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Caven LT, Carabeo RA. The role of infected epithelial cells in Chlamydia-associated fibrosis. Front Cell Infect Microbiol 2023; 13:1208302. [PMID: 37265500 PMCID: PMC10230099 DOI: 10.3389/fcimb.2023.1208302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/08/2023] [Indexed: 06/03/2023] Open
Abstract
Ocular, genital, and anogenital infection by the obligate intracellular pathogen Chlamydia trachomatis have been consistently associated with scar-forming sequelae. In cases of chronic or repeated infection of the female genital tract, infection-associated fibrosis of the fallopian tubes can result in ectopic pregnancy or infertility. In light of this urgent concern to public health, the underlying mechanism of C. trachomatis-associated scarring is a topic of ongoing study. Fibrosis is understood to be an outcome of persistent injury and/or dysregulated wound healing, in which an aberrantly activated myofibroblast population mediates hypertrophic remodeling of the basement membrane via deposition of collagens and other components of the extracellular matrix, as well as induction of epithelial cell proliferation via growth factor signaling. Initial study of infection-associated immune cell recruitment and pro-inflammatory signaling have suggested the cellular paradigm of chlamydial pathogenesis, wherein inflammation-associated tissue damage and fibrosis are the indirect result of an immune response to the pathogen initiated by host epithelial cells. However, recent work has revealed more direct routes by which C. trachomatis may induce scarring, such as infection-associated induction of growth factor signaling and pro-fibrotic remodeling of the extracellular matrix. Additionally, C. trachomatis infection has been shown to induce an epithelial-to-mesenchymal transition in host epithelial cells, prompting transdifferentiation into a myofibroblast-like phenotype. In this review, we summarize the field's current understanding of Chlamydia-associated fibrosis, reviewing key new findings and identifying opportunities for further research.
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Affiliation(s)
- Liam T. Caven
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
| | - Rey A. Carabeo
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
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Resolution of Chlamydia trachomatis Infection Is Associated with a Distinct T Cell Response Profile. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:1206-18. [PMID: 26446421 DOI: 10.1128/cvi.00247-15] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/11/2015] [Indexed: 12/26/2022]
Abstract
Chlamydia trachomatis is the causative agent of the most frequently reported bacterial sexually transmitted infection, the total burden of which is underestimated due to the asymptomatic nature of the infection. Untreated C. trachomatis infections can cause significant morbidities, including pelvic inflammatory disease and tubal factor infertility (TFI). The human immune response against C. trachomatis, an obligate intracellular bacterium, is poorly characterized but is thought to rely on cell-mediated immunity, with CD4(+) and CD8(+) T cells implicated in protection. In this report, we present immune profiling data of subjects enrolled in a multicenter study of C. trachomatis genital infection. CD4(+) and CD8(+) T cells from subjects grouped into disease-specific cohorts were screened using a C. trachomatis proteomic library to identify the antigen specificities of recall T cell responses after natural exposure by measuring interferon gamma (IFN-γ) levels. We identified specific T cell responses associated with the resolution of infection, including unique antigens identified in subjects who spontaneously cleared infection and different antigens associated with C. trachomatis-related sequelae, such as TFI. These data suggest that novel and unique C. trachomatis T cell antigens identified in individuals with effective immune responses can be considered as targets for vaccine development, and by excluding antigens associated with deleterious sequelae, immune-mediated pathologies may be circumvented.
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Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health. J Pathog 2014; 2014:183167. [PMID: 25614838 PMCID: PMC4295611 DOI: 10.1155/2014/183167] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/09/2014] [Accepted: 12/11/2014] [Indexed: 11/30/2022] Open
Abstract
The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health.
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Cheng C, Jain P, Pal S, Tifrea D, Sun G, Teng AA, Liang X, Felgner PL, de la Maza LM. Assessment of the role in protection and pathogenesis of the Chlamydia muridarum V-type ATP synthase subunit A (AtpA) (TC0582). Microbes Infect 2013; 16:123-133. [PMID: 24161793 DOI: 10.1016/j.micinf.2013.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/11/2013] [Accepted: 10/14/2013] [Indexed: 11/16/2022]
Abstract
A novel Chlamydia muridarum antigen (TC0582) was used to vaccinate BALB/c mice. Mice were also immunized with other components of the ATP synthase complex (TC0580, TC0581, and TC0584), or with the major outer membrane protein (MOMP). TC0582 was also formulated in combination with TC0580, TC0581 or MOMP. TC0582 alone, or in combination with the other antigens, elicited strong Chlamydia-specific humoral and cellular immune responses. Vaccinated animals were challenged intranasally and the course of the infection was followed for 10 days. Based on percentage change in body weight, lung weight, and number of Chlamydia inclusion forming units recovered from the lungs, mice immunized with TC0582, TC0581 or MOMP, as single antigens, showed significant protection. Mice immunized with combinations of two antigens were also protected but the level of protection was not additive. TC0582 has sequence homology with the eukaryotic ATP synthase subunit A (AtpA). Therefore, to determine if immunization with TC0582, or with Chlamydia, elicited antibodies that cross-reacted with the mouse AtpA, the two proteins were printed on a microarray. Sera from mice immunized with TC0582 and/or live Chlamydia, strongly reacted with TC0582 but did not recognize the mouse AtpA. In conclusion, TC0582 may be considered as a Chlamydia vaccine candidate.
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Affiliation(s)
- Chunmei Cheng
- Department of Pathology and Laboratory Medicine Medical Sciences I, Room D440 University of California, Irvine Irvine, California 92697-4800
| | - Pooja Jain
- Department of Pathology and Laboratory Medicine Medical Sciences I, Room D440 University of California, Irvine Irvine, California 92697-4800
| | - Sukumar Pal
- Department of Pathology and Laboratory Medicine Medical Sciences I, Room D440 University of California, Irvine Irvine, California 92697-4800
| | - Delia Tifrea
- Department of Pathology and Laboratory Medicine Medical Sciences I, Room D440 University of California, Irvine Irvine, California 92697-4800
| | - Guifeng Sun
- Department of Pathology and Laboratory Medicine Medical Sciences I, Room D440 University of California, Irvine Irvine, California 92697-4800
| | - Andy A Teng
- ImmPORT Therapeutics, Inc./Antigen Discovery Inc. 1 Technology Dr., Suite E309 Irvine, CA 92618
| | - Xiaowu Liang
- ImmPORT Therapeutics, Inc./Antigen Discovery Inc. 1 Technology Dr., Suite E309 Irvine, CA 92618
| | - Philip L Felgner
- ImmPORT Therapeutics, Inc./Antigen Discovery Inc. 1 Technology Dr., Suite E309 Irvine, CA 92618.,Department of Medicine 3052 Hewitt Hall University of California, Irvine Irvine, California 92697-4068
| | - Luis M de la Maza
- Department of Pathology and Laboratory Medicine Medical Sciences I, Room D440 University of California, Irvine Irvine, California 92697-4800
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Immune recognition of the 60kD heat shock protein: implications for subsequent fertility. Infect Dis Obstet Gynecol 2012; 4:152-8. [PMID: 18476087 PMCID: PMC2364488 DOI: 10.1155/s1064744996000336] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/1996] [Accepted: 10/01/1996] [Indexed: 11/18/2022] Open
Abstract
The 60kD heat shock protein (hsp60) is a highly conserved protein and a dominant antigen of
most pathogenic bacteria. In some women, chronic or repeated upper genital tract infections with
Chlamydia trachomatis, and possibly with other microorganisms, induces immune sensitization to
epitopes of hsp60 that are present in both the microbial and human hsp60. Once a woman becomes
sensitized to these conserved epitpes, any subsequent induction of human or bacterial hsp60
expression will reactivate hsp60-sensitized lymphocytes and initiate a pro-inflammatory immune
response. Hsp60 is expressed during the early stages of pregnancy, by both the embryo and the
maternal decidua. We examined, therefore, whether women who were sensitized to hsp60 experienced
less successful pregnancy outcomes compared to women who were not sensitized to this
antigen. In women undergoing in vitro fertilization (IVF), the presence of cervical IgA antibodies
reactive with the C. trachomatis hsp60 correlated with implantation failure after embryo transfer.
Further analysis revealed that an immunodominant epitope for these IgA antibodies was an hsp60
epitope shared between C. trachomatis and man. In subsequent studies of women not undergoing
IVF, cervical IgA antibodies to the human hsp60 were identified in 13 of 91 reproductive age
women. This antibody was most prevalent in those women with a history of primary infertility
(p = 0.003). In addition, cervical anti-hsp60 IgA correlated with the detection of the pro-inflammatory
cytokines interferon-γ (p = 0.001) and tumor necrosis factor-α (p = 0.02) in the cervix.
Conversely, women with proven fertility had the highest prevalence of the anti-inflammatory cytokine,
interleukin 10, in their cervices (p = 0.001). In an analysis of serum samples in a third study,
women with a history of two or more consecutive first trimester spontaneous abortions had a higher
prevalence (p = 0.01) of IgG antibodies to the human hsp60 (36.8%) than did age matched fertile
women (11.1%) or women with primary infertility (11.8%). Immune sensitization to epitopes expressed
by the human hsp60 may reduce the probability of a successful pregnancy outcome due to
reactivation of hsp60-reactive lymphocytes, induction of a pro-inflammatory cytokine response and
interference with early embryo development and/or implantation.
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Identification of antigen-specific antibody responses associated with upper genital tract pathology in mice infected with Chlamydia muridarum. Infect Immun 2011; 80:1098-106. [PMID: 22158739 DOI: 10.1128/iai.05894-11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Urogenital infection with Chlamydia trachomatis in some women can lead to upper genital tract pathologies, such as hydrosalpinx, potentially affecting fertility. In the current study, 27 of 40 mice intravaginally infected with Chlamydia muridarum developed visible hydrosalpinges in the oviduct while the remaining 13 did not, although all infected mice displayed similar infection time courses. Antisera from the 40 mice recognized 130 out of 257 C. muridarum proteins as antigens and 17 as immunodominant antigens. Importantly, the 27 mice with hydrosalpinges preferentially recognized two C. muridarum proteins (TC0582 and TC0912, designated pathology-associated antigens) while the 13 mice with no hydrosalpinx preferentially recognized 10 proteins (TC0047, TC0117, TC0190, TC0197, TC0257, TC0279, TC0326, TC0630, TC0689, and TC0816, designated nonpathology antigens). The preferential recognition was validated by absorption and independently confirmed in Western blots. The C. trachomatis homolog of TC0912 is encoded by a highly polymorphic gene that is associated with ocular pathogenesis. A fragment of TC0912 was found to improve the differentiation of hydrosalpinx from nonhydrosalpinx mice. TC0582 is a highly conserved ATP synthase, and it may contribute to chlamydial pathogenesis via mechanisms similar to those hypothesized for the highly conserved HSP60. Thus, we have identified chlamydial antigens and epitopes that are associated with either susceptibility or resistance to upper genital tract pathology, which will help us to further understand chlamydial pathogenesis and to develop anti-Chlamydia subunit vaccines.
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Genome-wide identification of Chlamydia trachomatis antigens associated with tubal factor infertility. Fertil Steril 2011; 96:715-21. [PMID: 21742324 DOI: 10.1016/j.fertnstert.2011.06.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 06/06/2011] [Accepted: 06/08/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify Chlamydia trachomatis antigens that can be used to differentially diagnose tubal factor infertility in comparison with previously reported heat shock protein 60. DESIGN In vitro study. SETTING Academic medical center. PATIENT(S) Infertile women with and without tubal pathology diagnosed laparoscopically. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Antibody responses to C. trachomatis in infertile women with or without tubal pathologies using a C. trachomatis genome-wide proteome array. RESULT(S) Comparison of the antibody profiles revealed 30 C. trachomatis antigens that were preferentially recognized in women with tubal factor infertility, with a detection sensitivity and specificity of 80.6% and 56.5%, respectively, 10 of which showed 100% specificity. A combination of CT443 and CT381 antigens yielded the highest detection sensitivity (67.7%) while maintaining 100% specificity. CONCLUSION(S) These findings have demonstrated that antibodies to CT443 and CT381, when used in combination, have higher sensitivity and specificity in predicting tubal factor infertility than other indicators for tubal factor infertility, such as heat shock protein 60 antibodies (35.5%, 100%) or hysterosalpingogram (65%, 83%). Using a panel of C. trachomatis antigens to serologically diagnose tubal factor infertility can save the patients from undertaking expensive and invasive procedures for determining tubal pathology and choosing treatment plans.
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Collet T, Macnaughton T, Walsh T, Debattista J, Timms P. Identification of novel markers for uncomplicated lower genital tract infections and upper genital tract pathology due to Chlamydia trachomatis. Int J Infect Dis 2011; 15:e257-66. [DOI: 10.1016/j.ijid.2010.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 11/19/2010] [Accepted: 12/19/2010] [Indexed: 10/18/2022] Open
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Rodgers AK, Wang J, Zhang Y, Holden A, Berryhill B, Budrys NM, Schenken RS, Zhong G. Association of tubal factor infertility with elevated antibodies to Chlamydia trachomatis caseinolytic protease P. Am J Obstet Gynecol 2010; 203:494.e7-494.e14. [PMID: 20643392 DOI: 10.1016/j.ajog.2010.06.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2009] [Revised: 05/20/2010] [Accepted: 06/01/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of the study was to assess antibodies against Chlamydia trachomatis heat shock proteins (HSP) in patients with tubal factor infertility (TFI), infertility controls (IFC), and fertile controls (FC). HSPs assist organisms in surviving caustic environments such as heat. STUDY DESIGN Twenty-one TFI, 15 IFC, and 29 FC patients were enrolled after laparoscopic tubal assessment. The titers of antibodies against C trachomatis organisms and 14 chlamydial HSPs were compared among the 3 groups. RESULTS TFI patients developed significantly higher levels of antibodies against C trachomatis and specifically recognizing chlamydial HSP60 and caseinolytic protease (Clp) P, a subunit of the ATP-dependent Clp protease complex involved in the degradation of abnormal proteins. CONCLUSION In addition to confirming high titers of antibodies against C trachomatis organisms and HSP60 in TFI patients, we identified a novel link of TFI with anti-ClpP antibodies. These findings may provide useful information for developing a noninvasive screening test for TFI and constructing subunit anti-C trachomatis vaccines.
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Affiliation(s)
- Allison K Rodgers
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229,USA
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Jha R, Vardhan H, Bas S, Salhan S, Mittal A. Chlamydia trachomatis heat shock proteins 60 and 10 induce apoptosis in endocervical epithelial cells. Inflamm Res 2010; 60:69-78. [DOI: 10.1007/s00011-010-0237-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 07/18/2010] [Indexed: 11/30/2022] Open
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Skwor T, Kandel RP, Basravi S, Khan A, Sharma B, Dean D. Characterization of humoral immune responses to chlamydial HSP60, CPAF, and CT795 in inflammatory and severe trachoma. Invest Ophthalmol Vis Sci 2010; 51:5128-36. [PMID: 20463311 DOI: 10.1167/iovs.09-5113] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Chlamydia trachomatis (Ct) remains the leading global cause of preventable blindness. There are limited data on humoral immune responses in trachoma. Evaluating these responses is important for understanding host-pathogen interactions and informing vaccine design. Antibodies to chlamydial heat shock protein 60 (cHSP60) have been associated with infertility and trachomatous scarring. Other proteins, including chlamydial protease-associated factor (CPAF) and a hypothetical protein unique to the family Chlamydiaceae, CT795, elicit strong immune responses in urogenital infections, but their role in trachomatous disease is unknown. METHODS This study was conducted to expand on previous cHSP60 findings and evaluate the association of CPAF and CT795 antibodies with ocular Ct infection and disease. Clinical trachoma grading was performed, and conjunctival samples were obtained from individuals with trachomatous trichiasis (TT; one or more inturned eyelashes) or inflammatory trachoma without trichiasis and control subjects without disease, all of whom resided in trachoma-endemic regions of Nepal. Ct infection was determined using commercial PCR. IgG and IgA tear antibodies against cHSP60, CT795, and CPAF fusion proteins were measured by quantitative ELISA. RESULTS Significantly higher IgG antibody levels were found against cHSP60, CPAF, and CT795 in the inflammatory cases compared with levels in the controls (P < 0.005 for all three). Ct infection was independently associated with IgG antibodies against all three immunogens in the inflammatory cases but not in the controls (P = 0.025, P = 0.03 and P = 0.017, respectively). Only IgG antibodies against CPAF were significantly elevated among the TT cases (P = 0.013). CONCLUSIONS Among individuals with trachoma, IgG antibody responses to CPAF are likely to be both a marker and risk factor for inflammatory trachoma and severe trachomatous disease.
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Affiliation(s)
- Troy Skwor
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute, Oakland, California 94609, USA
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Srivastava P, Jha R, Bas S, Salhan S, Mittal A. In infertile women, cells from Chlamydia trachomatis infected sites release higher levels of interferon-gamma, interleukin-10 and tumor necrosis factor-alpha upon heat-shock-protein stimulation than fertile women. Reprod Biol Endocrinol 2008; 6:20. [PMID: 18489796 PMCID: PMC2412883 DOI: 10.1186/1477-7827-6-20] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 05/20/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The magnitude of reproductive morbidity associated with sexually transmitted Chlamydia trachomatis infection is enormous. Association of antibodies to chlamydial heat shock proteins (cHSP) 60 and 10 with various disease sequelae such as infertility or ectopic pregnancy has been reported. Cell-mediated immunity is essential in resolution and in protection to Chlamydia as well as is involved in the immunopathogenesis of chlamydial diseases. To date only peripheral cell mediated immune responses have been evaluated for cHSP60. These studies suggest cHSPs as important factors involved in immunopathological condition associated with infection. Hence study of specific cytokine responses of mononuclear cells from the infectious site to cHSP60 and cHSP10 may elucidate their actual role in the cause of immunopathogenesis and the disease outcome. METHODS Female patients (n = 368) attending the gynecology out patient department of Safdarjung hospital, New Delhi were enrolled for the study and were clinically characterized into two groups; chlamydia positive fertile women (n = 63) and chlamydia positive infertile women (n = 70). Uninfected healthy women with no infertility problem were enrolled as controls (n = 39). cHSP60 and cHSP10 specific cytokine responses (Interferon (IFN)-gamma, Interleukin (IL)-10, Tumor Necrosis Factor (TNF)-alpha, IL-13 and IL-4) were assessed by ELISA in stimulated cervical mononuclear cell supernatants. RESULTS cHSP60 and cHSP10 stimulation results in significant increase in IFN-gamma (P = 0.006 and P = 0.04 respectively) and IL-10 levels (P = 0.04) in infertile group as compared to fertile group. A significant cHSP60 specific increase in TNF-alpha levels (P = 0.0008) was observed in infertile group as compared to fertile group. cHSP60 and cHSP10 specific IFN-gamma and IL-10 levels were significantly correlated (P < 0.0001, r = 0.54 and P = 0.004, r = 0.33 respectively) in infertile group. CONCLUSION Our results suggest that exposure to chlamydial heat shock proteins (cHSP60 and cHSP10) could significantly affect mucosal immune function by increasing the release of IFN-gamma, IL-10 and TNF-alpha by cervical mononuclear cells.
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Affiliation(s)
- Pragya Srivastava
- Institute of Pathology – ICMR, Safdarjung Hospital Campus, Post Box no. 4909, New Delhi-110 029, India
| | - Rajneesh Jha
- Institute of Pathology – ICMR, Safdarjung Hospital Campus, Post Box no. 4909, New Delhi-110 029, India
| | - Sylvette Bas
- Division of Rheumatology, Department of Internal Medicine, University Hospital, 1211 Geneva 14, Switzerland
| | - Sudha Salhan
- Department of Gynecology & Obstetrics, Safdarjung Hospital, New Delhi-110 029, India
| | - Aruna Mittal
- Institute of Pathology – ICMR, Safdarjung Hospital Campus, Post Box no. 4909, New Delhi-110 029, India
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Sziller I, Fedorcsák P, Csapó Z, Szirmai K, Linhares IM, Papp Z, Witkin SS. Circulating antibodies to a conserved epitope of the Chlamydia trachomatis 60-kDa heat shock protein is associated with decreased spontaneous fertility rate in ectopic pregnant women treated by salpingectomy. Am J Reprod Immunol 2008; 59:99-104. [PMID: 18211535 DOI: 10.1111/j.1600-0897.2007.00553.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PROBLEM This prospective study was aimed to evaluate whether non-invasive clinical and serologic parameters of tubal disease are predictive for subsequent spontaneous conception and pregnancy outcome after first episode of ectopic pregnancy (EP). METHOD OF STUDY Overall, 144 women aged <35 years were enrolled. Outcome of subsequent spontaneous conception was analyzed after 3 years and compared with clinical parameters and antibody responses to Chlamydia trachomatis and epitopes of the 60-kDa chlamydial heat shock protein (CHSP-60). RESULTS Antibody response to a conserved epitope of CHSP-60 (amino acids, aa 260-277) was independently correlated with both decreased spontaneous conception and term delivery rates (adjusted odds ratios, OR: 3.6 and 5.4, respectively). CONCLUSION Presence of circulating antibodies to a conserved epitope of the CHSP-60 is associated with a lower spontaneous conception rate, and increased likelihood of adverse pregnancy outcome in women treated by salpingectomy for first episode of EP.
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Affiliation(s)
- István Sziller
- First Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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den Hartog JE, Morré SA, Land JA. Chlamydia trachomatis-associated tubal factor subfertility: Immunogenetic aspects and serological screening. Hum Reprod Update 2006; 12:719-30. [PMID: 16832042 DOI: 10.1093/humupd/dml030] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Chlamydia (C.) trachomatis female genital tract infections usually remain asymptomatic and untreated. Therefore, an adequate immune response, rather than antibiotic treatment, is essential to clear the pathogen. Most women will effectively clear C. trachomatis infections, but some will have persistent C. trachomatis infections, which may ascend to the upper genital tract and increase the risk of tubal factor subfertility. Pattern recognition receptors (PRRs) of the toll-like receptor (TLR) and nucleotide-binding oligomerization domain (NOD) families recognize C. trachomatis and initiate the immune response. Host immune factors are determinants of the course of C. trachomatis infections. Genetic variations in TLR and NOD genes may affect receptor function, leading to inadequate recognition of C. trachomatis, an inadequate immune response, and consequently an increased risk of persistence and late sequelae. For the risk assessment of tubal pathology in subfertile women, C. trachomatis immunoglobulin (Ig) G antibody testing (CAT) in serum is widely used. A positive CAT is indicative of a previous infection but not of a persistent infection. Measuring serological markers of persistence, of which C-reactive protein (CRP) seems promising, in CAT-positive women may identify a subgroup of subfertile women with persistent C. trachomatis infections and the highest risk of tubal pathology.
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Affiliation(s)
- J E den Hartog
- Research Institute Growth and Development (GROW) and Department of Obstetrics and Gynaecology, Academic Hospital Maastricht, Maastricht, the Netherlands.
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Sharma J, Zhong Y, Dong F, Piper JM, Wang G, Zhong G. Profiling of human antibody responses to Chlamydia trachomatis urogenital tract infection using microplates arrayed with 156 chlamydial fusion proteins. Infect Immun 2006; 74:1490-9. [PMID: 16495519 PMCID: PMC1418620 DOI: 10.1128/iai.74.3.1490-1499.2006] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The available chlamydial genome sequences have made it possible to comprehensively analyze host responses to all chlamydial proteins, which is essential for further understanding of chlamydial pathogenesis and development of effective chlamydial vaccines. Microplates arrayed with 156 Chlamydia trachomatis fusion proteins were used to evaluate antibody responses in women urogenitally infected with C. trachomatis. Based on both the antibody recognition frequency and titer, seven chlamydial antigens encoded by open reading frames (ORFs) CT089, CT147, CT226, CT681, CT694, CT795, and CT858, respectively, were identified as relatively immunodominant; six of these are encoded by hypothetical ORFs. Antibody binding to these chlamydial fusion proteins was blocked by C. trachomatis-infected but not by normal HeLa cell lysates or irrelevant bacterial lysates. These results have revealed novel immune-reactive chlamydial antigens, not only indicating that the hypothetical ORF-encoded proteins are expressed during chlamydial infection in humans but also providing the proof of principle that the fusion protein-based approach can be used to profile human immune responses to chlamydial infection at the whole-genome scale.
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Affiliation(s)
- Jyotika Sharma
- Department of Microbiology and Immunology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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Giles DK, Whittimore JD, LaRue RW, Raulston JE, Wyrick PB. Ultrastructural analysis of chlamydial antigen-containing vesicles everting from the Chlamydia trachomatis inclusion. Microbes Infect 2006; 8:1579-91. [PMID: 16698305 DOI: 10.1016/j.micinf.2006.01.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2005] [Revised: 01/13/2006] [Accepted: 01/17/2006] [Indexed: 11/18/2022]
Abstract
Several chlamydial antigens have been detected in the infected epithelial cell cytosol and on the host cell surface prior to their presumed natural release at the end of the 72-96 h developmental cycle. These extra-inclusion antigens are proposed to influence vital host cell functions, antigen trafficking and presentation and, ultimately, contribute to a prolonged inflammatory response. To begin to dissect the mechanisms for escape of these antigens from the chlamydial inclusion, which are enhanced on exposure to antibiotics, polarized endometrial epithelial cells (HEC-1B) were infected with Chlamydia trachomatis serovar E for 36 h or 48 h. Infected cells were then exposed to chemotactic human polymorphonuclear neutrophils not loaded or pre-loaded in vitro with the antibiotic azithromycin. Viewed by electron microscopy, the azithromycin-mediated killing of chlamydiae involved an increase in chlamydial outer membrane blebbing followed by the appearance of the blebs in larger vesicles (i) everting from but still associated with the inclusion as well as (ii) external to the inclusion. Evidence that the vesicles originated from the chlamydial inclusion membrane was shown by immuno-localization of inclusion membrane proteins A, F, and G on the vesicular membranes. Chlamydial heat shock protein 60 (chsp60) copies 2 and 3, but not copy 1, were released from RB and incorporated into the everted inclusion membrane vesicles and delivered to the infected cell surface. These data represent direct evidence for one mechanism of early antigen delivery, albeit membrane-bound, beyond the confines of the chlamydial inclusion.
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Affiliation(s)
- David K Giles
- Department of Microbiology, Box 70579, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614-0579, USA
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Gazzard CM, Wood RN, Debattista J, Allan JA, Allan JM, Timms P. Use of a commercial assay for detecting the 60 kDa chlamydial heat shock protein in a range of patient groups. Sex Transm Dis 2006; 33:77-9. [PMID: 16432477 DOI: 10.1097/01.olq.0000187212.30915.f5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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den Hartog JE, Land JA, Stassen FRM, Kessels AGH, Bruggeman CA. Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility. Hum Reprod 2005; 20:986-90. [PMID: 15640255 DOI: 10.1093/humrep/deh710] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Persistent C. trachomatis infections are assumed to increase the risk of tubal pathology. We studied whether serological markers, assumed to be associated with persistent C. trachomatis infections, could identify subfertile women at risk of tubal pathology. METHODS Sera of 313 subfertile women, who all underwent a laparoscopy with tubal testing to assess the grade of tubal pathology, were tested for the presence of immunoglobulin (Ig) G and IgA antibodies to C. trachomatis, IgG antibodies to chlamydia heat shock protein 60 (cHSP60) and C-reactive protein (CRP). RESULTS C. trachomatis IgA, cHSP60 IgG and CRP, all serological markers of persistent infections, were significantly more prevalent in women with tubal pathology as compared to those without tubal pathology. The predictive value of the currently used screening test for tubal pathology (IgG to C. trachomatis) could be significantly improved by adding the CRP test. CONCLUSIONS In subfertile women with tubal pathology, serological markers of persistent C. trachomatis infections are significantly more common as compared to women without tubal pathology. C. trachomatis IgG-positive subfertile women with slightly elevated (< 10 mg/l) CRP levels are at highest risk of persistent C. trachomatis infections and tubal pathology.
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Affiliation(s)
- J E den Hartog
- Research Institute Growth and Development (GROW) and Department of Obstetrics and Gynaecology, Academisch Ziekenhuis Maastricht, P.O.Box 5800, 6202 AZ Maastricht, The Netherlands.
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19
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Shibahara H, Takamizawa S, Hirano Y, Takei Y, Fujiwara H, Tamada S, Sato I. Relationships between Chlamydia trachomatis
Antibody Titers and Tubal Pathology Assessed using Transvaginal Hydrolaparoscopy in Infertile Women. Am J Reprod Immunol 2003; 50:7-12. [PMID: 14506923 DOI: 10.1034/j.1600-0897.2003.01173.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology, Jichi Medical School, Kawachi-gun, Tochigi, Japan.
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Debattista J, Timms P, Allan J, Allan J. Immunopathogenesis of chlamydia trachomatis infections in women. Fertil Steril 2003; 79:1273-87. [PMID: 12798871 DOI: 10.1016/s0015-0282(03)00396-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To develop a model of pathogenesis by which Chlamydia trachomatis progresses from acute to chronic infection, and finally serious disease (salpingitis, tubal occlusion). DESIGN Review of current literature located through web-based Medline searches using key words: Chlamydia trachomatis, immunology, cytokines, heat shock protein, infertility. RESULT(S) Cell-mediated immune mechanisms appear to be critical in determining whether acute infection is resolved or progresses into chronicity with pathological outcome. What determines the particular immune pathway depends on a range of determinants-HLA subtype and human genetics, cytokine profile, infectious load, route of infection, and endocrinology. A clearer picture of the natural history of chlamydial pathology may assist in providing better predictors of those women who may go on to develop significant sequelae after infection. CONCLUSION(S) Predicting those who may develop serious disease, including infertility, may contribute to improved management of such persons during earlier stages of infection and assist in prevention.
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Affiliation(s)
- Joseph Debattista
- Centre for Molecular Biotechnology, Queensland University of Technology, Queensland, Australia.
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21
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Abstract
Diseases caused by Chlamydia are based on intense and chronic inflammation elicited and maintained by reinfection or persistent infection. The traditional view in the field is that disease is mediated by antigen-dependent delayed-type hypersensitivity or autoimmunity. This immunological paradigm has served as the basis for years of chlamydial research but the mechanism or the antigen that causes pathology has yet to be unequivocally revealed. Recent research on responses elicited in Chlamydia-infected cells defines a new direction for our understanding of this microorganism-host interaction and provides the basis for a reassessment of disease mechanisms. Chlamydia-infected non-immune mammalian cells produce proinflammatory chemokines, cytokines, growth factors and other cellular modulators. This cellular response to infection supports an alternative hypothesis for chlamydial pathogenesis: the inflammatory processes of chlamydial pathogenesis are elicited by infected host cells and are necessary and sufficient to account for chronic and intense inflammation and the promotion of cellular proliferation, tissue remodeling and scarring, the ultimate cause of disease sequelae.
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Affiliation(s)
- Richard S Stephens
- Division of Infectious Diseases, School of Public Health, 140 Earl Warren Hall, University of California, Berkeley 94720, USA.
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Persson K. The role of serology, antibiotic susceptibility testing and serovar determination in genital chlamydial infections. Best Pract Res Clin Obstet Gynaecol 2002; 16:801-14. [PMID: 12473283 DOI: 10.1053/beog.2002.0321] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Systemic and local antibodies regularly develop in genital infections caused by Chlamydia trachomatis. Such antibodies cannot be used as a sign of current infection as they often persist for years after the infection has resolved. Chlamydial antibodies have, however, been extremely useful for demonstrating associations between C. trachomatis and clinical conditions such as ectopic pregnancy and tubal factor infertility. In particular, antibodies to the chlamydial heat shock protein 60 predict the presence of tubal scarring.C. trachomatis has been divided into 15 (or 18) serovars, with many genotypes within each serovar. Differences in pathogenicity between serovars have been reported but no general pattern has emerged. Genotyping is a powerful epidemiological tool but is not yet ready for routine clinical use.C. trachomatis infections can be successfully treated by tetracycline or macrolides. Some resistant strains have been reported, causing treatment failures, and the problem of emerging antibiotic resistance cannot be neglected.
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Affiliation(s)
- Kenneth Persson
- Department of Clinical Microbiology, Malmö University Hospital, SE 205 02 Malmö, Sweden
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23
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Abstract
In the majority of women chlamydia infections remain asymptomatic but they may increase the risk for tubal factor subfertility. Pelvic inflammatory disease (PID) and its chronic sequelae are associated with chlamydial IgG antibody formation in serum, and a correlation between the height of antibody titres and the presence of tubal factor subfertility has been established. The predictive value of chlamydia antibody testing (CAT) is limited however. Several factors affecting sensitivity and specificity of CAT have been identified. Because it is assumed that the presence of chlamydial heat shock proteins (HSPs) may be indicative of chronic inflammation, chlamydial HSP60 antibody testing has been evaluated in its prediction of tubal factor subfertility.
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Affiliation(s)
- Jolande A Land
- Department of Obstetrics and Gynaecology, Research Institute GROW, Academisch Ziekenhuis Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
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24
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Abstract
Chlamydia trachomatis ascends from the cervix to the Fallopian tubes where it forms a persistent infection. The immune response to this infection results in tubal occlusion and infertility. In its persistent formC. trachomatis produces high levels of a 60-kDa heat shock protein (c-hsp60). There is a human hsp60 (h-hsp60) which shares a 50% amino acid sequence homology with the c-hsp60. Therefore, a chlamydial Fallopian tube infection can induce the development of autoantibodies to h-hsp60. H-hsp60 is one of the first proteins synthesized following fertilization. It is also expressed by epithelial cells in the decidua. Therefore, expression of h-hsp60 in early pregnancy can reactivate the c-hsp60-sensitized lymphocytes, leading to immune rejection of the embryo. The role of C. trachomatis in male infertility requires clarification. Because most C. trachomatis infections occur without defined symptoms, only the screening of sexually active women will reveal whether a woman is infected with this organism. Detection and treatment of a recently acquired infection can prevent development of h-hsp60 autoantibodies and tubal occlusion, preserve fertility, and prevent complications such as ectopic pregnancy.
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Affiliation(s)
- Steven S Witkin
- Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 525 East 68th Street, Box 35, New York, New York 10021, USA
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Debattista J, Timms P, Allan J, Allan J. Reduced levels of gamma-interferon secretion in response to chlamydial 60 kDa heat shock protein amongst women with pelvic inflammatory disease and a history of repeated Chlamydia trachomatis infections. Immunol Lett 2002; 81:205-10. [PMID: 11947926 DOI: 10.1016/s0165-2478(02)00036-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Peripheral lymphocytes in uninfected fertile controls, women with various histories of Chlamydia trachomatis infection, pelvic inflammatory disease (PID) and infertility not due to C. trachomatis infection (endometriosis) were cultured overnight with PHA mitogen and the 60 kDa chlamydial heat shock protein. Plasma samples were then assayed for levels of gamma-interferon and IL-10 using a commercial ELISA system. Women with PID and those with a history of multiple C. trachomatis infections showed reduced gamma-interferon production in response to cHSP60, not seen in women infected only once and those with infertility due to other causes (endometriosis). Secretion of IL-10 in response to cHSP60 did not vary significantly across the various patient groups, though all patients showed elevated levels of total IL-10 compared with uninfected controls.
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Affiliation(s)
- J Debattista
- Centre for Molecular Biotechnology, Queensland University of Technology, 484 Adelaide Street, Gardens Point Campus, Brisbane, Qld 4000, Australia.
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Kinnunen A, Paavonen J, Surcel HM. Heat shock protein 60 specific T-cell response in chlamydial infections. Scand J Immunol 2001; 54:76-81. [PMID: 11439151 DOI: 10.1046/j.1365-3083.2001.00940.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Heat shock proteins (HSPs) of most pathogens, including Chlamydia, are major immune targets of both humoral- and cell-mediated immune mechanisms. During the last decade, many investigators have focused their research to elucidate the complex relationship of chlamydial HSPs, especially chlamydial HSP60, and the host immune response. A central issue is whether the pathologic mechanisms in chronic chlamydial diseases are associated with an enhanced immune response to chlamydial HSP60 which can mediate tissue destruction through cytotoxic reactions, or whether they are related to the Th2 type of response that eventually leads to partial or temporary suppression of an effective antichlamydial response. Our review highlights the available knowledge between immune responses to chlamydial HSP60 and chronic chlamydial infections in human.
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Affiliation(s)
- A Kinnunen
- Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki and National Public Health Institute, Oulu, Finland
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27
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Kinnunen A, Molander P, Laurila A, Rantala I, Morrison R, Lehtinen M, Karttunen R, Tiitinen A, Paavonen J, Surcel HM. Chlamydia trachomatis reactive T lymphocytes from upper genital tract tissue specimens. Hum Reprod 2000; 15:1484-9. [PMID: 10875854 DOI: 10.1093/humrep/15.7.1484] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Chlamydia trachomatis infection is associated with pelvic inflammatory disease (PID) and tubal factor infertility (TFI). We investigated the role of C. trachomatis as a target antigen of endometrial and salpingeal tissue lymphocytes derived from PID and TFI patients. Antigen specificity of the tissue originated T lymphocyte lines (TLL) was tested against C. trachomatis elementary bodies and chlamydial heat shock protein 60 (CHSP60). C. trachomatis antigen stimulated proliferation in two out of eight endometrial TLL derived from PID patients and three out of four TLL derived from TFI patients. All (n = 4) TLL derived from the salpingeal specimens responded to CHSP60 compared with only one out of 12 TLL derived from the endometrial specimens. In-vivo expression of interferon-gamma (IFN-gamma) mRNA revealed that it was present in nine of 13 specimens obtained from PID patients. The dominant activity of type-1 T lymphocytes was confirmed by the in-vitro production of IFN-gamma (median 1007 pg/ml) from all (n = 5) C. trachomatis specific TLL while IL-5 secretion was lower (median 779 pg/ml). In conclusion, C. trachomatis reactive TLL were established from in-vivo activated lymphocytes from the upper genital tract tissue of PID and TFI patients. The reactivity of the salpingeal TLL to CHSP60 provided further evidence that immunoreactivity to CHSP60 is a predominant response in patients with tubal damage.
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Affiliation(s)
- A Kinnunen
- National Public Health Institute, Aapistie 1, Box 310, 90101 Oulu, Finland
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28
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Abstract
Chlamydia trachomatis is one the most important sexually transmitted diseases; it can cause serious sequelae despite the absence of symptoms in some people. It's estimated that about 25% of women who have acute salpingitis become infertile, and chlamydial infection is the commonest cause. The introduction of screening programs for its detection are still a topic of discussion. The literature shows that the total cost of examination and treatment of complications known to be associated with genital chlamydial infection (PID, chronic pelvic pain, tubal factor infertility) is generally higher than the total cost of a large-scale Chlamydia screening program. The selection of a diagnostic test for detection of chlamydial genital infection depends on availability, local expertise, and prevalence of Chlamydia trachomatis in the test population. Cell culture is too expensive in nonendemic regions, so the use of non-culture techniques is very attractive. PCR (polymerase chain reaction) and LCR (ligase chain reaction) are actually the two most commonly used alternatives to conventional methods for detecting STD agents. In fact, PCR and LCR have proved useful for detection of Chlamydia trachomatis in cervical and urethral samples both in symptomatic and asymptomatic women. Recently, testing of first-void urine (FVU) specimens with these techniques has shown that the amplification tests are as sensitive as tests with endocervical swab cultures.
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Affiliation(s)
- S Guaschino
- Department of Obstetrics and Gynecology B. Garofolo, University of Trieste, Italy
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29
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Persson K, Osser S, Birkelund S, Christiansen G, Brade H. Antibodies to Chlamydia trachomatis heat shock proteins in women with tubal factor infertility are associated with prior infection by C. trachomatis but not by C. pneumoniae. Hum Reprod 1999; 14:1969-73. [PMID: 10438411 DOI: 10.1093/humrep/14.8.1969] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The antibody response to heat shock proteins 60 and 10 were studied in 163 patients with tubal factor infertility and in 163 age-matched pregnant women. The associations of these antibodies with specific antibodies to Chlamydia trachomatis and to Chlamydia pneumoniae as well as with antibodies to the common chlamydial lipopolysaccharide antigen were studied. Patients with tubal factor infertility had significantly higher frequencies and titres of all antibodies except to C. pneumoniae. In a logistic regression model an association was found between the prevalence of antibodies to the heat shock proteins and to C. trachomatis but no independent influence of antibodies to C. pneumoniae. No interaction between C. trachomatis and C. pneumoniae suggesting a synergistic effect was found although the heat shock proteins from these two organisms are immunologically similar. Antibodies to the chlamydial lipopolysaccharide also seemed to be related to C. trachomatis and not to C. pneumoniae in these women.
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Affiliation(s)
- K Persson
- Department of Clinical Microbiology and Gynecology and Obstetrics, Malmö University Hospital, S-205 02 Malmö, Sweden
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30
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Askienazy-Elbhar M, Henry-Suchet J. Persistent ?silent?Chlamydia trachomatis female genital tract infections. Infect Dis Obstet Gynecol 1999. [DOI: 10.1002/(sici)1098-0997(1999)7:1/2<31::aid-idog7>3.0.co;2-p] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Peeling RW, Mabey DC. Heat shock protein expression and immunity in chlamydial infections. Infect Dis Obstet Gynecol 1999; 7:72-9. [PMID: 10231013 PMCID: PMC1784719 DOI: 10.1155/s1064744999000149] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- R W Peeling
- Laboratory Centre for Disease Control, Winnipeg, Manitoba, Canada
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33
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Askienazy-Elbhar M, Suchet JH. Persistent "silent" Chlamydia trachomatis female genital tract infections. Infect Dis Obstet Gynecol 1999; 7:31-4. [PMID: 10231006 PMCID: PMC1784722 DOI: 10.1155/s1064744999000071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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LaVerda D, Byrne GI. Use of monoclonal antibodies to facilitate identification, cloning, and purification of Chlamydia trachomatis hsp10. J Clin Microbiol 1997; 35:1209-15. [PMID: 9114409 PMCID: PMC232731 DOI: 10.1128/jcm.35.5.1209-1215.1997] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
As a requisite for a physiological and immunological investigation, reagents were developed that facilitated the identification and purification of Chlamydia trachomatis hsp10 (chsp10). Monoclonal antibodies that specifically recognize chsp10 were generated with multiple-antigen peptides (MAPs) to promote recognition of Chlamydia-specific epitopes. MAP2, containing amino acids 54 to 69 of the hsp10 sequence, elicited strong antibody responses after immunization of BALB/c mice. Monoclonal antibodies from several cloned hybridomas reacted on immunoblots with an approximately 15-kDa chlamydial protein and recombinant chsp10. Because of its strict specificity for chsp10, monoclonal antibody M1.2 was selected for routine use. M1.2 reacted by immunoblot with the hsp10s of several C. trachomatis strains but not with Chlamydia psittaci hsp10 or Escherichia coli homolog GroES, suggesting that M1.2 recognizes a species-specific epitope. Recombinant chsp10 was purified by immunoaffinity chromatography with M1.2. For large-scale purification, chsp10 was appended with a C-terminal six-histidine tag for purification by nickel chelate affinity chromatography. The hypA gene encoding the chsp10 of C. trachomatis serovar E/Bour was cloned into the pQE-60 vector (QIAGEN, Inc.) following PCR amplification from genomic DNA. E. coli DH5 transformants were screened for chsp10 expression by colony immunoblotting with M1.2, were tested for nickel matrix binding, and were sequenced. The sequence of serovar E/Bour chsp10 was found to be closely homologous to those of hsp10s of other chlamydiae. Purified chsp10 and specific anti-chsp10 monoclonal antibodies will be useful for investigating the biological and immunological roles of hsp10 in chlamydial infections.
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Affiliation(s)
- D LaVerda
- Department of Medical Microbiology and Immunology, University of Wisconsin, Madison 53706, USA
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Claman P, Honey L, Peeling RW, Jessamine P, Toye B. The presence of serum antibody to the chlamydial heat shock protein (CHSP60) as a diagnostic test for tubal factor infertility. Fertil Steril 1997; 67:501-4. [PMID: 9091338 DOI: 10.1016/s0015-0282(97)80077-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To study the utility of testing for heat shock protein 60 (CHSP60) antibodies in the diagnosis of tubal factor infertility. DESIGN Prospective case control. SETTING Canadian university hospital infertility clinic. PATIENT(S) Women presenting for infertility investigation. INTERVENTION(S) Sera were collected from 77 patients. MAIN OUTCOME MEASURE(S) The relationship between tubal factor infertility and the presence of antibodies to Chlamydia trachomatis and CHSP60 was assessed. RESULT(S) There were no significant differences between antibodies to C. trachomatis in women with tubal factor infertility (63%) and other causes of infertility (46%). However, more women with tubal factor infertility (44%) had anti-CHSP60 antibodies compared with other causes of infertility (8%). Antibody testing for C. trachomatis has only a 63% sensitivity and a 54% specificity for detecting tubal factor infertility. In contrast, the CHSP60 antibody test has a 44% sensitivity and a 92% specificity for detecting tubal factor infertility. There is a good positive likelihood ratio of 5.5 for CHSP60 antibody testing detecting the presence of tubal factor infertility. Combining CHSP60 antibody with antibody testing for C. trachomatis has an excellent positive likelihood ratio of 10 for the detection of C. trachomatis-associated tubal factor infertility. CONCLUSION(S) CHSP60 antibody testing is a more accurate test than antibody testing for C. trachomatis for predicting chlamydia-associated tubal factor infertility. These tests, when used in combination at initial infertility evaluation, would provide a rapid noninterventive means of diagnosing tubal factor infertility.
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Affiliation(s)
- P Claman
- Ottawa Civic and General Hospitals, University of Ottawa, Ontario, Canada.
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36
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Abstract
The recognition of genital chlamydial infection as an important public health problem was made first by the recognition of its role in acute clinical syndromes, as well as in serious reproductive and ocular complications, and secondly by our awareness of its prevalence when diagnostic tests became widely accessible. The recent availability of effective single dose oral antimicrobial therapy and sensitive molecular amplification tests that allow the use of noninvasive specimens for diagnosis and screening is expected to have a major impact in reducing the prevalence of disease in the next decade. Clinical manifestations associated with Chlamydia pneumoniae infection continue to emerge beyond respiratory illness. In particular, its association with atherosclerosis deserves further investigation. Chlamydia pecorum, a pathogen of ruminants, was recently recognized as a new species. The continued application of molecular techniques will likely elucidate an expanding role for chlamydiae in human and animal diseases, delineate the phylogenetic relationships among chlamydial species and within the eubacteria domain, and provide tools for detection and control of chlamydial infections.
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Affiliation(s)
- R W Peeling
- Laboratory Centre for Disease Control Health, Winnipeg, Manitoba, Canada.
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