Tiitinen A, Surcel H-M, Halttunen M, Birkelund S, Bloigu A, Christiansen G, Koskela P, Morrison S G, Morrison R P, Paavonen J
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland.
Hum Reprod. 2006 Jun;21(6):1533-8. doi: 10.1093/humrep/del014. Epub 2006 Feb 14.
To evaluate the role of Chlamydia trachomatis-induced humoral and cell-mediated immune (CMI) responses in predicting tubal factor infertility (TFI).
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.
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.
Our results show that TFI prediction model can be improved by combining tests for humoral and CMI response to chlamydial antigens.
评估沙眼衣原体诱导的体液免疫和细胞介导免疫（CMI）反应在预测输卵管因素不孕症（TFI）中的作用。
采集88例TFI女性和163例对照女性的血液样本。使用酶联免疫吸附测定（ELISA）试剂盒分析沙眼衣原体和衣原体热休克蛋白60（CHSP60）特异性免疫球蛋白G（IgG）抗体。体外研究外周血单个核细胞对沙眼衣原体原体（EB）和重组CHSP60抗原的增殖反应性。
沙眼衣原体特异性IgG抗体在TFI病例中更频繁地被发现（43.2%对13.5%），且TFI病例中的抗体水平高于对照组（P<0.001）。沙眼衣原体EB诱导的淋巴细胞反应在81.8%的TFI病例和58.9%的对照组中呈阳性（P<0.001）。同样，CHSP60诱导的淋巴细胞反应在45.5%的TFI病例和30.7%的对照组中被发现（P<0.001）。CHSP60抗体检测是预测TFI的最佳单项检测。与所有四个标志物均为阴性的病例相比，有一个阳性标志物的患者TFI的估计风险为4.1（95%CI 1.4 - 11.9），有三到四个阳性标志物的患者为19.9（95%CI 6.9 - 57.4）。
我们的结果表明，通过结合针对衣原体抗原的体液免疫和CMI反应检测，可以改进TFI预测模型。
