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Obesity is characterized by low-grade inflammation, energy imbalance and impaired thermogenesis. The role of regulatory T cells (Treg) in inflammation-mediated maladaptive thermogenesis is not well established. Here, we find that the p38 pathway is a key regulator of T cell-mediated adipose tissue (AT) inflammation and browning. Mice with T cells specifically lacking the p38 activators MKK3/6 are protected against diet-induced obesity, leading to an improved metabolic profile, increased browning, and enhanced thermogenesis. We identify IL-35 as a driver of adipocyte thermogenic program through the ATF2/UCP1/FGF21 pathway. IL-35 limits CD8+ T cell infiltration and inflammation in AT. Interestingly, we find that IL-35 levels are reduced in visceral fat from obese patients. Mechanistically, we demonstrate that p38 controls the expression of IL-35 in human and mouse Treg cells through mTOR pathway activation. Our findings highlight p38 signaling as a molecular orchestrator of AT T cell accumulation and function.
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Interleucinas , Obesidade , Linfócitos T Reguladores , Termogênese , Proteínas Quinases p38 Ativadas por Mitógeno , Animais , Interleucinas/metabolismo , Obesidade/metabolismo , Camundongos , Humanos , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Transdução de Sinais , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Inflamação/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos KnockoutRESUMO
Ribosome profiling experiments support the translation of a range of novel human open reading frames. By contrast, most peptides from large-scale proteomics experiments derive from just one source, 5' untranslated regions. Across the human genome we find evidence for 192 translated upstream regions, most of which would produce protein isoforms with extended N-terminal ends. Almost all of these N-terminal extensions are from highly abundant genes, which suggests that the novel regions we detect are just the tip of the iceberg. These upstream regions have characteristics that are not typical of coding exons. Their GC-content is remarkably high, even higher than 5' regions in other genes, and a large majority have non-canonical start codons. Although some novel upstream regions have cross-species conservation - five have orthologues in invertebrates for example - the reading frames of two thirds are not conserved beyond simians. These non-conserved regions also have no evidence of purifying selection, which suggests that much of this translation is not functional. In addition, non-conserved upstream regions have significantly more peptides in cancer cell lines than would be expected, a strong indication that an aberrant or noisy translation initiation process may play an important role in translation from upstream regions.
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Regiões 5' não Traduzidas , Biossíntese de Proteínas , Humanos , Códon de Iniciação/genética , Composição de Bases , Genoma Humano , Animais , Fases de Leitura Aberta/genética , Sequência Conservada , Peptídeos/genética , Peptídeos/metabolismoRESUMO
Thoracic aortic aneurysm (TAA) is mainly sporadic and with higher incidence in the presence of a bicuspid aortic valve (BAV) for unknown reasons. The lack of drug therapy to delay TAA progression lies in the limited knowledge of pathophysiology. We aimed to identify the molecular hallmarks that differentiate the aortic dilatation associated with BAV and tricuspid aortic valve (TAV). Aortic vascular smooth muscle cells (VSMCs) isolated from sporadic TAA patients with BAV or TAV were analyzed by mass spectrometry. DNA oxidative damage assay and cell cycle profiling were performed in three independent cohorts supporting proteomics data. The alteration of secreted proteins was confirmed in plasma. Stress phenotype, oxidative stress, and enhanced DNA damage response (increased S-phase arrest and apoptosis) were found in BAV-TAA patients. The increased levels of plasma C1QTNF5, LAMA2, THSB3, and FAP confirm the enhanced stress in BAV-TAA. Plasma FAP and BGN point to an increased inflammatory condition in TAV. The arterial wall of BAV patients shows a limited capacity to counteract drivers of sporadic TAA. The molecular pathways identified support the need of differential molecular diagnosis and therapeutic approaches for BAV and TAV patients, showing specific markers in plasma which may serve to monitor therapy efficacy.
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Aneurisma da Aorta Torácica , Valva Aórtica , Doença da Válvula Aórtica Bicúspide , Pontos de Checagem do Ciclo Celular , Dano ao DNA , Músculo Liso Vascular , Miócitos de Músculo Liso , Humanos , Doença da Válvula Aórtica Bicúspide/patologia , Doença da Válvula Aórtica Bicúspide/metabolismo , Aneurisma da Aorta Torácica/patologia , Aneurisma da Aorta Torácica/genética , Aneurisma da Aorta Torácica/metabolismo , Músculo Liso Vascular/patologia , Músculo Liso Vascular/metabolismo , Pontos de Checagem do Ciclo Celular/genética , Masculino , Valva Aórtica/patologia , Valva Aórtica/anormalidades , Valva Aórtica/metabolismo , Feminino , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/patologia , Pessoa de Meia-Idade , Estresse Oxidativo , Doenças das Valvas Cardíacas/patologia , Doenças das Valvas Cardíacas/metabolismo , Doenças das Valvas Cardíacas/genética , Idoso , Proteômica/métodos , Apoptose/genéticaRESUMO
Right ventricular (RV) failure remains the strongest determinant of survival in pulmonary hypertension (PH). We aimed to identify relevant mechanisms, beyond pressure overload, associated with maladaptive RV hypertrophy in PH. To separate the effect of pressure overload from other potential mechanisms, we developed in pigs two experimental models of PH (M1, by pulmonary vein banding and M2, by aorto-pulmonary shunting) and compared them with a model of pure pressure overload (M3, pulmonary artery banding) and a sham-operated group. Animals were assessed at 1 and 8 months by right heart catheterization, cardiac magnetic resonance and blood sampling, and myocardial tissue was analyzed. Plasma unbiased proteomic and metabolomic data were compared among groups and integrated by an interaction network analysis. A total of 33 pigs completed follow-up (M1, n = 8; M2, n = 6; M3, n = 10; and M0, n = 9). M1 and M2 animals developed PH and reduced RV systolic function, whereas animals in M3 showed increased RV systolic pressure but maintained normal function. Significant plasma arginine and histidine deficiency and complement system activation were observed in both PH models (M1&M2), with additional alterations to taurine and purine pathways in M2. Changes in lipid metabolism were very remarkable, particularly the elevation of free fatty acids in M2. In the integrative analysis, arginine-histidine-purines deficiency, complement activation, and fatty acid accumulation were significantly associated with maladaptive RV hypertrophy. Our study integrating imaging and omics in large-animal experimental models demonstrates that, beyond pressure overload, metabolic alterations play a relevant role in RV dysfunction in PH.
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Modelos Animais de Doenças , Hipertensão Pulmonar , Hipertrofia Ventricular Direita , Metabolômica , Proteômica , Animais , Hipertensão Pulmonar/metabolismo , Hipertensão Pulmonar/fisiopatologia , Hipertensão Pulmonar/diagnóstico por imagem , Hipertrofia Ventricular Direita/metabolismo , Hipertrofia Ventricular Direita/fisiopatologia , Hipertrofia Ventricular Direita/diagnóstico por imagem , Função Ventricular Direita , Remodelação Ventricular , Sus scrofa , Suínos , MasculinoRESUMO
The valence-shell dissociative photoionization of acetaldehyde has been investigated by means of the photoion photoelectron coincidence technique in conjunction with tuneable synchrotron radiation. The experimental results consist of threshold photoelectron spectra for the parent ion and for each fragment ion in the 10.2-19.5 eV photon energy range, along with (ion, e) kinetic energy coincidence diagrams obtained from measurements at fixed photon energies. The results are complemented by high-level ab initio calculations of potential energy curves as a function of the C-H bond distance. The nudged elastic band (NEB) method has been employed to connect the parent ion Franck-Condon region to the formation of the HCO+, CH3+ and CH4+ ion fragments. Appearance energies have been determined for six fragment ions with an improved accuracy, including two fragmentation channels, which to the best of our knowledge have not been reported previously, i.e. the formation of CH2CO+, lying at 13.10 ± 0.05 eV, and the formation of CH2+ at 15.1 ± 0.1 eV. Based on both experimental and theoretical results, the dissociation dynamics following ionization of acetaldehyde into the different fragmentation channels are discussed.
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We present a comprehensive theoretical study of valence-shell photoionization of the CO2 molecule by using the XCHEM methodology. This method makes use of a fully correlated molecular electronic continuum at a level comparable to that provided by state-of-the-art quantum chemistry packages in bound-state calculations. The calculated total and angularly resolved photoionization cross sections are presented and discussed, with particular emphasis on the series of autoionizing resonances that appear between the first and the fourth ionization thresholds. Ten series of Rydberg autoionizing states are identified, including some not previously reported in the literature, and their energy positions and widths are provided. This is relevant in the context of ongoing experimental and theoretical efforts aimed at observing in real-time (attosecond time scale) the autoionization dynamics in molecules.
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Over the years, theoretical calculations and scalable computer simulations have complemented ultrafast experiments, as they offer the advantage of overcoming experimental restrictions and having access to the whole dynamics. This synergy between theory and experiment promises to yield a deeper understanding of photochemical processes, offering valuable insights into the behavior of complex systems at the molecular level. However, the ability of theoretical models to predict ultrafast experimental outcomes has remained largely unexplored. In this work, we aim to predict the electron diffraction signals of an upcoming ultrafast photochemical experiment using high-level electronic structure calculations and non-adiabatic dynamics simulations. In particular, we perform trajectory surface hopping with extended multi-state complete active space with second order perturbation simulations for understanding the photodissociation of cyclobutanone (CB) upon excitation at 200 nm. Spin-orbit couplings are considered for investigating the role of triplet states. Our simulations capture the bond cleavage after ultrafast relaxation from the 3s Rydberg state, leading to the formation of the previously observed primary photoproducts: CO + cyclopropane/propene (C3 products), ketene, and ethene (C2 products). The ratio of the C3:C2 products is found to be about 1:1. Within 700 fs, the majority of trajectories transition to their electronic ground state, with a small fraction conserving the initial cyclobutanone ring structure. We found a minimal influence of triplet states during the early stages of the dynamics, with their significance increasing at later times. We simulate MeV-ultrafast electron diffraction (UED) patterns from our trajectory results, linking the observed features with specific photoproducts and the underlying structural dynamics. Our analysis reveals highly intense features in the UED signals corresponding to the photochemical processes of CB. These features offer valuable insights into the experimental monitoring of ring opening dynamics and the formation of C3 and C2 photoproducts.
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Over the last few decades, the study of congenital heart disease (CHD) has benefited from various model systems and the development of molecular biological techniques enabling the analysis of single gene as well as global effects. In this chapter, we first describe different models including CHD patients and their families, animal models ranging from invertebrates to mammals, and various cell culture systems. Moreover, techniques to experimentally manipulate these models are discussed. Second, we introduce cardiac phenotyping technologies comprising the analysis of mouse and cell culture models, live imaging of cardiogenesis, and histological methods for fixed hearts. Finally, the most important and latest molecular biotechniques are described. These include genotyping technologies, different applications of next-generation sequencing, and the analysis of transcriptome, epigenome, proteome, and metabolome. In summary, the models and technologies presented in this chapter are essential to study the function and development of the heart and to understand the molecular pathways underlying CHD.
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Cardiopatias Congênitas , Animais , Humanos , Cardiopatias Congênitas/genética , Cardiopatias Congênitas/metabolismo , Modelos Animais de Doenças , Camundongos , Fenótipo , Sequenciamento de Nucleotídeos em Larga Escala , Técnicas de Cultura de Células/métodosRESUMO
Early diagnosis and treatment of chronic kidney disease (CKD) is a worldwide challenge. Subjects with albumin-to-creatinine ratio (ACR) ≥ 30 mg/g and preserved renal function are considered to be at no cardiorenal risk in clinical practice, but prospective clinical studies evidence increased risk, even at the high-normal (HN) ACR range (10-30 mg/g), supporting the need to identify other molecular indicators for early assessment of patients at higher risk. Following our previous studies, here we aim to stratify the normoalbuminuria range according to cardiorenal risk and identify the glycoproteins and N-glycosylation sites associated with kidney damage in subclinical CKD. Glycoproteins were analyzed in urine from hypertensive patients within the HN ACR range compared to control group (C; ACR < 10 mg/g) by mass spectrometry. A different cohort was analyzed for confirmation (ELISA) and sex perspective was evaluated. Patients' follow-up for 8 years since basal urine collection revealed higher renal function decline and ACR progression for HN patients. Differential N-glycopeptides and their N -glycosylation sites were also identified, together with their pathogenicity. N-glycosylation may condition pathological protein deregulation, and a panel of 62 glycoproteins evidenced alteration in normoalbuminuric subjects within the HN range. Haptoglobin-related protein, haptoglobin, afamin, transferrin, and immunoglobulin heavy constant gamma 1 (IGHG1) and 2 (IGHG2) showed increased levels in HN patients, pointing to disturbed iron metabolism and tubular reabsorption and supporting the tubule as a target of interest in the early progression of CKD. When analyzed separately, haptoglobin, afamin, transferrin, and IGHG2 remained significant in HN, in both women and men. At the peptide level, 172 N-glycopeptides showed differential abundance in HN patients, and 26 showed high pathogenicity, 10 of them belonging to glycoproteins that do not show variation between HN and C groups. This study highlights the value of glycosylation in subjects not meeting KDIGO criteria for CKD. The identified N-glycopeptides and glycosylation sites showed novel targets, for both the early assessment of individual cardiorenal risk and for intervention aimed at anticipating CKD progression.
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Glicopeptídeos , Insuficiência Renal Crônica , Humanos , Masculino , Feminino , Glicopeptídeos/urina , Insuficiência Renal Crônica/urina , Pessoa de Meia-Idade , Glicosilação , Idoso , Biomarcadores/urina , Creatinina/urina , Glicoproteínas/urina , Progressão da Doença , Albuminúria/urina , Fatores de Risco , Haptoglobinas/metabolismoRESUMO
We present a 47-year-old male without a relevant history or past respiratory diseases. He debuted with an acute, non-complicated COVID-19 infection, and later he started with mMRC-2 dyspnea, accompanied by a non-expectorant cough of four months evolution. A CT thoracic scan showed a dilatation of the aerial homogenous space and a well-defined anterior left pericardiac level, and a pericardial left bulla was diagnosed. The patient was treated with surgical intervention by video-assisted thoracoscopic surgery and had an adequate post-surgical evolution. The PPT must be managed by a multidisciplinary team with the definitive treatment of surgical resection.
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Mass spectrometry-based proteomics has traditionally been limited by the amount of input material for analysis. Single-cell proteomics has emerged as a challenging discipline due to the ultra-high sensitivity required. Isobaric labeling-based multiplex strategies with a carrier proteome offer an approach to overcome the sensitivity limitations. Following this as the basic strategy, we show here the general workflow for preparing cells for single-cell mass spectrometry-based proteomics. This protocol can also be applied to manually isolated cells when large cells, such as cardiomyocytes, are difficult to isolate properly with conventional fluorescence-activated cell sorting (FACS) sorter methods.
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Proteômica , Análise de Célula Única , Proteômica/métodos , Análise de Célula Única/métodos , Humanos , Espectrometria de Massas/métodos , Citometria de Fluxo/métodos , Proteoma/análise , Animais , Marcação por Isótopo/métodos , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/citologia , Coloração e Rotulagem/métodosRESUMO
The landscape of survival analysis is constantly being revolutionized to answer biomedical challenges, most recently the statistical challenge of censored covariates rather than outcomes. There are many promising strategies to tackle censored covariates, including weighting, imputation, maximum likelihood, and Bayesian methods. Still, this is a relatively fresh area of research, different from the areas of censored outcomes (i.e., survival analysis) or missing covariates. In this review, we discuss the unique statistical challenges encountered when handling censored covariates and provide an in-depth review of existing methods designed to address those challenges. We emphasize each method's relative strengths and weaknesses, providing recommendations to help investigators pinpoint the best approach to handling censored covariates in their data.
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Respiratory complex I plays a crucial role in the mitochondrial electron transport chain and shows promise as a therapeutic target for various human diseases. While most studies focus on inhibiting complex I at the Q-site, little is known about inhibitors targeting other sites within the complex. In this study, we demonstrate that diphenyleneiodonium (DPI), a N-site inhibitor, uniquely affects the stability of complex I by reacting with its flavin cofactor FMN. Treatment with DPI blocks the final stage of complex I assembly, leading to the complete and reversible degradation of complex I in different cellular models. Growing cells in medium lacking the FMN precursor riboflavin or knocking out the mitochondrial flavin carrier gene SLC25A32 results in a similar complex I degradation. Overall, our findings establish a direct connection between mitochondrial flavin homeostasis and complex I stability and assembly, paving the way for novel pharmacological strategies to regulate respiratory complex I.
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Complexo I de Transporte de Elétrons , Riboflavina , Humanos , Complexo I de Transporte de Elétrons/genética , Complexo I de Transporte de Elétrons/metabolismo , Riboflavina/metabolismo , Mitocôndrias/metabolismoRESUMO
OBJECTIVES: The validity of the Global Physical Activity Questionnaire has not been thoroughly evaluated among Hispanics/Latinos. In this cross-sectional study, we assessed the concurrent validity and correlates of discordance of the Global Physical Activity Questionnaire by comparing it to accelerometry in estimating sedentary behavior, moderate-to-vigorous physical activity, and meeting United States physical activity guidelines by sociodemographic, behavioral, and health characteristics. DESIGN: The Hispanic Community Health Study/Study of Latinos is a 4-site cohort study of United States adults aged 18-74â¯years enrolled from 2008 to 2011. METHODS: Participants (nâ¯=â¯11,873) completed the Global Physical Activity Questionnaire and wore an accelerometer for 1â¯week. Lin's concordance and Pearson correlations assessed concurrent validity between self-reported and accelerometry-assessed measures of sedentary behavior and moderate-to-vigorous physical activity. Kappa coefficients assessed agreement of meeting physical activity guidelines. Linear and logistic regression models identified correlates of discordance. RESULTS: The overall Lin's concordance and Pearson correlations between the Global Physical Activity Questionnaire and accelerometry estimates were 0.10 (95â¯% confidence interval 0.09, 0.12) and 0.24 (0.21, 0.27) for sedentary behavior, and 0.04 (0.03, 0.05) and 0.18 (0.15, 0.22) for moderate-to-vigorous physical activity, respectively. Agreement was poor for meeting the physical activity guideline classifications (Kappa coefficients: 0.12 to 0.26). Over a 16-hour day, sedentary behavior was under-reported by 3.8â¯h and moderate-to-vigorous physical activity was over-reported by 1.9â¯h. CONCLUSIONS: The concurrent validity of the Global Physical Activity Questionnaire in measuring moderate-to-vigorous physical activity and sedentary behavior when compared to accelerometry was poor among Hispanic/Latino adults.
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The valence-shell dissociative photoionization of methyl iodide (CH3I) is studied using double imaging photoelectron photoion coincidence (i2 PEPICO) spectroscopy in combination with highly-tunable synchrotron radiation from synchrotron SOLEIL. The experimental results are complemented by new high-level ab initio calculations of the potential energy curves of the relevant electronic states of the methyl iodide cation (CH3I+). An elusive conical intersection is found to mediate internal conversion from the initially populated first excited state, CH3I+(Ã2A1), into the ground cationic state, leading to the formation of methyl ions (CH3+). The reported threshold photoelectron spectrum for CH3+ reveals that the ν5 scissors vibrational mode promotes the access to this conical intersection and hence, the transfer of population. An intramolecular charge transfer takes place simultaneously, prior to dissociation. Upon photoionization into the second excited cationic state, CH3I+(BÌ2E), a predissociative mechanism is shown to lead to the formation of atomic I+.
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Protein optoelectronics is an emerging field facing implementation and stabilization challenges of proteins in harsh non-natural environments, such as dry polymers, inorganic materials, etc., operating at high temperatures/irradiations. In this context, additives promoting structural and functional protein stabilization are paramount to realize highly performing devices. On one hand, trial-error experimental assays based on previous knowledge of classical additives in aqueous solutions are effort/time-consuming, while their translation to water-less matrices is uncertain. On the other hand, computational simulations (molecular dynamics, electronic structure methods, etc.) are limited by the system size and time. Herein, ligand-binding affinity and atomic perturbations to create a day-fast computational method combining Vina And Rosetta for Protein Additives (VARPA) to simulate the stabilization effect of sugars for the archetypal enhanced green fluorescent protein embedded in a standard dry polymer color-converting filter for bio-hybrid light-emitting diodes is merged. The VARPA's sugar additive prediction trend for protein stabilization is nicely validated by thermal and photophysical studies as well as lighting device analysis. The device stability followed the predicted enhanced stability trend, reaching a 40-fold improvement compared to reference devices. Overall, VARPA can be adapted to a myriad of additives and proteins, driving first-step experimental efforts toward highly performing protein devices.
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Iluminação , Polímeros , Polímeros/química , ÁguaRESUMO
Serine protease inhibitor clade E member 1 (SERPINE1) inhibits extracellular matrix proteolysis and cell detachment. However, SERPINE1 expression also promotes tumor progression and plays a crucial role in metastasis. Here, we solve this apparent paradox and report that Serpine1 mRNA per se, independent of its protein-coding function, confers mesenchymal properties to the cell, promoting migration, invasiveness, and resistance to anoikis and increasing glycolytic activity by sequestering miRNAs. Expression of Serpine1 mRNA upregulates the expression of the TRA2B splicing factor without affecting its mRNA levels. Through transcriptional profiling, we found that Serpine1 mRNA expression downregulates through TRA2B the expression of genes involved in the immune response. Analysis of human colon tumor samples showed an inverse correlation between SERPINE1 mRNA expression and CD8+ T cell infiltration, unveiling the potential value of SERPINE1 mRNA as a promising therapeutic target for colon tumors.
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Mass-tolerant open search methods allow the high-throughput analysis of modified peptides by mass spectrometry. These techniques have paved the way to unbiased analysis of post-translational modifications in biological contexts, as well as of chemical modifications produced during the manipulation of protein samples. In this work, we have analyzed in-depth a wide variety of samples of different biological origin, including cells, extracellular vesicles, secretomes, centrosomes and tissue preparations, using Comet-ReCom, a recently improved version of the open search engine Comet-PTM. Our results demonstrate that glutamic acid residues undergo intensive methyl esterification when protein digestion is performed using in-gel techniques, but not using gel-free approaches. This effect was highly specific to Glu and was not found for other methylable residues such as Asp.
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Ácido Glutâmico , Metanol , Metanol/química , Metilação , Humanos , Ácido Glutâmico/metabolismo , Processamento de Proteína Pós-Traducional , Proteômica/métodos , AnimaisRESUMO
The oxidative phosphorylation (OXPHOS) system is intricately organized, with respiratory complexes forming super-assembled quaternary structures whose assembly mechanisms and physiological roles remain under investigation. Cox7a2l, also known as Scaf1, facilitates complex III and complex IV (CIII-CIV) super-assembly, enhancing energetic efficiency in various species. We examined the role of Cox7a1, another Cox7a family member, in supercomplex assembly and muscle physiology. Zebrafish lacking Cox7a1 exhibited reduced CIV2 formation, metabolic alterations, and non-pathological muscle performance decline. Additionally, cox7a1-/- hearts displayed a pro-regenerative metabolic profile, impacting cardiac regenerative response. The distinct phenotypic effects of cox7a1-/- and cox7a2l-/- underscore the diverse metabolic and physiological consequences of impaired supercomplex formation, emphasizing the significance of Cox7a1 in muscle maturation within the OXPHOS system.
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Complexo IV da Cadeia de Transporte de Elétrons , Coração , Músculo Esquelético , Fosforilação Oxidativa , Regeneração , Proteínas de Peixe-Zebra , Peixe-Zebra , Animais , Peixe-Zebra/metabolismo , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Complexo IV da Cadeia de Transporte de Elétrons/genética , Músculo Esquelético/metabolismo , Regeneração/fisiologia , Coração/fisiologia , Proteínas de Peixe-Zebra/metabolismo , Proteínas de Peixe-Zebra/genética , Miocárdio/metabolismo , Multimerização ProteicaRESUMO
PURPOSE: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. MATERIALS AND METHODS: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). RESULTS: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.89]; p<0.01). CONCLUSIONS: This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.