, signs of prostate inflammation.  See table 1 for all the details about the symptoms relief.   Overall, they have not « cured » the patient, and were honest enough to recognize the implication, that is, there is more at play in POIS than a simple allergy, and it is more complex than, for example, allergic rhinitis.

So, they clearly share the view expressed in Waldinger latest article, that POIS is more than just an « allergy to semen », and more research is necessary to understand its mechanism. 

In the discussion part they clearly state, as Cicco have mentioned, that allergy alone cannot explain all the symptoms seen in POIS. 

This article also accept what have been found in the Chinese study, that is, that the skin-prick test is not specific for the diagnosis of POIS, and, also, that all POIS sufferers will not necessarily have specific IgE for their own semen, only those with the allergic component.

They also share some interesting details about their IgE testing :
« The IgE immunoblotting of autologous seminal fluid incubated with serum from the patient and 1 healthy control showed IgE binding bands at 14, 16, 34, and 55 kD (eFigure 3). The IgE binding band at 55 kD was particularly prominent before ILIT, but it was fainter when seminal fluid was incubated with serum obtained from the patient 8 months after ILIT. In addition, ELISA analysis showed that the level of semen-specific IgE was increased in the patient's serum before ILIT compared with the healthy control, but it had deceased to levels similar to those of the healthy control 8 months after ILIT (eFigure 4) »

Could this 55 kD IgE test become an objective test that could establish the presence or not of the alllergy-like part of POIS?   It would be very interesting to simply have many POIS sufferers and many healthy, control subjects have these tests done, even if no treatment is tested, just to validate this potential objective test for at least a part of POIS diagnosis.   This could confirm that the prominence of this 55kD IgE band is specific for those who have allergy-like POIS symptoms, and not in healthy subjects, and even not in POIS sufferers that have no allergy-like symptoms.


I note that what I have called emotional symptoms ( irritability, anxiety, depression,..),  are called « neuropsychiatric symptoms" in the article – see table 1.  I introduced the term « emotional symptoms" when I fist arrived on the forum to distinguish them from cognitive symptoms ( brain fog, speech impairment, loss of problem-solving capacities, memory problems, …), rather then include both in « Brain symptoms » or « mental symptoms » as it was used to be then.

Again, about emotional and cognitive symptoms, I note the this Korean patient didn't report any cognitive symptoms  ( no mention of brain fog, concentration issues, memory impairment, …).  He has allergy-like, flu-like and emotional/neuropsychiatric symptoms, but no mention of cognitive impairment in POIS.

One thing I would have like is some comments about how the subject reacted to the last, full concentration injection.  They gave discomfort reports for the other injections, but not for that last one.

Overall, about this article, I feel it is a good thing that this case report attracts attention to our rare syndrome.  The authors have been courageous to share some of their conclusions, like the fact that there is more than one type of POIS and that it cannot be explained by IgE and allergy alone,  and they have been honest in defining the limits of this report of only one case.  The results they had with their method were not that impressive,  and surely not a complete cure for POIS, but it has helped this POIS sufferer in diminishing the intensity of many of his symptoms, and some of the duration as well.  I feel it is an improvement over the 3 years protocol that Waldinger had used ( but stopped using), both for the dramatically reduced duration and injecitons number, and for patient comfort ( less semen sample collection, less injections, etc..).

I wouldn't trade my pre-pack method and try their protocol,  because I have no allergy like symptoms, and have no fever,  but even if I had those, my 80% to 100% relief level is better than what they achieved.  However, I am happy to see the time these MDs have invested in this case, and that they cared to published their results.

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Nas

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Hey Quantum,
Hi Muon and Cicco,

The symptoms they had the best results with, with that new desens method, is sneezing, which is the only symptom that completely disappeared in this case report, and is clearly an allergy-like symptom  ( it is interesting to note that the technique they used was first studied in allergic rhinitis).  It also helped for some flu-like symptoms like fever, at around 80% relief at the end of treatment protocol.  However, there have been only about 30% to 50% on average for other allergy-like symptoms like burning eyes and for the relief for other types of symptoms like neuropsychiatric symptoms.  There was no relief at all for local inflammation symptoms like weak stream and voiding difficulties, signs of prostate inflammation.  See table 1 for all the details about the symptoms relief.   Overall, they have not « cured » the patient, and were honest enough to recognize the implication, that is, there is more at play in POIS than a simple allergy, and it is more complex than, for example, allergic rhinitis.

So, they clearly share the view expressed in Waldinger latest article, that POIS is more than just an « allergy to semen », and more research is necessary to understand its mechanism. 

In the discussion part they clearly state, as Cicco have mentioned, that allergy alone cannot explain all the symptoms seen in POIS. 



I was thinking the same when I read the article, and I was thinking, if you think about, it perhaps semen allergy and POIS are two completely different things. They might be a part of the bigger POIS mechanism; perhaps it helps initiating POIS. Or even just two problems occurring at the same instance. I personally subscribe to the former.
I'm also worried that POISers with cognitive/emotional symptoms become overshadowed by the allergy symptoms, and you can see that in most if not all articles about POIS, where it is defined as "flu-like symptoms after orgasm" primarily. Especially for your case which is like the rarest of the rare. 
« Last Edit: March 23, 2018, 10:55:37 PM by Nas »

Muon

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What I don't understand from this study is why they didn't measure IgG4 after ILIT, such a missed opportunity.

''The mechanism of ILIT is not sufficiently understood, but we propose that ILIT might be mediated byplasmablasts, plasma cells, and memory B cells that are activatedby allergens injected into lymph nodes and produce allergen-specific IgE, IgG4, or other antibody isotypes with or withoutenhanced affinity.''

Quote from: Quantum
Could this 55 kD IgE test become an objective test that could establish the presence or not of the alllergy-like part of POIS?   It would be very interesting to simply have many POIS sufferers and many healthy, control subjects have these tests done, even if no treatment is tested, just to validate this potential objective test for at least a part of POIS diagnosis.   This could confirm that the prominence of this 55kD IgE band is specific for those who have allergy-like POIS symptoms, and not in healthy subjects, and even not in POIS sufferers that have no allergy-like symptoms.

This test could be investigated in a group study yes but I wonder whether the faded 55kD band is responsible for his alleviation at all.
« Last Edit: January 31, 2019, 01:34:37 PM by Muon »

Hopeoneday

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I yust found one link on my native language(Croatian):
https://translate.google.com/translate?hl=en&sl=hr&tl=en&u=http%3A%2F%2Fwww.krenizdravo.rtl.hr%2Fzdravlje%2Fje-li-alergija-na-spermu-opasna

Its seys that : Namely, contact with the sperm may result in swallowing respiratory tract and blood clots. This can lead to choking, loss of consciousness, and in extreme cases to lethal anaphylactic shock.

Those symptomes i hawe when my pois atacked me hard.

And what is the most intresting to me is that not semen itself is coused
reaction, but some protein produced in glandular prostate cells
, discovered by Dr. Johannes Ringu , Germany  :

The allergic reaction is caused by fluid seeds , not sperm itself. The immune system of the body behaves like in the case of pelvis allergy. It identifies an innocuous substance as a possible cause of the disease and reacts to it briskly.

And while in the case of pajamas(flowers dust , polen- bad google translate) allergy knows which proteins are responsible for a burning reaction, in the case of sperm allergy, the cause has long been unknown. Alergologu Dr. Johannes Ringu, of the University Clinic in Munich, managed to determine that Prostate Specific Antigen (PSA) , a protein produced by glandular prostate cells, is secreted into semen fluid.
« Last Edit: January 31, 2019, 03:34:27 PM by Hopeoneday »
Dr-pois.

Muon

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And while in the case of pajamas(flowers dust , polen- bad google translate) allergy knows which proteins are responsible for a burning reaction, in the case of sperm allergy, the cause has long been unknown. Alergologu Dr. Johannes Ringu, of the University Clinic in Munich, managed to determine that Prostate Specific Antigen (PSA) , a protein produced by glandular prostate cells, is secreted into semen fluid.
So how do I know if that's the case? PSA level is normal

Hopeoneday

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 ;D Muon, we will knew it one day.
We see that psa is not the "answer"
Somewhere here betwen those lines is posible answer:

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-065X.2006.00438.x

Summary: The production, differentiation, and presence of male gametes represent inimitable challenges to the immune system, as they are unique to the body and appear long after the maturation of the immune system and formation of systemic self?tolerance. Known to protect germ cells and foreign tissue grafts from autoimmune attack, the ‘immune privilege’ of the testis was originally, and somewhat simplistically, attributed to the existence of the blood–testis barrier. Recent research has shown a previously unknown level of complexity with a multitude of factors, both physical and immunological, necessary for the establishment and maintenance of the immunotolerance in the testis. Besides the blood–testis barrier and a diminished capability of the large testicular resident macrophage population to mount an inflammatory response, it is the constitutive expression of anti?inflammatory cytokines in the testis by immune and particularly somatic cells, that represents an essential element for local immunosuppression. The role of androgens in testicular immune regulation has long been underestimated; yet, accumulating evidence now shows that they orchestrate the inhibition of proinflammatory cytokine expression and shift cytokine balance toward a tolerogenic environment. Furthermore, the role of the testicular dendritic cells in suppressing antigen?specific immunity and T?lymphocyte activation is discussed. Finally, the active role mast cells play in the induction and amplification of immune responses, both in infertile humans and in experimental models, highlights the importance of preventing mast cell activation to maintain the immune?privileged status of the testis.

Guys , enebody know how prostate immunotolerance "working"?
Is it work in sinergy with testicles, or separate?
« Last Edit: February 02, 2019, 05:36:32 PM by Hopeoneday »
Dr-pois.