Upregulation of adhesion molecules allows leukocyte migration into inflamed tissues. Co-stimulatory molecules may contribute to sustained local immune activation. Therefore, blockage of these molecules suppose to be a protentional therapeutic strategy for suppressing the inflammatory progression.Elevated levels of proteases and collagenases which damage the corneal stroma have also been found in affected conjunctival tissues. Diagnosis
In view of rarity and limited knowledge of the etiology of Mooren’s ulcer, the diagnosis of the disease is complicated.The absence of any systematic disorders which can lead to peripheral corneal ulceration supports the diagnosis of Mooren’s ulcer. To diagnose Mooren’s ulcer, it is necessary to rule out other forms of non-infectious peripheral ulcerative keratitis. Treatment
Medical treatment
Topical corticosteroids are usually used as first line of therapy. Severe cases require administration of systemic immunosuppressive agents. The more commonly used drugs are cyclosporine A, methotrexate and cyclophosphamide. Several case reports showed that biological agents, such as anti-tumor necrosis factor alpha (anti-TNF) or monoclonal antibodies against CD20, also can be used as an effective treatment of progressive Mooren’s ulceration. Surgical treatment
If patients do not respond to medication, surgical intervention must be performed. Conjunctival excision has been shown to be an effective method. The principle of this surgery is based on the removal of unhealthy limbal conjunctiva adjacent to the ulcer. slow down the disease progression due to eliminating the local source of inflammatory cells, mediators and enzymes which cause the tissue damage.Another surgical treatment option which has been successfully used as a treatment for Mooren’s ulcer is amniotic membrane transplantation (AMT).
If reproduced in humans, this could potentially enable infertile men to father children with their own sperm.Researchers from Montana State University developed precursors of sperm from skin cells of infertile men.Sharpe et al. comment on the success of intracytoplasmic sperm injection (ICSI) in women saying, "[t]hus, the woman carries the treatment burden for male infertility, a fairly unique scenario in medical practice. Ironically, ICSIs success has effectively diverted attention from identifying what causes male infertility and focused research onto the female, to optimize the provision of eggs and a receptive endometrium, on which ICSIs success depends." Prevalence
Currently, there are no solid numbers on how many couples worldwide experience infertility, but the World Health Organization estimates between 60 and 80 million couples are affected. The population in different regions have varying amounts of infertility. Starting in the late 20th century, scientists have expressed concerns about the declining semen quality in men. A study was done in 1992 with men who had never experienced infertility showed that the amount of sperm in semen had declined by 1% per year since 1938. Further research a few years later also confirmed the decline in sperm count and also seminal volume. Various studies in Finland, Southern Tunisia, and Argentina also showed a decline in sperm count, motility, morphology, and seminal volume. Males from India had a 30.3% decline in sperm count, 22.9% decline in sperm motility, and a 51% decrease in morphology over a span of a decade.