Hong Yanggang, Wang Yi
The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
The First School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Am J Reprod Immunol. 2025 Jan;93(1):e70036. doi: 10.1111/aji.70036.
Characterized as a prevalent sexually transmitted infection, Chlamydia trachomatis is intimately associated with reproductive tract complications, including pelvic inflammatory disease (PID) and infertility. However, the causal relationships between C. trachomatis infection and reproductive tract complications remain elusive.
To investigate the causal relationships between C. trachomatis antibodies and seven reproductive tract complications, we conducted a bidirectional Mendelian randomization (MR) analysis. The fundamental data were originated from the genome-wide association studies (GWAS) database. While the influences of C. trachomatis antibodies on reproductive tract complications such as tubal factor infertility (TFI) and PID have been assessed, the reverse MR analysis examined how these complications impacted C. trachomatis antibodies.
The forward MR analysis revealed that the upregulation of MOMP A antibodies was significantly associated with a reduced risk of TFI (OR = 0.932, p = 0.007), while MOMP D antibodies were associated with a reduced risk of ectopic pregnancy (EP) (OR = 0.923, p = 0.005). However, no significant causal interactions were identified for other reproductive complications. Moreover, the reverse MR analysis indicated that cervicitis was significantly correlated with lower MOMP A antibody levels (OR = 0.900, p = 0.016).
This study demonstrates the protective effects of C. trachomatis antibodies, particularly MOMP A and MOMP D, against TFI and EP, respectively. It also emphasizes the potential role of cervical inflammation in shaping immune responses to C. trachomatis. These insights provide a foundation for future research to develop immune-targeted therapies and integrated approaches for preventing and managing C. trachomatis-related reproductive tract complications.
沙眼衣原体是一种常见的性传播感染病原体，与包括盆腔炎（PID）和不孕症在内的生殖道并发症密切相关。然而，沙眼衣原体感染与生殖道并发症之间的因果关系仍不明确。
为了研究沙眼衣原体抗体与七种生殖道并发症之间的因果关系，我们进行了双向孟德尔随机化（MR）分析。基础数据来源于全基因组关联研究（GWAS）数据库。虽然已经评估了沙眼衣原体抗体对输卵管因素不孕症（TFI）和PID等生殖道并发症的影响，但反向MR分析考察了这些并发症如何影响沙眼衣原体抗体。
正向MR分析显示，MOMP A抗体的上调与TFI风险降低显著相关（OR = 0.932，p = 0.007），而MOMP D抗体与异位妊娠（EP）风险降低相关（OR = 0.923，p = 0.005）。然而，未发现其他生殖并发症存在显著的因果相互作用。此外，反向MR分析表明宫颈炎与较低的MOMP A抗体水平显著相关（OR = 0.900，p = 0.016）。
本研究证明了沙眼衣原体抗体，特别是MOMP A和MOMP D，分别对TFI和EP具有保护作用。它还强调了宫颈炎症在塑造对沙眼衣原体免疫反应中的潜在作用。这些见解为未来开发免疫靶向疗法以及预防和管理沙眼衣原体相关生殖道并发症的综合方法的研究奠定了基础。
