Serum antibody response to Chlamydia trachomatis TroA and HtrA in women with tubal factor infertility

Rantsi, Tiina; Joki-Korpela, Päivi; Hokynar, Kati; Kalliala, Ilkka; Öhman, Hanna; Surcel, Heljä‐Marja; Paavonen, Jorma; Tiitinen, Aila; Puolakkainen, Mirja

doi:10.1007/s10096-018-3276-9

Cited by 7 publications

(13 citation statements)

References 12 publications

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“…For example, studies conducted by Rantsi et al . 18 19 showed that CT+ women had a longer natural pregnancy time than CT− women, and persistent CT infection led to tubal infertility in women. Tang et al .…”

Section: Discussionmentioning

confidence: 99%

Chlamydia trachomatis infection in the genital tract is associated with inflammation and hypospermia in the infertile male of China

Zhou

Tang

et al. 2022

Asian Journal of Andrology

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Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide. However, unlike that in female infertility, the role of CT infection in male infertility remains controversial. The objective of this retrospective study was to explore the impacts of CT infection in the genital tract on sperm quality, sperm acrosin activity, antisperm antibody levels, and inflammation in a large cohort of infertile males in China. A total of 7154 semen samples were collected from infertile male subjects, 416 of whom were CT positive (CT+ group) and 6738 of whom were CT negative (CT− group), in our hospital between January 2016 and December 2018. Routine semen parameters (semen volume, pH, sperm concentration, viability, motility, morphology, etc.), granulocyte elastase levels, antisperm antibody levels, and sperm acrosin activity were compared between the CT+ and CT− groups. Our results showed that CT infection was significantly correlated with an abnormally low semen volume, as well as an increased white blood cell count and granulocyte elastase level (all P < 0.05) in the semen of infertile males; other routine semen parameters were not negatively impacted. The antisperm antibody level and sperm acrosin activity were not affected by CT infection. These findings suggested that CT infection might contribute to inflammation and hypospermia but does not impair sperm viability, motility morphology, and acrosin activity or generate antisperm antibodies in the infertile males of China.

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Section: Discussionmentioning

confidence: 99%

Chlamydia trachomatis infection in the genital tract is associated with inflammation and hypospermia in the infertile male of China

Zhou

Tang

et al. 2022

Asian Journal of Andrology

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“…In the present study in CAT-positive infertile women, we could not confirm these findings and found that CRP is not a suitable marker for identifying a subgroup at highest risk for TFI. As there is a clinical need for adequate non-invasive screening tests for TFI, to enable preselection of patients for subsequent invasive diagnostic testing by HSG or laparoscopy, several other inflammatory factors to predict the course of C. trachomatis infection have been studied, such as heat shock protein 60 and antibodies to specific chlamydial proteins (TroA and HtrA) (Hjelholt et al ., 2011; Rantsi et al , 2018a; Tiitinen et al , 2006). A sensitive and specific serum marker has not been found so far.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein as a marker of persistent Chlamydia trachomatis infection is not associated with tubal factor infertility—an independent clinical validation study

Jansen

Ess

Ouburg

et al. 2019

Human Reproduction Open

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STUDY QUESTION Does C-reactive protein (CRP), as a marker of persisting low-grade inflammation, identify Chlamydia trachomatis IgG antibody test (CAT)-positive women who are at the highest risk for tubal factor infertility (TFI)? SUMMARY ANSWER No association was found between slightly elevated CRP (seCRP) levels and TFI in our CAT-positive patient population. WHAT IS KNOWN ALREADY In the fertility work-up, CAT is used to estimate the risk for TFI and to select high-risk patients for additional invasive diagnostic procedures (e.g. hysterosalpingography and laparoscopy). However, a high number of false positives exist among CAT-positive patients. In a previous study, it has been suggested that women with TFI may be identified more accurately when combining CAT with CRP, a marker for persistent low-grade inflammation. STUDY DESIGN, SIZE, DURATION Our original retrospective cohort consisted of 887 consecutive female patients who visited the fertility clinic of a tertiary care centre between 2007 and 2015. All CAT-positive women who underwent laparoscopy (as the reference test for evaluation of tubal function) and who had not undergone previous pelvic surgery were included in the study. CRP was determined in spare serum samples, and medical data was obtained by chart review. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 101 women (11.4%) were CAT-positive, and 64 of these 101 women (7.2%) met all inclusion criteria. CAT was performed with an ELISA. TFI was assessed by laparoscopy and strictly defined as extensive peri-adnexal adhesions and/or distal occlusion of at least one tube. In spare sera, CRP was performed with a high-sensitivity CRP ELISA, and CRP levels between 3 and 10 mg/L were defined as positive. Analyses were corrected for BMI, endometriosis and smoking. MAIN RESULTS AND THE ROLE OF CHANCE There was no statistically significant association between seCRP level and TFI after adjusting for BMI, endometriosis and smoking (odds ratio 1.0; 95% CI 0.3–3.3; n = 64). LIMITATIONS, REASONS FOR CAUTION Our retrospective study had a small sample size due to a low CAT-positivity rate and a conservative clinical policy with regard to invasive diagnostic testing. Additionally, CRP levels were only measured once, while they may change throughout the menstrual cycle and in time. WIDER IMPLICATIONS OF THE FINDINGS Contrary to previous findings, our results show CRP is not suitable as a marker of persistent low-grade inflammation in CAT-positive women. Other inflammatory markers and immunogenetic host factors should be studied on their clinical validity and utility to improve non-invasive risk assessment for TFI in the fertility work-up. STUDY FUNDING/COMPETING INTEREST(S) This work was partially supported by the European EuroTrans-Bio Grant [Reference number 110012 ETB] and the Eurostars grant (E!9372). S.A.M., a full-time employee of Amsterdam University Medical Centres location VUMC (0.56 fte) and the Maastricht University Medical Center (0.44 fte), is the founder (2011) and CEO of TubaScan Ltd, a spin-off company, Dept. of Medical Microbiology and Infection Prevention, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands. S.O. and E.F.v.E. at the time of conducting this research had a partial appointment at TubaScan Ltd.

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“…Spare serum was cryopreserved at −20 °C for research purposes and thawed to perform serological assays for the present study. Serum samples of the Finnish women had been collected and analyzed for our previous studies, in which we studied the performance of C. trachomatis -specific cell-mediated and humoral immune responses in TFI prediction [17] and the prevalence of TroA and HtrA antibodies among unselected subfertile women [16].…”

Section: Methodsmentioning

confidence: 99%

“…IgG antibody responses to recombinant C. trachomatis TroA and HtrA were analyzed by an in-house enzyme immune assay (EIA) at the Department of Virology, Helsinki University, as described earlier [15,16]. Purified TroA (CT067) and HtrA (CT823) proteins were coated (100 ng) to Nunc Maxisorp ELISA plate wells.…”

Section: Methodsmentioning

confidence: 99%

“…HtrA levels has been shown to increase during the developmental cycle when C. trachomatis is cultured at the presence of penicillin, which is another means to induce persistence in vitro [14]. Also in vivo, IgG antibody responses to C. trachomatis TroA and HtrA are more common in patients with ascending and repeated chlamydial infections than in healthy controls [15], and women with TFI have more often serum IgG antibodies to TroA and HtrA than subfertile women with patent Fallopian tubes [16]. Use of such differentially expressed C. trachomatis antigens as TroA and HtrA may offer a means to develop more specific tools for TFI diagnostics.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Values of Serum Chlamydia trachomatis TroA and HtrA IgG Antibodies as Markers of Persistent Infection in the Detection of Pelvic Adhesions and Tubal Occlusion

et al. 2019

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Chlamydia trachomatis IgG antibody testing (CAT) has been used as a screening test for tubal factor infertility (TFI), but as the CAT is only a marker of a past exposure to C. trachomatis and not of late sequelae, the positive predictive value (PPV) of the test is low. The persistence of C. trachomatis in the upper genital tract has been suggested as one of the key mechanisms in the development of TFI. Serum antibodies against C. trachomatis TroA and HtrA, proteins expressed specifically during persistent infection, have been suggested as novel biomarkers for TFI diagnostics. We studied serum IgG antibody responses against C. trachomatis TroA, HtrA and MOMP in 79 subfertile women, of whom 28 had laparoscopically proven TFI. We confirmed that the accuracy of CAT in diagnosing TFI is low, whereas TroA IgG and HtrA IgG are more accurate tests in detecting tubal occlusion and pelvic adhesions. However, the sensitivity and negative predictive value (NPV) of TroA IgG and HtrA IgG are still too low to justify their use as a screening test in clinical practice. Individual immunogenetic profiles combined with TroA and HtrA antibody responses might identify women with the highest risk for developing late complications after C. trachomatis infection.

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Serum antibody response to Chlamydia trachomatis TroA and HtrA in women with tubal factor infertility

Cited by 7 publications

References 12 publications

Chlamydia trachomatis infection in the genital tract is associated with inflammation and hypospermia in the infertile male of China

Chlamydia trachomatis infection in the genital tract is associated with inflammation and hypospermia in the infertile male of China

C-reactive protein as a marker of persistent Chlamydia trachomatis infection is not associated with tubal factor infertility—an independent clinical validation study

Predictive Values of Serum Chlamydia trachomatis TroA and HtrA IgG Antibodies as Markers of Persistent Infection in the Detection of Pelvic Adhesions and Tubal Occlusion

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