Tiina Rantsi1, Hanna Öhman2,3, Mirja Puolakkainen4, Aini Bloigu5, Jorma Paavonen1, Heljä-Marja Surcel2,3,5, Aila Tiitinen1, Päivi Joki-Korpela1. 1. The Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 2. National Institute for Health and Welfare, Oulu, Finland. 3. Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland. 4. Virology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 5. Faculty of Medicine, University of Oulu, Oulu, Finland.
Abstract
PROBLEM: The accuracy of Chlamydia trachomatis antibody test in predicting tubal factor infertility (TFI) is limited, and more accurate methods are needed. Cell-mediated immune response (CMI) is crucial in the resolution of pathogen, but it may play an important role in the pathogenesis of C trachomatis-associated tubal damage. We studied whether combining the markers of C trachomatis-induced CMI to humoral immune response improves the accuracy of serology in TFI prediction. METHOD OF STUDY: Our prospective study consists of 258 subfertile women, of whom 22 (8.5%) had TFI. Women with other causes for subfertility served as a reference group. Serum C trachomatis major outer membrane protein (MOMP) and chlamydial heat-shock protein 60 (cHSP60) IgG antibodies were measured by ELISA. CMI was studied by lymphocyte proliferation assay in vitro. RESULTS: Serological markers were more prevalent in women with TFI than in other subfertile women (40.9% vs 12.3% for MOMP IgG and 27.3% vs 10.2% for cHSP60 IgG). The best test combination for TFI was C. trachomatis MOMP and cHSP60 antibody with an accuracy of 90.3%, sensitivity of 22.7% and specificity of 96.6%. Positive post-test probability of this combination was 54.2%, and negative post-test probability was 12.4%. Adding of the markers of CMI did not significantly improve the accuracy of serology in TFI prediction. CONCLUSION: The accuracy of TFI prediction increases when the combination of C trachomatis MOMP and cHSP60 antibody tests is used. C trachomatis-induced CMI was common in our study population, but the markers of CMI did not predict TFI.
PROBLEM: The accuracy of Chlamydia trachomatis antibody test in predicting tubal factor infertility (TFI) is limited, and more accurate methods are needed. Cell-mediated immune response (CMI) is crucial in the resolution of pathogen, but it may play an important role in the pathogenesis of C trachomatis-associated tubal damage. We studied whether combining the markers of C trachomatis-induced CMI to humoral immune response improves the accuracy of serology in TFI prediction. METHOD OF STUDY: Our prospective study consists of 258 subfertile women, of whom 22 (8.5%) had TFI. Women with other causes for subfertility served as a reference group. Serum C trachomatis major outer membrane protein (MOMP) and chlamydial heat-shock protein 60 (cHSP60) IgG antibodies were measured by ELISA. CMI was studied by lymphocyte proliferation assay in vitro. RESULTS: Serological markers were more prevalent in women with TFI than in other subfertile women (40.9% vs 12.3% for MOMP IgG and 27.3% vs 10.2% for cHSP60 IgG). The best test combination for TFI was C. trachomatis MOMP and cHSP60 antibody with an accuracy of 90.3%, sensitivity of 22.7% and specificity of 96.6%. Positive post-test probability of this combination was 54.2%, and negative post-test probability was 12.4%. Adding of the markers of CMI did not significantly improve the accuracy of serology in TFI prediction. CONCLUSION: The accuracy of TFI prediction increases when the combination of C trachomatis MOMP and cHSP60 antibody tests is used. C trachomatis-induced CMI was common in our study population, but the markers of CMI did not predict TFI.
Authors: Gloria E Anyalechi; Jaeyoung Hong; Damien C Danavall; Diana L Martin; Sarah E Gwyn; Patrick J Horner; Brian H Raphael; Robert D Kirkcaldy; Ellen N Kersh; Kyle T Bernstein Journal: Clin Infect Dis Date: 2021-10-20 Impact factor: 20.999
Authors: Gloria E Anyalechi; Jaeyoung Hong; Robert D Kirkcaldy; Harold C Wiesenfeld; Paddy Horner; Gillian S Wills; Myra O McClure; Karen R Hammond; Catherine L Haggerty; Dmitry M Kissin; Edward W Hook; Michael P Steinkampf; Kyle Bernstein; William M Geisler Journal: Sex Transm Dis Date: 2021-03-31 Impact factor: 3.868