Xiaojing Zheng1,2, Wujuan Zhong2, Catherine M O'Connell1, Yutong Liu2, Catherine L Haggerty3, William M Geisler4, Gloria E Anyalechi5, Robert D Kirkcaldy5, Harold C Wiesenfeld6, Sharon L Hillier6, Michael P Steinkampf7, Karen R Hammond7, Jason Fine2, Yun Li2,8, Toni Darville1. 1. Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 2. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 4. Departments of Medicine and Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA. 5. Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia, USA. 6. Department of Obstetrics, Gynecology and Reproductive Sciences, the University of Pittsburgh School of Medicine and the Magee-Womens Research Institute Pittsburgh, Pittsburgh, Pennsylvania, USA. 7. Alabama Fertility Specialists, Birmingham, Alabama, USA. 8. Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Abstract
BACKGROUND: Chlamydia trachomatis (Ct) infection ascending to the upper genital tract can cause infertility. Direct association of genetic variants as contributors is challenging because infertility may not be diagnosed until years after infection. Investigating the intermediate trait of ascension bridges this gap. METHODS: We identified infertility genome-wide association study (GWAS) loci using deoxyribonucleic acid from Ct-seropositive cisgender women in a tubal factor infertility study and Ct-infected cisgender women from a longitudinal pelvic inflammatory disease cohort with known fertility status. Deoxyribonucleic acid and blood messenger ribonucleic acid from 2 additional female cohorts with active Ct infection and known endometrial infection status were used to investigate the impact of infertility single-nucleotide polymorphisms (SNPs) on Ct ascension. A statistical mediation test examined whether multiple infertility SNPs jointly influenced ascension risk by modulating expression of mediator genes. RESULTS: We identified 112 candidate infertility GWAS loci, and 31 associated with Ct ascension. The SNPs altered chlamydial ascension by modulating expression of 40 mediator genes. Mediator genes identified are involved in innate immune responses including type I interferon production, T-cell function, fibrosis, female reproductive tract health, and protein synthesis and degradation. CONCLUSIONS: We identified Ct-related infertility loci and their potential functional effects on Ct ascension.
BACKGROUND: Chlamydia trachomatis (Ct) infection ascending to the upper genital tract can cause infertility. Direct association of genetic variants as contributors is challenging because infertility may not be diagnosed until years after infection. Investigating the intermediate trait of ascension bridges this gap. METHODS: We identified infertility genome-wide association study (GWAS) loci using deoxyribonucleic acid from Ct-seropositive cisgender women in a tubal factor infertility study and Ct-infected cisgender women from a longitudinal pelvic inflammatory disease cohort with known fertility status. Deoxyribonucleic acid and blood messenger ribonucleic acid from 2 additional female cohorts with active Ct infection and known endometrial infection status were used to investigate the impact of infertility single-nucleotide polymorphisms (SNPs) on Ct ascension. A statistical mediation test examined whether multiple infertility SNPs jointly influenced ascension risk by modulating expression of mediator genes. RESULTS: We identified 112 candidate infertility GWAS loci, and 31 associated with Ct ascension. The SNPs altered chlamydial ascension by modulating expression of 40 mediator genes. Mediator genes identified are involved in innate immune responses including type I interferon production, T-cell function, fibrosis, female reproductive tract health, and protein synthesis and degradation. CONCLUSIONS: We identified Ct-related infertility loci and their potential functional effects on Ct ascension.
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