ABSTRACT
Background and Aim: Chlamydia [C.] trachomatis infections in females are a major cause of tubal factor infertility and ectopic pregnancy. However, the precise pathogenesis of C. trachomatis infections remains to be elucidated. Not all women who have undergone a C. trachomatis infection will develop tubal pathology. Variations, like single nucleotide polymorphisms [SNPs], in immunologically important host genes are assumed to play a role in the course and outcome of a C. trachomatis infection. We studied whether genetic traits [carrying multiple SNPs in different genes] in the bacterial sensing system are associated with an aberrant immune response and subsequently with tubal pathology following a C. trachomatis infection. The genes studied all encode for pattern recognition receptors [PRRs] involved in sensing bacterial components
Methods: Of 259 subfertile women, serum was available for C. trachomatis IgG antibody testing and genotyping [common versus rare allele] of the PRR genes TLR9, TLR4, CD14 and CARD15/NOD2. In all women, a laparoscopy was performed to assess the grade of tubal pathology. Tubal pathology was defined as extensive peri-adnexal adhesions and/or distal occlusion of at least one tube
Results: Following a C. trachomatis infection [i.e. C. trachomatis IgG positive], infertile women carrying two or more SNPs in C. trachomatis PRR genes were at increased risk of tubal pathology compared to women carrying less than two SNPs [73% vs 33% risk]. The differences were not statistically significant [P = 0.15], but a trend was observed
Conclusion: Carrying multiple SNPs in C. trachomatis PRR genes tends to result in an aberrant immune response and a higher risk of tubal pathology following a C. trachomatis infection. Larger studies are needed to confirm our preliminary findings