Trachomatis IgA Research Articles

Seroprevalence of Chlamydia trachomatis IgA, IgM and IgG Antibodies and Associated Risk Factors among Sexually Active Individuals at Saint Vincent de Paul Hospital in Dschang, West Cameroon

Background: Chlamydia trachomatis is the most common cause of sexually transmitted infections worldwide. Infections caused by this pathogen are usually symptomatic in men and asymptomatic in about 2/3 of women resulting in a variety of clinical complications.
 Aim: To determine the seroprevalence of immunological markers and the risk factors associated with the seropositivity to C. trachomatis infection in sexually active individuals visiting the Saint Vincent de Paul Hospital in Dschang, West region Cameroon
 Study Design: This was an analytical cross-sectional study conducted between July and September 2020 at Saint Vincent de Paul Hospital in Dschang, Cameroon.
 Methods: A total of 154 participants were recruited during the data collection period. An indirect ELISA method was used to analyse participant’s serum samples. Risk factors were assessed through univariate and multivariate logistic regression using SPSS 25.
 Results: The seroprevalence of C. trachomatis infection was 38.3% (95%CI: 30.6 - 46.0). Only 39.6% (95%CI: 31.6 - 47.3) of the study population had never been in contact with the bacterium. The reinfection rate among participants was 8.4% (95%CI: 4.0 - 12.8). Results revealed that being Male is a protective factor against the infection [aOR: 0.12; 95% CI: 0.03 - 0.56; P ꞊ .007]. The non-use of condom [aOR: 21.58; 95% CI: 3.53 – 132.06; P ꞊ .001] and having encountered three or more sexual partners [aOR: 9.90; 95%CI: 1.07 – 91.60; P ꞊ .043] were the significant predictors of Chlamydia seropositivity.
 Conclusion: The implementation of proactive strategies to curb down the spread of the infection is necessary in this locality. This can be done by providing NAATs to as many health facilities as possible, educating the population and standardizing treatment protocols.

Higher Levels of Secretory IgA Are Associated with Low Disease Activity Index in Patients with Reactive Arthritis and Undifferentiated Spondyloarthritis.

Both reactive arthritis (ReA) and undifferentiated spondyloarthritis (uSpA) belong to the group of autoinflammatory diseases called spondyloarthritis (SpA). Hypotheses have been proposed about a relationship between the intestinal mucosa and inflammation of joint tissues. The role of immunoglobulin IgA or secretory immunoglobulin A (SIgA) in the inflammatory and/or clinical activity of patients with SpA remains poorly understood. To evaluate the status of total IgA and SIgA, and the association among the levels of SIgA, IgA, IgA anti-Chlamydia trachomatis, and anti-Shigella spp. with the disease activity measures, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, was compared in a cohort of patients with ReA and uSpA and healthy subjects. This was a cross-sectional study. The serum concentrations of SIgA, IgA anti-C. trachomatis, anti-Shigella spp., and total IgA were measured. Disease activity was measured in each patient by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS). Statistical analysis did include as bivariate evaluation, comparisons by Student's t-test, Kruskal-Wallis test, and U Mann-Whitney test, with a multivariate evaluation by principal components analysis (PCA). A correlation analysis was carried out using the Pearson correlation coefficient and a linear regression models. All analysis were made using Stata version 11.2® for Windows, R V3.3.21. Statistical significance was defined a p-value <0.05. In all, 46 patients (78.2% men; mean age, 34.8 ± 12.3 years) and 53 controls (41% men; mean age, 32 ± 11.4 years) were included in the study. The mean serum levels of SIgA were higher in SpA patients than in healthy subjects (p < 0.001). Only SIgA levels correlated with disease activity: BASDAI (r = -0.42, p = 0.0046), ASDAS-CRP (r = -0.37, p = 0.014), and ASDAS-ESR (r = -0.45, p = 0.0021). The negative correlation between SIgA and all activity indices was higher in HLA-B27-positive patients (BASDAI r = -0.70, p = 0.0009, ASDAS-CRP r = -0.58, p = 0.0093, and ASDAS-ESR r = -0.57, p = 0.0083). The PCA showed three factors: the first component was constituted by variables referred as clinical activity measures, the second did include the serological activity markers, and the last component was compounded by age and symptoms time. Elevated serum levels of SIgA were found to be related with low disease activity in patients with ReA and uSpA.

Augmented oxidative stress in infertile women with persistent chlamydial infection

There is established association between oxidative stress, infections of genital tract and fertility. Genital tract infections may provoke increased production of free radicals and generate oxidative stress that can be involved in pathophysiology of a number of reproductive diseases and complications during pregnancy. The aim of this study was to determine connection between oxidative stress and infertility associated with persistent chlamydial infection. Serum samples of infertile women with tubal factor infertility (TFI), women with multiple spontaneous abortions (MSA) and fertile women was screened for C. trachomatis MOMP specific IgG and IgA antibodies and cHSP60 specific igG antibodies using ELISA. The levels of superoxide anion radical, nitric oxide and reduced glutathione were determined spectrophotometricaly. Serum levels of testosterone, luteinizing hormone and follicle stimulating hormone were determined by enzyme-linked fluorescent immunoassay method. Our results showed that persistent infection was more prevalent in TFI than in MSA group, whereas seropositivity was higher in MSA than in TFI group of patients. We also found that superoxide anion was significantly lower, while LH was markedly higher in TFI and MSA group of patients. However, when our results were analyzed according to the serological status of chlamydial infection, we found that parameters of oxidative stress, superoxide anion and index of oxidative stress, defined as relative ratio between superoxide anion and nitrites sum and glutathione ((O2−+NO2−)/GSH) were significantly elevated in infertile patients with persistent chlamydial infection compared to seropositive and seronegative patients. Our findings point to the possible impact of Chlamydia trachomatis infection on prooxidative-antioxidative balance that can influence fertility potential in women with persistent chlamydial infection.

ELISA Serology for Antibodies Against Chlamydia trachomatis in Crohn's Disease.

BackgroundRecently we reported IgA anti-Chlamydia antibodies in patients with Crohn’s disease (CD), in particular in four patients from a single family of six with CD.MethodsWe studied sera from four cohorts from the north of France. These were identified as: EPIMAD (80 pediatric onset CD and 20 pediatric onset ulcerative colitis), MINOTOR (148 adult onset sporadic CD and 50 adult onset ulcerative colitis), Grande Famillies (50) and matched controls for the Grande Famillies cohort (49). Sera were tested using commercial anti-Chlamydia trachomatis (LGV2:434) IgG and IgA human enzyme-linked immunosorbent assay (ELISA) kits. Cutoff for positivity was 11.0 standard units.ResultsPatients with sporadic CD, unaffected first degree relatives from multiplex families and ulcerative colitis patients had no greater serologic reactivity than controls. However, multiplex families’ patients had twice as many positives as the other groups: for IgG 20% vs. 8%; for IgA 20% vs. 10%.ConclusionsThough not attaining statistical significance, the data showed that familial CD patients had greater exposure to C. trachomatis than sporadic CD patients, supporting our earlier results from one family from the north of France. More specific serologic tests based on outer membrane proteins will need to be employed against the various Chlamydia species with zoonotic potential.

ON THE ASSESSMENT AND TREATMENT OF PATIENTS WITH CHRONIC PROSTATITIS IN PERSISTENT UROGENITAL CHLAMYDIOSIS

Актуальность. Урогенитальный хламидиоз – наиболее распространенная бактериальная инфекция, передаваемая половым путем, сопровождающаяся высокой частотой осложнений (хронический простатит, сальпингоофорит и др.) и неблагоприятных последствий (нарушение половой и репродуктивной функций). В последние годы отмечается нарастание персистирующей хламидийной инфекции, которая не поддается лечению антибиотиками и диагностируется на основании обнаружения методом иммуноферментного анализа антител иммуноглобулина (Ig) класса G к белку теплового шока хламидий с молекулярной массой 60 кД (HSP60) и определения секреторного IgA к Chlamydia trachomatis в семенной плазме. Цель – выявление частоты пер- систирующей хламидийной инфекции у больных хроническим простатитом путем определения сывороточных антител IgG к HSP60 C. trachomatis и наличия противохламидийных IgA в семенной плазме. Материал и методы. В рамках проспективного исследования мы провели обследование 18 больных хроническим простатитом в возрасте от 21 до 58 лет, в контрольную группу вошли 30 человек без хламидийной урогенитальной патологии. Клиническое обследование включало сбор анамнеза, инструментальное обследование, ультразвуковое исследование предстательной железы и семенных пузырьков. Серологические исследования проводились с помощью иммуноферментного анализа в четырех тест-системах фирмы “Medac” (Германия) к двум антигенам: родоспецифическому липополисахариду хламидий r-ELISA (антитела классов IgM, IgG и IgA к Chlamydia) и основному белку наружной мембраны (МОМР) C. trachomatis (анти- тела классов IgG и IgA). Антитела к HSP60 хлами- дий определяли в тест-системе c HSP60-IgG-ELISA фирмы “Medac”. Определение секреторного IgA в семенной жидкости проводили с помощью тест-системы Chlamydia trachomatis-IgA-pELISA. Результаты. В основной группе в 13 (72,2%) из 18 случаев выявлен хронический хламидийный простатит, который в 7 (38,9%) случаях протекал на фоне персистирующей хламидийной инфекции, сопровождаясь одновременным повышением титра сывороточных антител IgG к HSP60 C. trachomatis и наличием противохламидийных антител IgA в семенной плазме. У 30 че- ловек контрольной группы сывороточные антитела IgG к C. trachomatis обнаружены не были. Заключение. Полученные данные подтверждают диагностическую ценность определения присутствия IgA к С. trachomatis с целью установления этиологии воспалительного процесса в мужском генитальном тракте, а также свидетельствуют о высокой частоте персистирующей хламидийной инфекции у больных хроническим простатитом и целесообразности использования серологического обследования на наличие сывороточных антител IgG к HSP60 C. trachomatis и противохламидийных IgA в семенной плазме.

Do IgA antibodies to Chlamydia trachomatis have protective role in humoral immunity: a study in reactive arthritis patients

Chlamydia trachomatis-induced genitourinary Reactive Arthritis (ReA) can serve as good model for host–pathogen interaction. However, due to poor antigen presentation, cell-mediated immunity does not contribute as anticipated. Present study aims to evaluate protective role of anti-C. trachomatis antibodies vis-a-vis inflammatory chlamydial Major Outer Membrane Protein (MOMP). Prospective study was undertaken in 30 patients with genitourinary ReA. 30 Rheumatoid Arthritis (RA) and 30 osteoarthritis patients constituted controls. Subjects found to be PCR-positive for C. trachomatis were investigated for presence of MOMP in Synovial Fluid (SF) by fluorescence assay while anti-C. trachomatis IgA/IgM antibodies were estimated in SF/venous blood by ELISA. C. trachomatis MOMP was evident by the presence of elementary bodies in SF of 9 ReA PCR-positive patients (30%; p < 0.05 versus controls). Local secretory IgA antibodies were detected in 12 (40%) patients with ReA (p < 0.0001 versus controls); among 12 patients with anti-chlamydial IgA antibodies, 9 showed the presence of both MOMP and IgA antibodies in SF. 58.3% ReA patients (7/12) with secretory IgA antibodies were also positive for circulatory IgA antibodies (p < 0.01 versus controls). Serum IgM antibodies were present in 4 ReA (13.3%) and in 1 RA (3.3%) patient, respectively. In conclusion, the present study suggests that in ReA patients with chronic, persistent C. trachomatis infection in synovium, the chlamydial MOMP is triggering factor for generating a protective immune response by inducing anti-C. trachomatis IgA antibodies in the SF of large number of patients.

Association between anti-chlamydial immunity and IVF outcome

Background: Elevated antibody titers to Chlamydia trachomatis are detected in up to 70% of women with tubal factor infertility (TFI). In order to evaluate the influence of past chlamydial infection on the results of IVF treatment, a prospective cohort study was performed.Materials and methods: A total of 242 women with TFI were enrolled in the study. Serum samples (n = 242) and follicular fluid (n = 197) were analyzed using enzyme-linked immunosorbent assay for anti-C. trachomatis IgG, IgA, IgM and anti-chlamydial heat shock protein 60 kDa IgG.Results: “Poor response” to ovarian stimulation was two times more frequent in seropositive subjects (22.9% versus 13.3%, p = 0.039). Seropositive and seronegative women had similar IVF outcomes, expressed by clinical pregnancy (20.5% versus 25.0%), life birth (13.1% versus 20.0%) and miscarriage rates (36.0% versus 16.7%, p = 0.092). Incidence of missed abortion after IVF was higher in women with previous exposure to C. trachomatis (28.0%) as compared to those without antibodies (3.3%), p = 0.018.Conclusions: Anti-chlamydial antibody detection is not related to oocyte maturity, embryo quality, pregnancy and life birth rates. However, past chlamydial infection in TFI patients is associated with decreased IVF success: “poor response” to ovarian stimulation and missed abortion rate.

Clinical significance of circulatory chlamydial heat shock protein-60 antibodies in spondyloarthropathy patients

Background Chlamydia trachomatis is a multifaceted, asymptomatic, most prevalent sexually transmitted pathogen worldwide. Due to lack of specific diagnostic methods for C. trachomatis in Spondyloarthropathy (SpA) patients, this pathogen is under diagnosed and under estimated in various countries including India. We aimed to estimate circulatory antibodies to chlamydial heat shock protein60 (chsp60) IgG/ anti C. trachomatis IgA and evaluate their clinical significance in SpA patients.

Sexually transmitted infections and infertility in Rwanda: Diagnostic significance of IgG and IgA antibodies testing

Background: In many developing countries, little is known about the prevalence of genital Chlamydia trachomatis infections and complications, such as infertility, thus preventing any policy from being formulated regarding screening for C. trachomatis of patients at risk for infertility. The objective of the present study was to determine the prevalence of C. trachomatis and evaluate the diagnostic utility of serological markers namely anti-C. trachomatis IgG and IgA antibodies in women attending an infertility clinic. Methods & Materials: Two commercial species-specific ELISA to determine serum IgG and IgA antibodies to C. trachomatis, PCR onvaginal swabs specimens andHysterosalpingography (HSG)was performed on Serum and vaginal swab specimens of 303 women presenting with infertility to the infertility clinic of the Kigali University Teaching Hospital and 312 fertile controls in subfertile women. Results: The prevalence of C. trachomatis infection by PCR and serological test (IgG and IgA) were relatively low in both subfertile and fertile women and no significant differences in overall prevalence ratesofC. trachomatis amongbothgroupswereobserved. The only factor associated with C. trachomatis infection in our study population was age 25 years. Evidence of tubal pathology identified by HSG was found in 185 patients in the subfertile group (67.8%). All the serological markers measured in this study had very low sensitivities and negative predictive values in predicting tubal pathology. The specificities for ANILabsystems IgG, Vircell IgG, Anilabsystem IgA and positive C. trachomatis DNA to predict tubalpathologywere84,86, 95and98%, respectively,whereas their respective positive predictive values were 73, 76, 81 and 80%. Conclusion: The prevalence of C. trachomatis in our study population in Rwanda appears to be low and women aged 25 years are more likely to have genital infection with C. trachomatis. Since serological testing for Chlamydia shows an excellent negative predictive value for lower genital tract infection, specific peptide-based serological assays may be of use for screening in low prevalence settings. Our data suggest that C. trachomatis is not the primary pathogen responsible for tubal pathology in Rwandan women.

Is the role of Chlamydia trachomatis underestimated in reactive arthritis patients in India

Background: Although Chlamydia trachomatis-induced Reactive Arthritis (ReA) constitutes a significant disease burden in various countries, however it remains largely unrecognized and probably underestimated in India. Due to availability of multiple serovars, biphasic lifecycle and asymptomatic infection, diagnosis of this pathogen is difficult, thereby leading to chronic, persistent chlamydial infection in the synovium. The aim of the present prospective study was to find the presence of intra-articular C. trachomatis infection by nucleic acid amplification tests and secretory IgA determination in patients with ReA and in forme fruste of ReA, viz.: Undifferentiated Spondyloarthropathy (uSpA) attending a major tertiary Army hospital inNew Delhi (India). Methods & Materials: Synovial fluid was aspirated from the knee joints of age and sex-matched 30 arthritic patients, viz.: ReA/uSpA (n=15) and Osteoarthritis controls (OA) (n =15) following the European Spondyloarthropathy Study Group criteria for ReA while clinical and radiological diagnosis was done for OA patients. The clinical details were recorded in all patients. Both C. trachomatis-specific surface Major Outer Membrane Protein (MOMP) and endogenous plasmid genes were targeted using semi-nested Polymerase Chain Reaction (snPCR) and nested PCR (nPCR), while anti-C. trachomatis IgA antibodies were estimated by commercial enzyme-linked immunosorbent assay kit (Savyon Diagnostics, Israel). Statistical evaluation of data was done by using trial version of Graph Prism Pad software (version 5.0; GraphPad Software, Inc., San Diego, California, USA). Results: Overall, 33.3% (5/15) ReA/uSpA patients were found to be C. trachomatis-positive for either MOMP/plasmid gene in the joint fluid. 20% (3/15) were positive for plasmid gene while MOMPgenewas present in 13.3% (2/15) patients in the study group (ReA/uSpA). Intra-articular anti-C. trachomatis IgA antibodies were detected in 26.6% (4/15) patients in the synovial fluid. Significant correlation (‘p’ value <0.05) was found between PCR and serologic findings. None of OA controls was found positive for either chlamydial antibody/MOMP gene/plasmid gene. Conclusion: The observations in the present study indicate that intra-articular C. trachomatis infection in ReA/uSpA patients is both underestimated as well as underdiagnosed inIndia. It also suggests the usefulness of serology for better clinical management of such patients.

Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing

In many developing countries, little is known about the prevalence of genital Chlamydia trachomatis infections and complications, such as infertility, thus preventing any policy from being formulated regarding screening for C. trachomatis of patients at risk for infertility. The objective of the present study was to determine the prevalence of C. trachomatis and evaluate the diagnostic utility of serological markers namely anti-C. trachomatis IgG and IgA antibodies in women attending an infertility clinic. Serum and vaginal swab specimens of 303 women presenting with infertility to the infertility clinic of the Kigali University Teaching Hospital and 312 fertile controls who recently delivered were investigated. Two commercial species-specific ELISA were used to determine serum IgG and IgA antibodies to C. trachomatis and vaginal swabs specimens were tested by PCR. Hysterosalpingography (HSG) was performed in subfertile women. The PCR prevalence of C. trachomatis infection was relatively low and did not differ significantly among subfertile and fertile women (3.3 versus 3.8%). Similarly, no significant differences in overall prevalence rates of C. trachomatis IgG and IgA among both groups were observed. The only factor associated with C. trachomatis infection in our study population was age <25 years. The seroprevalence of IgG in both assays (86.4% for ANILabsystems and 90.9% for Vircell) was significantly higher in the group of PCR C. trachomatis-positive women compared with that of PCR-negative women. Evidence of tubal pathology identified by HSG was found in 185 patients in the subfertile group (67.8%). All the serological markers measured in this study had very low sensitivities and negative predictive values in predicting tubal pathology. The specificities for ANILabsystems IgG, Vircell IgG, Anilabsystem IgA and positive C. trachomatis DNA to predict tubal pathology were 84, 86, 95 and 98%, respectively, whereas their respective positive predictive values were 73, 76, 81 and 80%. The prevalence of C. trachomatis in our study population in Rwanda appears to be low and women aged <25 years are more likely to have genital infection with C. trachomatis. Since serological testing for Chlamydia shows an excellent negative predictive value for lower genital tract infection, specific peptide-based serological assays may be of use for screening in low prevalence settings. Our data suggest that C. trachomatis is not the primary pathogen responsible for tubal pathology in Rwandan women.

Chlamydia trachomatis Infection Is Related to Poor Semen Quality in Young Prostatitis Patients

BackgroundThe impact of chronic prostatitis resulting from Chlamydia trachomatis infection on male fertility is controversial. ObjectiveTo investigate the correlation between C. trachomatis infection and semen quality in young male patients affected by chronic prostatitis resulting from C. trachomatis infection and to evaluate the correlation between anti–C. trachomatis immunoglobulin (Ig) A against heat shock protein 60 (HSP60), heat shock protein 70 (HSP70), and semen parameters. Design, setting, and participantsAll patients with clinical and instrumental diagnosis of chronic prostatitis underwent microbiological cultures for common bacteria, DNA extraction, mucosal and serum antibody evaluation for C. trachomatis, and semen parameter analysis. Western blot analysis of mucosal anti–C. trachomatis IgA was performed. InterventionsSubjects were split into two groups: Group A consisted of patients with chronic prostatitis resulting from common bacteria (uropathogens), and group B consisted of patients with chronic prostatitis resulting from C. trachomatis infection. MeasurementsThe relationship between C. trachomatis infection and semen parameters as well as the correlation among IgA levels, IgA characterisation, and semen analysis were determined. Results and limitationsWe enrolled 1161 patients (mean age: 36.5 yr). Of these, 707 patients were placed in group A, and 454 were placed in group B. Significant statistical differences were reported between groups in terms of sperm concentration (p<0.001), percentage of motile sperm (p<0.001), and normal morphologic forms (p<0.001). Strong correlations between mucosal anti–C. trachomatis IgA and sperm concentration (p<0.001) and normal morphologic forms (p<0.001) were reported. Correlations among positivity to HSP60, HSP70, and sperm concentration (p<0.003) and normal morphologic forms (p<0.001) were also reported. ConclusionsThis study demonstrated the role of chronic prostatitis resulting from C. trachomatis in male fertility decrease, highlighting probable immunomediated damage to germinal cells because of C. trachomatis infections.

Multiple site sampling does not increase the sensitivity of Chlamydia trachomatis detection in infertility patients

Persistent Chlamydia trachomatis infections are associated with tubal pathology. We studied whether sampling from multiple sites would increase the identification of the infections. Prospective cohort study. Tertiary care facility. Two hundred two infertile women. Smears were taken from the cervix, urethra, high vagina, fimbriae and the Douglas cavity. Blood samples were collected and tubal patency was assessed by pertubation with lipiodol and methylene blue. Detection of C. trachomatis DNA, detection of IgA and IgG antibodies against C. trachomatis, and antibodies against chlamydial heat-shock protein 60, tubal patency. Chlamydia trachomatis was detected in 2 of 202 patients, for an overall prevalence of 1%. In both patients PCR results were positive in the cervical, vaginal, and urethral specimens. Chlamydia trachomatis IgG, IgA, and chlamydial heat-shock protein 60 IgG were significantly more prevalent in women with distal tubal pathology than in those without (26/40 [65.0%] vs. 16/162 [9.9%], 9/40 [22.5%] vs. 7/162 [4.3%], and 34/40 [85.0%] vs. 34/162 [21.0%]). Bacterial colonization was found in 1 of 202 samples from the Douglas cavity. Routine DNA testing for C. trachomatis should be confined to cervical sampling. The association between tubal pathology and seropositivity of IgG, IgA, and cHSP60 IgG was confirmed but did not add clinically valuable information during the diagnostic workup of infertility patients.

Relationships between Chlamydia trachomatis antibody titers and tubal pathology assessed using transvaginal hydrolaparoscopy in infertile women.

Since transvaginal hydrolaparoscopy (THL) was introduced as the first-line procedure in the early stages of the exploration of the adnexal structures in infertile women, it has been shown that THL is a less traumatic and a more suitable outpatient procedure than diagnostic laparoscopy. This study was performed to investigate the relationships between Chlamydia trachomatis antibody titers and tubal pathology assessed using THL in infertile women. The C. trachomatis antibody titers (IgG and IgA) were evaluated by ELISA. The posterior of the uterus and the tubo-ovarian structures were carefully observed, and tubal passage using indigocarmine was confirmed using THL. THL was carried out in 32 infertile women having C. trachomatis antibody in their sera between May 1999 and October 2001. Unilateral salpingectomy had been performed on two of the 32 patients. Tubal occlusion was confirmed in 20 (32.3%) of the 62 tubes, while peritubal adhesion was diagnosed in 37 (59.7%) of the 62 tubes. Using receiver operating characteristics curves, the cut-off value of C. trachomatis IgG antibody titer to predict tubal occlusion was determined to be 3.55. Tubal occlusion was observed in 16 (51.6%) of the 31 tubes in patients with the C. trachomatis IgG antibody titer of more than 3.55, which was significantly higher in four (12.9%) of the 31 tubes having the antibody titer less than 3.55 (P = 0.004). However, there was no correlation between C. trachomatis IgG antibody titer and peritubal adhesion. As for C. trachomatis IgA antibody titer, there was no correlation between antibody titer and tubal occlusion or peritubal adhesion. These results suggest that C. trachomatis infection is significantly associated with tubal pathology. Although the cut-off value of C. trachomatis IgG antibody titer to predict the existence of tubal occlusion was shown to be 3.55, we would suggest that THL or standard laparoscopy is performed to consider appropriate treatments in patients with past C. trachomatis infection because of the high prevalence of peritubal adhesion.

Detection of Antibodies to Chlamydia trachomatis With Peptide‐Based Species‐SpecificEnzyme Immunoassay

Objective: We have evaluated the sensitivity and specificity of a new synthetic peptide-based species-specific enzyme immunoassay (EIA) for detection of Chlamydia trachomatis IgG and IgA antibodies. Methods: Synthetic peptides derived from variable domain IV of major outer membrane protein (MOMP) were used as antigen in indirect EIA. IgG and IgA antibodies were measured in parallel with serum samples from C. trachomatis culture positive, culture negative, and antigen positive patients, and women with suspected C. trachomatis infection and blood donors. Sera from children under 15 years of age were used as controls. Results: Culture positive women, culture positive men, and antigen positive women had positive peptide serology in 84.2%, 61.3%, and 93.1% of the cases, respectively. Among C. trachomatis suspected women, the antibody prevalence was 63.6%. Randomly collected blood donors showed a prevalence of 21.5%. Children with C. pneumoniae antibodies determined with the microimmuno-fluorescence (MIF) method did not show any reactivity in the C. trachomatis peptide EIA. Conclusions: The results suggest that the new EIA test is highly specific for C. trachomatis, and C. pneumoniae antibodies do not interfere. Both IgG and IgA antibodies appear within at least 2 weeks in acute phase of infection among both culture positive and culture negative patients.

Detection of antibodies toChlamydia trachomatis with peptide-based species-specific enzyme immunoassay

Objective: We have evaluated the sensitivity and specificity of a new synthetic peptide-based species-specific enzyme immunoassay (EIA) for detection of Chlamydia trachomatis IgG and IgA antibodies.

A study on the role of Chlamydia trachomatis in chronic prostatitis--analysis of anti-Chlamydia trachomatis specific IgA in expressed prostate secretion by western-blotting method

Opinion among researchers is divided as to whether Chlamydia trachomatis is the causative organism of chronic prostatitis. In this study, using enzyme immuno assay, we examined the positive rate of anti-C. trachomatis IgA according to the leukocyte count in expressed prostate secretion (EPS), in a total of 169 patients including 92 patients who showed chronic prostatitis-like symptoms. And we confirmed, by western-blotting, the presence or absence of anti-heat shock protein (HSP: 60 KDa) IgA in EPS, and we investigated the role of C. trachomatis in chronic prostatitis. The total positive rate of anti-C. trachomatis IgA in EPS was 26.0% (44/169). According to the leukocyte count in EPS, the positive rate for the group with more than 10 WBC/hpf was 29.0% (20/69), for the group with 5-9 WBC/hpf was 37.9% (11/29), for the group with less than 5 WBC/hpf was 18.3% (13/71). Accordingly the positive rate of anti-C. trachomatis IgA in EPS was not higher in direct correlation to the severity of the inflammation at the infected site (p = 0.09). But the positive rate for the group with more than 5 WBC/hpf was higher than for the group with less than 5 WBC/hpf. On the other hand, the total positive rate of anti-HSP IgA in EPS was 17.6% (6/34), and according to the leukocyte count in EPS, the positive rate for the group with more than 10 WBC/hpf was 38.5% (5/13), for the group with 5-9 WBC/hpf was 0% (0/12). Accordingly the positive rate of anti-HSP IgA in EPS was higher in direct correlation to the severity of the inflammation at the infected site (p = 0.13). From this results, it was suggested that C. trachomatis was concerned with 29.0% (20/69) of chronic prostatitis with more than 10 WBC/hpf, and also C. trachomatis is the causative organism of chronic prostatis.

不顕性の男性 Chlamydia trachomatis 感染症の診断における特異的血清IgA, IgG抗体価測定に関する検討

We determined the serum concentrations of IgA and IgG antibodies specific for Chlamydia trachomatis (C. trachomatis) by an indirect immunoperoxidase assay (IPAzyme kit, Savyon Diagnostics, Ltd., Bee, Shova, Israel) to evaluate their diagnostic significance in latent infections in males. Forty-five asymptomatic males whose wife or partner was suspected to be infected with C. trachomatis were studied and the incidence of serum IgA (titer greater than or equal to 16) and IgG (titer greater than or equal to 64) antibodies for C. trachomatis was compared with that in a healthy group, a group with non-gonococcal urethritis (NGU) patients. Changes in IgA titer during treatment were also examined. The incidence of IgA and IgG antibodies in the healthy group was found to be 2.4% and 11.9% in males, and 4.8% and 18.1% in females, respectively. In patients whose wife or partner who was positive to C. trachomatis, the incidence of IgA and IgG antibodies was 42.2% and 75.6%, respectively. In the NGU patients the incidence of IgA and IgG antibodies was 56.3% and 62.5%, respectively. The incidence of IgA and IgG antibodies in patients whose wife or partner was antibody-positive were significantly higher (p less than 0.01) than the corresponding value in healthy men and women, but there was no significant difference from NGU patients or the elderly group. The IgA antibody titer during treatment of C. trachomatis infection showed no reduction in some cases. This study revealed frequent latent incidence of C. trachomatis infection in male patients. Determination of C. trachomatis IgA and IgG antibodies is considered to be supplemental for diagnosis of chlamydial latent infections.

Serum-Specific Antibodies forChlamydiatrachomatisin Preterm Premature Rupture of the Membranes

A case control study was performed to examine possible morbidity associated with Chlamydia trachomatis in 15 pregnant women with idiopathic preterm premature rupture of the membranes (PROM; group A), and in two control groups, 35 healthy preterm pregnant women (group B), and 43 healthy pregnant women at term (group C). Serum C. trachomatis IgG and IgA specific antibodies were determined using the single serovar (L2) inclusion immunoperoxidase assay. There were no significant differences in the prevalence rate of elevated levels of chlamydia IgG specific antibodies (titer greater than or equal to 1:128) between pregnant women suffering from idiopathic preterm PROM, as compared to healthy preterm and term pregnant women (20, 28 and 26%, respectively). Nor were there any significant differences in the prevalence rate of elevated levels of chlamydia IgA specific antibodies (titer greater than or equal to 1:16) between pregnant women with idiopathic preterm PROM, as compared to healthy preterm and term pregnant women (20, 20 and 17%, respectively). These findings do not support the assumption that C. trachomatis may play role in preterm PROM.

IgG and IgA Antibodies Specific for Chlamydia trachomatis in Acute Epididymitis

The possibility of using elevated Chlamydia trachomatis-specific serum IgG and IgA as a screening test for Chlamydia-associated epididymitis was analyzed in 28 acute epididymitis patients and 42 apparently healthy men by the single antigen (L2) immunoperoxidase assay. The prevalence rates of C. trachomatis IgG antibody titer greater than or equal to 64 and elevated C. trachomatis IgG titers (greater than or equal to 128) were significantly higher in the epididymitis patients (75 vs. 40%, p less than 0.01, and 39 vs. 14%, p less than 0.025, respectively) than in controls. The prevalence rate of C. trachomatis IgA antibodies (titer greater than or equal to 8) was significantly higher (p less than 0.001) in epididymitis patients as compared to controls (46 vs. 10%, respectively). The potential application of elevated serum C. trachomatis IgG and IgA antibodies as a noninvasive screening marker in epididymitis patients is discussed.