Immunophysiology and pathology of inflammation in the testis and epididymis

J Androl. Nov-Dec 2011;32(6):625-40. doi: 10.2164/jandrol.111.012989. Epub 2011 Jul 15.


The ability of spermatogenic cells to evade the host immune system and the ability of systemic inflammation to inhibit male reproductive function represent two of the most intriguing conundrums of male reproduction. Clearly, an understanding of the underlying immunology of the male reproductive tract is crucial to resolving these superficially incompatible observations. One important consideration must be the very different immunological environments of the testis, where sperm develop, and the epididymis, where sperm mature and are stored. Compared with the elaborate blood-testis barrier, the tight junctions of the epididymis are much less effective. Unlike the seminiferous epithelium, immune cells are commonly observed within the epithelium, and can even be found within the lumen, of the epididymis. Crucially, there is little evidence for extended allograft survival (immune privilege) in the epididymis, as it exists in the testis, and the epididymis is much more susceptible to loss of immune tolerance. Moreover, the incidence of epididymitis is considerably greater than that of orchitis in humans, and susceptibility to sperm antibody formation after damage to the epididymis or vas deferens increases with increasing distance of the damage from the testis. Although we still know relatively little about testicular immunity, we know less about the interactions between the epididymis and the immune system. Given that the epididymis appears to be more susceptible to inflammation and immune reactions than the testis, and thereby represents the weaker link in protecting developing sperm from the immune system, it is probably time this imbalance in knowledge was addressed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Bacterial Infections / immunology
  • Blood-Testis Barrier / immunology
  • Epididymis / immunology*
  • Epididymitis / immunology*
  • Epididymitis / microbiology
  • Humans
  • Immune Tolerance
  • Immunity, Cellular
  • Immunity, Innate
  • Male
  • Mice
  • Orchitis / immunology*
  • Orchitis / microbiology
  • Rats
  • Testis / immunology*
  • Vas Deferens / immunology
  • Virus Diseases / immunology