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沙眼衣原体与输卵管性不孕相关的全基因组抗原鉴定。

Genome-wide identification of Chlamydia trachomatis antigens associated with tubal factor infertility.

机构信息

Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.

出版信息

Fertil Steril. 2011 Sep;96(3):715-21. doi: 10.1016/j.fertnstert.2011.06.021. Epub 2011 Jul 13.

Abstract

OBJECTIVE

To identify Chlamydia trachomatis antigens that can be used to differentially diagnose tubal factor infertility in comparison with previously reported heat shock protein 60.

DESIGN

In vitro study.

SETTING

Academic medical center.

PATIENT(S): Infertile women with and without tubal pathology diagnosed laparoscopically.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Antibody responses to C. trachomatis in infertile women with or without tubal pathologies using a C. trachomatis genome-wide proteome array.

RESULT(S): Comparison of the antibody profiles revealed 30 C. trachomatis antigens that were preferentially recognized in women with tubal factor infertility, with a detection sensitivity and specificity of 80.6% and 56.5%, respectively, 10 of which showed 100% specificity. A combination of CT443 and CT381 antigens yielded the highest detection sensitivity (67.7%) while maintaining 100% specificity.

CONCLUSION(S): These findings have demonstrated that antibodies to CT443 and CT381, when used in combination, have higher sensitivity and specificity in predicting tubal factor infertility than other indicators for tubal factor infertility, such as heat shock protein 60 antibodies (35.5%, 100%) or hysterosalpingogram (65%, 83%). Using a panel of C. trachomatis antigens to serologically diagnose tubal factor infertility can save the patients from undertaking expensive and invasive procedures for determining tubal pathology and choosing treatment plans.

摘要

目的

鉴定沙眼衣原体抗原,以便与先前报道的热休克蛋白 60 相比,用于对输卵管性不孕进行鉴别诊断。

设计

体外研究。

地点

学术医疗中心。

患者

经腹腔镜诊断为有或无输卵管病变的不孕妇女。

干预措施

无。

主要观察指标

使用沙眼衣原体全基因组蛋白质组阵列检测有无输卵管病变的不孕妇女对沙眼衣原体的抗体反应。

结果

对抗体谱的比较显示,有 30 种沙眼衣原体抗原在输卵管性不孕妇女中优先被识别,其检测灵敏度和特异性分别为 80.6%和 56.5%,其中 10 种具有 100%的特异性。CT443 和 CT381 两种抗原的组合具有最高的检测灵敏度(67.7%),同时保持 100%的特异性。

结论

这些发现表明,CT443 和 CT381 的抗体联合使用,在预测输卵管性不孕方面比其他指标(如热休克蛋白 60 抗体 35.5%、100%或子宫输卵管造影术 65%、83%)具有更高的灵敏度和特异性。使用一组沙眼衣原体抗原进行血清学诊断输卵管性不孕,可以避免患者进行昂贵和有创的检查以确定输卵管病变并选择治疗方案。

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