Antibodies to the Chlamydial 60 Kilodalton Heat Shock Protein in Women With Tubal Factor Infertility

[摘要] Introduction:Fallopian tube damage and subsequent infertility are common sequelae of upper genitaltract infection withChlamydia trachomatis. This fallopian tube damage is thought to be immunemediated. The 60 kilodalton chlamydial heat shock protein (hsp) may be the key antigen associatedwith this pathogenic response. Our objective was to study the relationship between antibody responseto 60 kilodalton chlamydial hsp and tubal factor infertility (TFI).Subjects and Methods:Twenty-three women with TFI and 33 women with male factor infertility(controls) were studied. Tubal factor infertility was defined as infertility for one year with hydrosalpinxor distal tubal occlusion. Patients’ sera were tested for antibodies to the chlamydial hspusing an enzyme-linked immunosorbent assay (ELISA). A stepwise logistic regression was performedby each patient’s age, race/ethnicity, self-reported history of chlamydia infection, gonorrhea,or pelvic inflammatory disease (PID), history of ectopic pregnancy, and antibodies to the chlamydialhsp.Results:Eighteen of the 23 women with TFI had a positive result on the hsp ELISA (78.6%)versus 23.4% of controls. Risk factors for TFI were a history of PID (P= 0.022), “nonwhite” race(P= 0.004), history of ectopic pregnancy (P = 0.027), and antibodies to the 60 kilodalton chlamydialhsp (P< 0.001).Conclusions:Antibodies to 60 kilodalton chlamydial hsp are strongly associated with TFI.

[学科分类] 妇产科学