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Hum. Reprod. Advance Access published online on February 14, 2006
Human Reproduction, doi:10.1093/humrep/del014
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received September 27, 2005
Revised November 28, 2005
Accepted December 23, 2005

Article

Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility

A. Tiitinen 1, H.-M. Surcel 2, M. Halttunen 1, S. Birkelund 3, A. Bloigu 2, G. Christiansen 3, P. Koskela 2, S.G. Morrison 4, R.P. Morrison 4, and J. Paavonen 1 *

1 Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
2 National Public Health Institute, Oulu, Finland
3 Department of Medical Microbiology and Immunology, University of Aarhus, Aarhus, Denmark
4 Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

* To whom correspondence should be addressed.
J. Paavonen, E-mail: aila.tiitinen{at}hus.fi


  Abstract

BACKGROUND: To evaluate the role of Chlamydia trachomatis-induced humoral and cell-mediated immune (CMI) responses in predicting tubal factor infertility (TFI). METHODS: Blood samples were taken from 88 women with TFI and 163 control women. C. trachomatis and chlamydial heat shock protein 60 (CHSP60)-specific immunoglobulin G (IgG) antibodies were analysed using enzyme-linked immunosorbent assay (ELISA) kits. Proliferative reactivity of peripheral blood mononuclear cells was studied in vitro against Chlamydia elementary body (EB) and recombinant CHSP60 antigens. RESULTS: C. trachomatis-specific IgG antibodies were found more frequently (43.2 versus 13.5%), and the antibody levels were higher in the TFI cases than in the controls (P < 0.001). C. trachomatis EB-induced lymphocyte responses were positive in 81.8% of the TFI cases and 58.9% of the controls (P < 0.001). Similarly, CHSP60-induced lymphocyte responses were found in 45.5% of the TFI cases and 30.7% of the controls (P < 0.001). CHSP60 antibody test was the best single test predicting TFI. Compared to cases with all four markers negative, the estimated risk for TFI was 4.1 (95% CI 1.4-11.9) among those with one positive marker and 19.9 (95% CI 6.9-57.4) among those with three to four positive markers. CONCLUSION: Our results show that TFI prediction model can be improved by combining tests for humoral and CMI response to chlamydial antigens.

Keywords: C. trachomatis/immune response to Chlamydia/tubal factor infertility.
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