The role of chlamydia genus-specific and species-specific IgG antibody testing in predicting tubal disease in subfertile women.
BACKGROUND
We evaluated whether measuring chlamydia genus- and species-specific immunoglobulin (Ig) G antibodies might improve the predictive value of C. trachomatis antibody testing (CAT) in screening for distal tubal pathology (DTP).


METHODS
Serum of 313 subfertile women was tested for the presence of species-specific antibodies to C. trachomatis, C. pneumoniae and C. psittaci and genus-specific antibodies to chlamydia lipopolysaccharide (LPS). Only patients who had undergone a laparoscopy with tubal testing, to assess the grade of DTP, were included in this study.


RESULTS
The presence of C. trachomatis antibodies was the only independent predictor for DTP. The predictive value of CAT for DTP could not be improved by adding test results of C. pneumoniae or LPS antibody testing. The role of C. psittaci could not be evaluated, due to the absence of C. psittaci-positive patients in our cohort.


CONCLUSIONS
In spite of the high interspecies homology, C. pneumoniae does not contribute to the development of DTP. Anti-LPS antibodies, which are considered to be markers for ongoing infections, do not identify C. trachomatis-positive subfertile women who are at highest risk of DTP. The high prevalence of anti-LPS antibodies in C. trachomatis-positive subfertile women may suggest that C. trachomatis remains more active in the upper genital tract than currently is presumed.
den Hartog
J E
JE
Research Institute Growth and Development (GROW) and Department of Obstetrics and Gynaecology, Maastricht, The Netherlands. jedh@sgyn.azm.nl
Land
J A
JA
Stassen
F R M
FR
Slobbe-van Drunen
M E P
ME
Kessels
A G H
AG
Bruggeman
C A
CA
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D002689:Chlamydia / Q000235:genetics* / Q000276:immunology* / Q000378:metabolism; D002692:Chlamydia trachomatis / Q000276:immunology; D005184:Fallopian Tube Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007247:Infertility, Female / Q000150:complications* / Q000276:immunology*; D008070:Lipopolysaccharides / Q000276:immunology; D011237:Predictive Value of Tests; D013045:Species Specificity
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D008070:Lipopolysaccharides