Functional states of the human testes in various conditions were analysed by histochemical methods. The main purpose of this investigation was to know whether there was any peculiar pattern of enzymatic distribution in the testicular tissues in relation with pathological states. Biopsy specimens were taken from the testes of 47 patients with various testicular disorders such as retentio testis (23 cases), male sterility (15 cases), hypogonadotropic hypogonadism (4 cases), Klinefelter's syndrome (3 cases), and idiopathic varicocele (2 cases). The tested enzymes were: lactic dehydrogenase (LDH), DPN diaphorase (DPN-D), alkaline phosphatase (ALP) and acid phosphatase (ACP). A modified Nachlas's method was employed for the first two enxymes and a Burstone's method for the last two. The findings were compared with those of the normal human testes.
The results obtained were as follows:
(1) In the normal human testes, the activities of LDH and DPN-D were prominent both in the peripherally situated cells of the seminiferous tubuli as well as in the interstitial cells. ALP was mainly distributed in the peripherally situated cells of the seminiferous tubuli and in the vessel walls of the interstitium, while no activity was found in the interstitial cells. Activity of ACP was also marked in the peripheral tubular cells and in the interstitial cells.
(2) Of 23 cases with retentio testes, 16 were prepuberal and 7 were puberal or postpuberal. In the prepuberal cases, no enzymatic activities were found in the interstitial cells. In 15 unilateral cases, the findings in the retained testes were compared with those in the scrotal testes. Activities of LDH, DPN-D and ACP showed similar distributions both in the retained testes and in the scrotal testes. Though there was no activity in the tubular cells of the retained testes, in 8 out of 15 cases ALP activity was observed in the tubular cells of the scrotal testes. The findings suggested a certain kind of metabolic disurbance in the retained testes even from the early prepuberal stage.
In the puberal or postpuberal cases, highly degenerative changes were observed in the seminiferous tubuli of the retained testes and hypospermatogenic findings in the scrotal testes. ALP activity was detected in the tubuli of the scrotal testes, but no activity was found in the retained testes, LDH, DPN-D and ACP activities showed similar distributions both in the retained testes and in the scrotal testes. Enzymatic distributions of the interstitium showed no difference between in the retained testes and in the scrotal testes. This finding suggested that the state of “retention” had no recognizable effect on the function of interstitial cells.
(3) Of cases with male sterility, those with hypospermatogenesis or spermatogenic arrest presented a normal pattern of enzymatic distribution, whereas cases with germinal cell aplasia or peritubular fibrosis presented a lack in ALP activity in the seminiferous tubule.
(4) In cases of hypogonadotropic hypogonadism there was no enzymatic activity in the interstitial cells, but the seminiferous tubuli which mainly consisted of undifferentiated cells showed a fairly recognizable distribution of the enzymes.
(5) In cases of Klinefelter's syndrome, the interstitial cells had well recognizable enzymatic activities, including the activity of nonspecific esterase. However, in one case, where islet-like grouping of the interstitial cells were prominent, ALP distribution also showed a patchy pattern, suggesting a functional disturbance of the interstitial cells.
(6) The testicles of patients with left varicocele showed spermatogenic disturbances of the same grade on both sides. But, there was no peculiar changes in enzymatic distribution.
These results indicated that, of four enzymatic activities investigated, alkaline phosphatase had a peculiar significance in the human testes in relation to functional disturbances.