Association of blood biomarkers with p53 gene expression in male infertility

Objectives To investigate the association between p53 gene expression, prostate-specific antigen (PSA), and oxidative stress markers (sialic acid and vitamin C) in infertile men. Methods This case–control study involved 150 infertile men and 150 fertile controls from Kerala, India. Serum sialic acid, PSA, and vitamin C were measured by ELISA, and p53 expression was quantified by real-time PCR (2 −ΔΔCt method). Non-parametric tests, correlation analyses, regression models, and ROC curves were used to assess associations, predictive value, and diagnostic performance. Results Infertile men showed significantly lower serum sialic acid and vitamin C levels and higher PSA concentrations and p53 gene expression than fertile controls (all p<0.05). p53 expression was significantly associated with PSA, sialic acid, and vitamin C in infertile men. Although no biomarker independently predicted infertility in logistic regression, robust linear regression identified vitamin C as a strong negative predictor and PSA as a positive predictor of p53 expression. ROC analysis revealed moderate discriminative ability for vitamin C, PSA, and sialic acid, while p53 expression alone showed limited diagnostic accuracy. Conclusions The concurrent elevation of p53 expression, increased PSA levels, and antioxidant depletion in infertile men reflects activation of cancer-related cellular stress and genomic surveillance pathways rather than evidence of malignancy.