BACKGROUND Spermatozoa acquire their fertilizing ability and forward motility properties during epididymal transit. Our knowledge of gamete physiology is based on studies conducted in laboratory and domestic species; our knowledge of these processes in humans is limited. Medical indications for assisted reproductive technologies (ART) have progressed to include male infertility. Surgical procedures allow collection of spermatozoa from all along the human excurrent ducts, and the former have been used with some success in reproductive medicine. This has raised questions over the role of the epididymis in human sperm physiology. OBJECTIVE AND RATIONALE To reanalyze what we now know about epididymal physiology in humans and to assess the relevance of laboratory animal models for understanding human physiology and the pathophysiology of the epididymis. SEARCH METHODS A systematic bibliographic search of PubMed for articles published in English before May 2015 was carried out using the search terms 'epididymis' and 'sperm maturation'. Literature on the consequences of vasectomy on the epididymis was also searched. OUTCOMES Whereas the proximal epididymis is almost exclusively occupied by efferent ducts, the sperm reservoir capacity is poorly developed in humans. At the molecular level, the human transcriptome and proteome show some segment specificity; conflicting results persist with regard to secretome variation along the tubule. The number of genes regulated along the excurrent ducts in men is lower when compared to rodent species, but remains significant. It is challenging to reconcile biochemical and physiological studies with clinical data obtained from men undergoing reanastomosis of the vas deferens at different points along the excurrent duct. We propose that vasectomy/vasovasostomy is a model to understand the consequences of obstruction on epididymis function in humans. WIDER IMPLICATIONS Despite the scarcity of biological material available, the interspecies variability of the male reproductive tract urges us to use modern molecular and cellular biology tools to better understand human epididymis physiology in order to apply ART in a more responsible manner.

中文翻译：

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人附睾：其在精子成熟中的功能。

背景技术在附睾转运期间，精子获得了它们的受精能力和向前运动的特性。我们对配子生理的了解基于对实验室和家养物种的研究；我们对人类这些过程的了解是有限的。辅助生殖技术（ART）的医学适应症已发展为包括男性不育症。外科手术程序允许从人的所有外部导管收集精子，并且前者已在生殖医学中获得了一定的成功。这就对附睾在人类精子生理中的作用提出了质疑。目的和理由重新分析我们现在对人类附睾生理的了解，并评估实验室动物模型对了解人类生理和附睾的病理生理的相关性。搜索方法使用搜索词“ epididymis”和“精子成熟”对PubMed进行系统书目检索，以检索2015年5月之前以英文发表的文章。还搜索了输精管结扎对附睾的影响的文献。结果尽管近端附睾几乎完全被传出的导管所占据，但人类的精子储存能力却很差。在分子水平上，人类转录组和蛋白质组显示出某些片段特异性。关于沿着肾小管的分泌组变化的矛盾结果仍然存在。与啮齿类动物相比，男性沿出气管调控的基因数量较少，但仍然很重要。要使生化和生理学研究与从沿输精管沿不同部位接受输精管再吻合术的男性获得的临床数据相协调具有挑战性。我们建议输精管结扎/输精管吻合术是一种模型，以了解阻塞对人附睾功能的影响。对人类的影响尽管缺乏可用的生物材料，但男性生殖道的种间变异性促使我们使用现代分子和细胞生物学工具更好地了解人类附睾生理，以便以更负责任的方式应用抗逆转录病毒疗法。将生化和生理学研究与从沿输精管沿不同位置接受输精管再吻合术的男性获得的临床数据相协调是具有挑战性的。我们建议输精管结扎/输精管吻合术是一种模型，以了解阻塞对人附睾功能的影响。对人类的影响尽管缺乏可用的生物材料，但男性生殖道的种间变异性促使我们使用现代分子和细胞生物学工具更好地了解人类附睾生理，以便以更负责任的方式应用抗逆转录病毒疗法。要使生化和生理学研究与从沿输精管沿不同部位接受输精管再吻合术的男性获得的临床数据相协调具有挑战性。我们建议输精管结扎/输精管吻合术是一种模型，以了解阻塞对人附睾功能的影响。对人类的影响尽管缺乏可用的生物材料，但男性生殖道的种间变异性促使我们使用现代分子和细胞生物学工具更好地了解人类附睾生理，以便以更负责任的方式应用抗逆转录病毒疗法。我们建议输精管结扎/输精管吻合术是一种模型，以了解阻塞对人附睾功能的影响。对人类的影响尽管缺乏可用的生物材料，但男性生殖道的种间变异性促使我们使用现代分子和细胞生物学工具更好地了解人类附睾生理，以便以更负责任的方式应用抗逆转录病毒疗法。我们建议输精管结扎/输精管吻合术是一种模型，以了解阻塞对人附睾功能的影响。对人类的影响尽管缺乏可用的生物材料，但男性生殖道的种间变异性促使我们使用现代分子和细胞生物学工具更好地了解人类附睾生理，以便以更负责任的方式应用抗逆转录病毒疗法。