一项旨在分析沙眼衣原体热休克蛋白 (CHSP60) 抗体对输卵管性不孕诊断特异性的前瞻性研究。

A PROSPECTIVE STUDY TO ANALYZE THE SPECIFICITY OF CHLAMYDIAL HEAT SHOCK PROTEIN (CHSP60) ANTIBODIES TO DIAGNOSE TUBAL INFERTILITY.

机构信息

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY OF POSTGRADUATE DEPARTMENT, BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY №3, BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.

出版信息

Wiad Lek. 2021;74(2):184-189.

PMID:33813469

Abstract

OBJECTIVE

The aim: To investigate the utility of testing for chlamydial heat shock protein 60 (CHSP60) antibodies in the diagnosis of tubal infertility.

PATIENTS AND METHODS

Materials and methods: All the collected samples were assayed for IgM and IgG antibodies to chlamydia trachomatis and chlamydial heat shock protein 60 (CHSP60) by using immunofluorescence and enzyme-linked immunosorbent assay (ELISA) techniques, respectively.

RESULTS

Results: There were no substantial differences between antibodies to C. trachomatis in females with tubal infertility (67%) and non-tubal infertility (48%). However, women with tubal infertility (45%) have more anti-CHSP60 antibodies than non-tubal infertility (9%). Antibody screening for C. trachomatis has only (63%) sensitivity and (54%) specificity for detecting tubal infertility. On the other hand, the CHSP60 antibody testing has (44%) sensitivity and 92% specificity for diagnosing tubal infertility. A positive microimmunofluorescence (MIF) titer was observed in 12 of 18 (67%) females with the tubal problem, 31 of 64 (48%) with non-tubal infertility (P=0.3, OR=2.2, 95% CI=0.71 to 8.01). The CHSP60 antibodies were found in 8 of 18 (45%) females with tubal problem & 6 of 64 (9%) women with non-tubal infertility, power factor alpha α P=0.004, OR=9.3, 95% CI=2.1 to 43.2, power= 1.002 for n= 0.05). Incorporating CHSP60 and C. trachomatis antibodies testing gives an excellent positive probability proportion of 10 to diagnose C. trachomatis associated tubal infertility.

CONCLUSION

Conclusions: CHSP60 antibody testing is a more specific evaluation than antibody testing for C. trachomatis for predicting chlamydia-associated tubal infertility. Using these tests at the first infertility examination may help the immediate diagnosis for non-interceptive tubal infertility.

摘要

目的

探讨检测沙眼衣原体热休克蛋白 60（CHSP60）抗体在输卵管性不孕诊断中的应用价值。

方法

收集所有标本，分别采用免疫荧光法和酶联免疫吸附试验（ELISA）检测沙眼衣原体 IgM 和 IgG 抗体。

结果

输卵管性不孕组（67%）和非输卵管性不孕组（48%）妇女沙眼衣原体抗体无明显差异。然而，输卵管性不孕组（45%）抗-CHSP60 抗体较非输卵管性不孕组（9%）高。沙眼衣原体抗体筛查对输卵管性不孕的敏感性为 63%，特异性为 54%。另一方面，CHSP60 抗体检测对输卵管性不孕的敏感性为 44%，特异性为 92%。18 例输卵管问题女性中 12 例（67%）MIF 滴度阳性，64 例非输卵管性不孕患者中 31 例（48%）阳性（P=0.3，OR=2.2，95%CI=0.71~~8.01）。18 例输卵管问题女性中 8 例（45%）和 64 例非输卵管性不孕女性中 6 例（9%）检测到 CHSP60 抗体，P=0.004，OR=9.3，95%CI=2.1~~43.2，power=1.002，n=0.05）。将 CHSP60 和沙眼衣原体抗体检测结合起来，可以很好地提高对沙眼衣原体相关输卵管性不孕的诊断阳性率，达到 10%。