為什麼精液進入體內不會被排斥？ - 成人話題討論

※ 引述《lpbrother (LP哥)》之銘言：
: 各位鄉民好，
: 大家都知道人體有免疫系統，
: 只要有任何奇怪的東西，細菌，病毒啥的進入體內，
: 只要不是自己身體的東西，免疫系統就會開始排斥，
: 精液是從另一個人身上出來的東西，
: 所以絕對不會是自己的，
: 為什麼這時候免疫系統不會作用？
: 為什麼精液進入體內不會被排斥？

摘錄自UP TO DATE

Allergic reactions to seminal plasma

精液過敏症

INTRODUCTION — The term "human seminal plasma" (HSP) refers to the components
of human semen other than spermatozoa. Allergic reactions to proteins in HSP
usually present as either systemic reactions or localized vaginal reactions
during or following vaginal sexual intercourse, which are prevented by condom
use. The clinical manifestations, epidemiology, pathophysiology, diagnosis, and
management of HSP allergy will be discussed in this topic review.

HSP為精液內除了精子以外的東西

有些人對HSP過敏(也就是對精液過敏)

用保險套可以預防

CLINICAL MANIFESTATIONS — Allergic reactions to human seminal plasma (HSP)
proteins present either as systemic-allergic reactions/anaphylaxis or as
localized vaginal reactions.

Systemic reactions — Anaphylactic reactions to HSP typically begin within
minutes after ejaculation. Initial symptoms commonly include localized vulvar
and vaginal pruritus and/or edema, followed by diffuse pruritus, nasal
obstruction, itchy eyes, urticaria, and/or angioedema, often involving the
face, lips, tongue, and throat. Gastrointestinal symptoms and respiratory
symptoms of dyspnea, wheezing, and stridor have also been reported during
systemic reactions. Life-threatening anaphylaxis with profound
hypotension and cardiovascular collapse requiring emergency treatment was
reported in 16 patients in the series of 74 women mentioned previously,
indicating that severe reactions are not characteristic [1]. Anaphylactic
deaths attributable to HSP allergy have not been confirmed [1].

In addition to immediate-type systemic reactions, there are case reports of a
patient presenting with a fixed cutaneous eruption [2] and a serum
sickness-like reaction [3]. Another uncommon reaction is worsening of
pre-existing eczema during the days following HSP anaphylaxis [4].

Local reactions — Local vaginal reactions to seminal plasma are manifested
by vulvar or vaginal pain, itching, burning, and edema [1]. Symptoms and
signs may begin immediately following ejaculation or may be delayed in onset
by minutes to hours. Vulvar and vaginal discomfort can last several days [5].

An immediate-onset pruritic rash accompanied by periorbital angioedema was
reported in one case after cutaneous exposure to HSP without any history of
vaginal intercourse, suggesting that the skin could be an important route of
sensitization [6]. Localized urticaria or eczema has been reported following
contact of the skin with HSP [7]. Symptoms from oral contact have not been
reported.

對精液過敏的現象, 在被中出之後發作

對精液過敏的發病過程分成:

1.系統性(全身)
2.局部性(生殖系統的局部黏膜)

簡單說就是:

被中出之後

系統性是全身癢

而局部性是妹妹癢

全身癢比較麻煩 嚴重的話會有呼吸困難等全身症狀 最極端者可能有生命危險


Signs and symptoms — The largest review of published cases included 74 women.
Seventy percent (52 patients) experienced systemic symptoms. Forty percent of
those with systemic reactions also had local reactions, whereas approximately
one-third of patients had only local reactions [1]. All types of reactions are
prevented by the use of condoms, which is a critical component of the clinical
history. (See 'Clinical history' below.)

最大的研究涵蓋74人
52%的人全身癢 而這之中(有系統表現的人)40%也同時妹妹癢

1/3的人只有妹妹癢

全部都可以用保險套預防

最大研究只有74人
可見這是比較嶄新的題目
做過的研究不多

RISK FACTORS — A history of other allergic disorders was present in over 80
percent of women with human seminal plasma (HSP) allergy in the large review
previously described [1]. Anecdotal reports suggest that adult atopic
dermatitis and asthma are common clinical features of women presenting with
severe HSP-induced anaphylaxis [4,10,11]. However, HSP anaphylaxis has also
been reported in nonatopic women [12,13].

據說精液過敏 與過敏體質(異位性皮膚炎)有相關性
但也有發現沒有過敏體質卻對精液過敏的人

Based upon case reports, HSP allergy has been associated with reproductive
events or surgical procedures, such as the following:

●Long intercourse-free periods (eg, pregnancy).
●Menopause.
●Insertion of an intrauterine device.
●Hysterectomy.
●Previous prostatectomy or reversal of vasectomy in the male partner,
although the clinical relevance of these procedures is unclear because many
women develop HSP allergy with their first intercourse [1].

可能造成精液過敏的因素有:

1.長時間沒打炮
2.停經
3.宮內裝置
4.子宮切除術
5.伴侶有過前列腺切除手術或反輸精管切除術(輸精管重建)

因為這是case report的資料沒有經過大量統計
看看就好

PATHOGENESIS — In most cases, systemic human seminal plasma (HSP) reactions
are caused by a type I immunoglobulin E (IgE)-mediated hypersensitivity
reaction [1]. In contrast, most localized reactions to HSP do not appear to
involve IgE nor have other causative immune mechanisms been clearly established
[14-18].

全身癢 如同大部分的過敏疾病是由IgE抗體主導

妹妹癢的機制不明

However, there is anecdotal evidence that other immunologic mechanisms can
account for some reactions (table 1):

●There is at least one case report of a delayed-onset systemic reaction
consisting of periorbital edema, skin rash, arthralgias, and diarrhea beginning
approximately eight hours after ejaculation and lasting four to five days [3]. A type III immunologic mechanism was implicated in this serum sickness-like reaction (table 1).
●There is at least one report of a woman with a fixed cutaneous reaction [2].

零星的case report 看看就好

Allergens — Multiple allergenic proteins with molecular weights ranging from
12 to 75 kDa have been identified in HSP [1,9,19]. In one case report,
serum-specific IgE binding to a 33 kDa protein with a molecular weight
identical to prostate-specific antigen (PSA) was demonstrated in a patient
with HSP anaphylaxis [20]. In contrast, sperm proteins have not been implicated
as allergens, and artificial insemination using sperm intensively washed free
of HSP is well-tolerated in women with severe HSP allergy. (See 'Conception
and pregnancy' below.)

精液蛋白大小從 12-75 kDa都有
有人號稱從患者身上分離出針對33 kDa的過敏抗體
一樣是零星的Case report

目前沒有發現對精子過敏的狀況

The observation that approximately 41 percent of all HSP-allergic reactions
occur following the first episode of sexual intercourse suggests that
susceptible women can become sensitized prior to their first known contact with
human semen [1,9]. The prevalence of HSP-specific IgE in women without HSP
allergy has not been studied. There are some data to suggest that sensitization
may result from exposure to cross-sensitizing dog proteins, although this is only one theory. In one study, 24 percent of
patients with serum-specific IgE to dog dander exhibited IgE binding to PSA,
suggesting existence of cross-reactivity between the major HSP allergen and
dog epithelial allergen, which has been identified as Can f 5 [21,22].
Prostatic kallikrein is a major dog allergen found in dog urine and epithelium
that cross-reacts with human PSA [23]. Based on this data, it is possible that
women with pre-existing dog allergy may be at greater risk for HSP allergy.
However, not all women with HSP hypersensitivity are dog owners, although dog
allergens are abundant in most indoor environments. There is little utility
to evaluating patients for sensitivity to dog allergens, since commercial
extracts cannot reliably exclude sensitization to relevant prostatic allergens
[24].


由於41%的患者
在第一次被中出就會癢
可見免疫系統早在之前就被其他原因誘發

被甚麼東西誘發目前沒有研究
有一個case report說跟狗有關係

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結論:

精液過敏引起全身癢與妹妹癢

不戴套與長時間沒打炮
是危險因素

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安安妳好 我都有戴套而且性生活頻繁

希望可以陪妳一起降低長時間沒打炮所造成的不良後果

幫助妳走過身體癢與妹妹癢的煩惱

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send from my Dick 17.5 cm

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