title: Identification of novel markers for uncomplicated lower genital tract infections and upper genital tract pathology due to Chlamydia trachomatis.
abstract: BACKGROUND
  Untreated Chlamydia trachomatis infections in women can result in disease sequelae such as salpingitis and pelvic inflammatory disease (PID), ultimately culminating in tubal occlusion and infertility. Whilst nucleic acid amplification tests can effectively diagnose uncomplicated lower genital tract (LGT) infections, they are not suitable for diagnosing upper genital tract (UGT) pathological sequelae. As a consequence, this study aimed to identify serological markers that can, with a high degree of sensitivity and specificity, discriminate between LGT infections and UGT pathology.
  
  
  METHODS
  Plasma was collected from 73 women with a history of LGT infection, UGT pathology due to C. trachomatis, or no serological evidence of C. trachomatis infection. Western blotting was used to analyze antibody reactivity against extracted chlamydial proteins. Sensitivity and specificity of differential markers were also calculated.
  
  
  RESULTS
  Four antigens (CT157, CT423, CT727 and CT396) were identified and found to be capable of discriminating between the infection and disease sequelae state. Sensitivity and specificity calculations showed that our assay for diagnosing LGT infection had a sensitivity of 75% and specificity of 76%, whilst the assay for identifying UGT pathology demonstrated 80% sensitivity and 86% specificity.
  
  
  CONCLUSIONS
  The use of these assays could potentially facilitate earlier diagnoses in women suffering UGT pathology due to C. trachomatis.
authors.affiliation: CRC for Diagnostics, Queensland University of Technology, 2 George Street, Brisbane, Queensland, Australia 4000. t.collet@qut.edu.au
authors.forename: Trudi
authors.initials: T
authors.lastname: Collet
authors.forename: Tom
authors.initials: T
authors.lastname: Macnaughton
authors.forename: Terence
authors.initials: T
authors.lastname: Walsh
authors.forename: Joseph
authors.initials: J
authors.lastname: Debattista
authors.forename: Peter
authors.initials: P
authors.lastname: Timms
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D015415:Biomarkers; D002460:Cell Line; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology* / Q000503:physiopathology; D002692:Chlamydia trachomatis / Q000145:classification / Q000235:genetics / Q000276:immunology* / Q000472:pathogenicity; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D015415:Biomarkers