Skip to main content
SpringerLink
Log in

Prevalence and diagnostic significance of specific IgA and anti-heat shock protein 60 Chlamydia trachomatis antibodies in subfertile women

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The objective of the present study was to evaluate the clinical usefulness of the simultaneous measurement of three serological markers of chlamydial infection in women with tubal factor infertility (TFI) and spontaneous miscarriage. Serum was collected from 87 patients (33 with TFI and 54 with spontaneous miscarriage) and analyzed for the presence of IgG and IgA antibodies against Chlamydia trachomatis MOMP antigen (Dia.Pro) and IgG antibodies to chlamydial heat shock protein 60 (cHSP60) antigen (Medac). We determined a high degree (64.5 %) of seropositivity against chlamydial antigens in our study population. The prevalence of persistent chlamydial infection has tended to be higher in the group of patients with TFI (41.4 %) than in patients with spontaneous miscarriage (21.3 %). The serum level of IgA, as a marker of active infection, was statistically higher in the TFI group with persistent infection than in the corresponding spontaneous miscarriage group (p = 0.008), while the serum level of IgG showed no statistically significant differences compared with the spontaneous miscarriage group with persistent infection (p = 0.227). Also, using the receiver operating characteristic (ROC) curve, we found that the serum level of IgA has the ability to discriminate patients with persistent chlamydial infection between the TFI and miscarriage groups, with a sensitivity and specificity of 74.3 % and 71.4 %, respectively. To the best of our knowledge, the present study is the first study which, besides the already confirmed linkage between serologic evidence of persistent chlamydial infection and TFI, also confirmed associations between spontaneous miscarriage and serologic evidence of persistent chlamydial infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bébéar C, de Barbeyrac B (2009) Genital Chlamydia trachomatis infections. Clin Microbiol Infect 15:4–10. doi:10.1111/j.1469-0691.2008.02647.x

    Article  PubMed  Google Scholar 

  2. Manavi K (2006) A review on infection with Chlamydia trachomatis. Best Pract Res Clin Obstet Gynaecol 20:941–951

    Article  PubMed  Google Scholar 

  3. Brunham RC, Rey-Ladino J (2005) Immunology of Chlamydia infection: implications for a Chlamydia trachomatis vaccine. Nat Rev Immunol 5:149–161

    Article  PubMed  CAS  Google Scholar 

  4. Peipert JF (2003) Clinical practice. Genital chlamydial infections. N Engl J Med 349:2424–2430

    Article  PubMed  CAS  Google Scholar 

  5. Morré SA, van den Brule AJ, Rozendaal L, Boeke AJ, Voorhorst FJ, de Blok S, Meijer CJ (2002) The natural course of asymptomatic Chlamydia trachomatis infections: 45% clearance and no development of clinical PID after one-year follow-up. Int J STD AIDS 13(Suppl 2):12–18

    Article  PubMed  Google Scholar 

  6. Geisler WM (2010) Duration of untreated, uncomplicated Chlamydia trachomatis genital infection and factors associated with chlamydia resolution: a review of human studies. J Infect Dis 201(Suppl 2):S104–S113. doi:10.1086/652402

    Article  PubMed  Google Scholar 

  7. Punnonen R, Terho P, Nikkanen V, Meurman O (1979) Chlamydial serology in infertile women by immunofluorescence. Fertil Steril 31:656–659

    PubMed  CAS  Google Scholar 

  8. Gijsen AP, Land JA, Goossens VJ, Slobbe ME, Bruggeman CA (2002) Chlamydia antibody testing in screening for tubal factor subfertility: the significance of IgG antibody decline over time. Hum Reprod 17:699–703

    Article  PubMed  Google Scholar 

  9. den Hartog JE, Morré SA, Land JA (2006) Chlamydia trachomatis-associated tubal factor subfertility: immunogenetic aspects and serological screening. Hum Reprod Update 12:719–730

    Article  Google Scholar 

  10. Komoda T (2007) Kinetic study of antibodies (IgG, IgA) to Chlamydia trachomatis: importance of IgA antibody in screening test for C. trachomatis infection by peptide-based enzyme immunosorbent assay. Jpn J Infect Dis 60:347–351

    PubMed  CAS  Google Scholar 

  11. Falck G, Gnarpe J, Hansson LO, Svärdsudd K, Gnarpe H (2002) Comparison of individuals with and without specific IgA antibodies to Chlamydia pneumoniae: respiratory morbidity and the metabolic syndrome. Chest 122:1587–1593

    Article  PubMed  Google Scholar 

  12. Mazzoli S, Cai T, Rupealta V, Gavazzi A, Castricchi Pagliai R, Mondaini N, Bartoletti R (2007) Interleukin 8 and anti-Chlamydia trachomatis mucosal IgA as urogenital immunologic markers in patients with C. trachomatis prostatic infection. Eur Urol 51:1385–1393

    Article  PubMed  CAS  Google Scholar 

  13. Mouton JW, Peeters MF, van Rijssort-Vos JH, Verkooyen RP (2002) Tubal factor pathology caused by Chlamydia trachomatis: the role of serology. Int J STD AIDS 13(Suppl 2):26–29

    Article  PubMed  Google Scholar 

  14. den Hartog JE, Land JA, Stassen FR, Kessels AG, Bruggeman CA (2005) Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility. Hum Reprod 20:986–990

    Article  Google Scholar 

  15. Zügel U, Kaufmann SH (1999) Role of heat shock proteins in protection from and pathogenesis of infectious diseases. Clin Microbiol Rev 12:19–39

    PubMed Central  PubMed  Google Scholar 

  16. Rajaiah R, Moudgil KD (2009) Heat-shock proteins can promote as well as regulate autoimmunity. Autoimmun Rev 8:388–393. doi:10.1016/j.autrev.2008.12.004

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  17. Kinnunen A, Molander P, Morrison R, Lehtinen M, Karttunen R, Tiitinen A, Paavonen J, Surcel HM (2002) Chlamydial heat shock protein 60-specific T cells in inflamed salpingeal tissue. Fertil Steril 77:162–166

    Article  PubMed  Google Scholar 

  18. Hjelholt A, Christiansen G, Johannesson TG, Ingerslev HJ, Birkelund S (2011) Tubal factor infertility is associated with antibodies against Chlamydia trachomatis heat shock protein 60 (HSP60) but not human HSP60. Hum Reprod 26:2069–2076. doi:10.1093/humrep/der167

    Article  PubMed  CAS  Google Scholar 

  19. Daponte A, Pournaras S, Deligeoroglou E, Skentou H, Messinis IE (2012) Serum interleukin-1β, interleukin-8 and anti-heat shock 60 Chlamydia trachomatis antibodies as markers of ectopic pregnancy. J Reprod Immunol 93:102–108. doi:10.1016/j.jri.2012.01.003

    Article  PubMed  CAS  Google Scholar 

  20. Equils O, Lu D, Gatter M, Witkin SS, Bertolotto C, Arditi M, McGregor JA, Simmons CF, Hobel CJ (2006) Chlamydia heat shock protein 60 induces trophoblast apoptosis through TLR4. J Immunol 177:1257–1263

    Article  PubMed  CAS  Google Scholar 

  21. Jakus S, Neuer A, Dieterle S, Bongiovanni AM, Witkin SS (2008) Antibody to the Chlamydia trachomatis 60 kDa heat shock protein in follicular fluid and in vitro fertilization outcome. Am J Reprod Immunol 59:85–89

    Article  PubMed  Google Scholar 

  22. Tiitinen A, Surcel HM, Halttunen M, Birkelund S, Bloigu A, Christiansen G, Koskela P, Morrison SG, Morrison RP, Paavonen J (2006) Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility. Hum Reprod 21:1533–1538

    Article  PubMed  CAS  Google Scholar 

  23. Kodaman PH, Arici A, Seli E (2004) Evidence-based diagnosis and management of tubal factor infertility. Curr Opin Obstet Gynecol 16:221–229

    Article  PubMed  Google Scholar 

  24. Thangappah RB, Paramasivan CN, Narayanan S (2011) Evaluating PCR, culture and histopathology in the diagnosis of female genital tuberculosis. Indian J Med Res 134:40–46

    PubMed Central  PubMed  CAS  Google Scholar 

  25. Clausen HF, Fedder J, Drasbek M, Nielsen PK, Toft B, Ingerslev HJ, Birkelund S, Christiansen G (2001) Serological investigation of Mycoplasma genitalium in infertile women. Hum Reprod 16:1866–1874

    Article  PubMed  CAS  Google Scholar 

  26. Dutta R, Jha R, Salhan S, Mittal A (2008) Chlamydia trachomatis-specific heat shock proteins 60 antibodies can serve as prognostic marker in secondary infertile women. Infection 36:374–378. doi:10.1007/s15010-008-7129-9

    Article  PubMed  CAS  Google Scholar 

  27. LaVerda D, Albanese LN, Ruther PE, Morrison SG, Morrison RP, Ault KA, Byrne GI (2000) Seroreactivity to Chlamydia trachomatis Hsp10 correlates with severity of human genital tract disease. Infect Immun 68:303–309

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  28. Dietrich W, Rath M, Stanek G, Apfalter P, Huber JC, Tempfer C (2010) Multiple site sampling does not increase the sensitivity of Chlamydia trachomatis detection in infertility patients. Fertil Steril 93:68–71. doi:10.1016/j.fertnstert.2008.09.047

    Article  PubMed  Google Scholar 

  29. Kinnunen A, Surcel HM, Halttunen M, Tiitinen A, Morrison RP, Morrison SG, Koskela P, Lehtinen M, Paavonen J (2003) Chlamydia trachomatis heat shock protein-60 induced interferon-gamma and interleukin-10 production in infertile women. Clin Exp Immunol 131:299–303

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  30. Bax CJ, Dörr PJ, Trimbos JB, Spaargaren J, Oostvogel PM, Peña AS, Morré SA (2004) Chlamydia trachomatis heat shock protein 60 (cHSP60) antibodies in women without and with tubal pathology using a new commercially available assay. Sex Transm Infect 80:415–416

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  31. Rodgers AK, Wang J, Zhang Y, Holden A, Berryhill B, Budrys NM, Schenken RS, Zhong G (2010) Association of tubal factor infertility with elevated antibodies to Chlamydia trachomatis caseinolytic protease P. Am J Obstet Gynecol 203:494.e7–494.e14. doi:10.1016/j.ajog.2010.06.005

    Google Scholar 

  32. Muvunyi CM, Dhont N, Verhelst R, Temmerman M, Claeys G, Padalko E (2011) Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing. Hum Reprod 26:3319–3326. doi:10.1093/humrep/der350

    Article  PubMed  CAS  Google Scholar 

  33. Baud D, Goy G, Jaton K, Osterheld MC, Blumer S, Borel N, Vial Y, Hohlfeld P, Pospischil A, Greub G (2011) Role of Chlamydia trachomatis in miscarriage. Emerg Infect Dis 17:1630–1635. doi:10.3201/eid1709.100865

    Article  PubMed Central  PubMed  Google Scholar 

  34. Wilkowska-Trojniel M, Zdrodowska-Stefanow B, Ostaszewska-Puchalska I, Redźko S, Przepieść J, Zdrodowski M (2009) The influence of Chlamydia trachomatis infection on spontaneous abortions. Adv Med Sci 54:86–90. doi:10.2478/v10039-009-0008-5

    PubMed  CAS  Google Scholar 

  35. Witkin SS, Ledger WJ (1992) Antibodies to Chlamydia trachomatis in sera of women with recurrent spontaneous abortions. Am J Obstet Gynecol 167:135–139

    Article  PubMed  CAS  Google Scholar 

  36. Baud D, Regan L, Greub G (2010) Comparison of five commercial serological tests for the detection of anti-Chlamydia trachomatis antibodies. Eur J Clin Microbiol Infect Dis 29:669–675. doi:10.1007/s10096-010-0912-4

    Article  PubMed  CAS  Google Scholar 

  37. Linhares IM, Witkin SS (2010) Immunopathogenic consequences of Chlamydia trachomatis 60 kDa heat shock protein expression in the female reproductive tract. Cell Stress Chaperones 15:467–467. doi:10.1007/s12192-010-0171-4

    Article  PubMed Central  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This study was supported by grant III41010 from the Ministry of Education, Science and Technological Development of the Republic of Serbia.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Medical Microbiology and Immunology, Medical Faculty, University of Pristina, Kosovska Mitrovica, Serbia

    A. Arsovic

  2. Department of Gynecology and Obstetrics, Clinical Center Kragujevac, Kragujevac, Serbia

    A. Nikolov & P. Sazdanovic

  3. Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

    S. Popovic & D. Baskic

  4. Public Health Institute Kragujevac, Kragujevac, Serbia

    D. Baskic

Authors
  1. A. Arsovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Nikolov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Sazdanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Popovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Baskic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Sazdanovic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arsovic, A., Nikolov, A., Sazdanovic, P. et al. Prevalence and diagnostic significance of specific IgA and anti-heat shock protein 60 Chlamydia trachomatis antibodies in subfertile women. Eur J Clin Microbiol Infect Dis 33, 761–766 (2014). https://doi.org/10.1007/s10096-013-2008-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-013-2008-4

Keywords

Search

Navigation