Chlamydia trachomatis-associated tubal factor subfertility: immunogenetic aspects and serological screening

Chlamydia (C.) trachomatis female genital tract infections usually remain asymptomatic and untreated. Therefore, an adequate immune response, rather than antibiotic treatment, is essential to clear the pathogen. Most women will effectively clear C. trachomatis infections, but some will have persiste...

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Bibliographic Details
Published in:Human reproduction update 2006-11, Vol.12 (6), p.719-730
Main Authors: den Hartog, J.E., Morré, S.A., Land, J.A.
Format: Article
Language:English
Subjects:
C-Reactive Protein - analysis
Chlamydia
Chlamydia Infections - complications
Chlamydia Infections - diagnosis
Chlamydia Infections - immunology
Chlamydia trachomatis
Chlamydia trachomatis - immunology
Chlamydia trachomatis - pathogenicity
Fallopian Tube Diseases - complications
Fallopian Tube Diseases - microbiology
Female
Humans
immunogenetics
Infertility, Female - diagnosis
Infertility, Female - immunology
Infertility, Female - microbiology
Serologic Tests - methods
serological markers
tubal factor subfertility
Virulence Factors - metabolism
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Summary:Chlamydia (C.) trachomatis female genital tract infections usually remain asymptomatic and untreated. Therefore, an adequate immune response, rather than antibiotic treatment, is essential to clear the pathogen. Most women will effectively clear C. trachomatis infections, but some will have persistent C. trachomatis infections, which may ascend to the upper genital tract and increase the risk of tubal factor subfertility. Pattern recognition receptors (PRRs) of the toll-like receptor (TLR) and nucleotide-binding oligomerization domain (NOD) families recognize C. trachomatis and initiate the immune response. Host immune factors are determinants of the course of C. trachomatis infections. Genetic variations in TLR and NOD genes may affect receptor function, leading to inadequate recognition of C. trachomatis, an inadequate immune response, and consequently an increased risk of persistence and late sequelae. For the risk assessment of tubal pathology in subfertile women, C. trachomatis immunoglobulin (Ig) G antibody testing (CAT) in serum is widely used. A positive CAT is indicative of a previous infection but not of a persistent infection. Measuring serological markers of persistence, of which C-reactive protein (CRP) seems promising, in CAT-positive women may identify a subgroup of subfertile women with persistent C. trachomatis infections and the highest risk of tubal pathology.
ISSN:1355-4786
1460-2369
DOI:10.1093/humupd/dml030