[Examination of possible role of the chlamydial stress proteins in pathogenesis of ectopic pregnancy].

INTRODUCTION: Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections recognized throughout the world. In the last few years, several studies have indicated that predisposition of C. trachomatis to persist within the host cell is recognized as a major factor in the pathogenesis of chlamydial infection. During persistent chlamydial infection, the stress protein hsp60 is synthesized continually as immunopathologic antigen. Antibodies to hsp60 are found in women with tubal occlusion, but these antibodies are not detected in women with the acute C. trachomatis infection, which indicates that hsp60 has an important role in pathogenesis of persistant chlamydial infection. OBJECTIVE: The aim of this study was to determine the role of chlamydial stress proteins (heat shock proteins) in pathogenesis of ectopic pregnancy. METHODS: The study included 40 women with ectopic pregnancy (experimental group) and 34 women with normal pregnancy (control group). C. trachomatis was detected in endocervical smears by direct immunofluorescence test, while specific antibodies against Chlamydia spp. and against hsp60 were detected by ELISA. RESULTS: DIF method detected the presence of C. trachomatis in 12.5% of women with the ectopic pregnancy and 17.6% of women with normal pregnancy. IgG antibodies against Chlamydia spp. were found in 57.5% of women with the ectopic pregnancy and 26.5% of women with normal pregnancy. IgA antibodies were positive in 37.5% of women with the ectopic pregnancy and 2.9% of women with normal pregnancy. IgG antibodies against hsp60 were positive in 37.5% of women with the ectopic pregnancy and 14.7% of women with normal pregnancy. CONCLUSION: The results of this study have proven the correlation between the ectopic pregnancy and the presence of IgG antibodies to chlamydial hsp60.

[Biology and intracellular life of chlamydia].

INTRODUCTION: Chlamydiae are Gram-negative obligate intracellular bacteria. The developmental cycle of Chlamydiae is specific and different from other bacteria. The elementary body is the infectious form of the organism, responsible for attaching to the target host cell and promoting its entry. The reticulate body is the larger, metabolically active form of the organism, synthesizing deoxyribonucleic acid, ribonucleic acid and proteins. The elementary body and reticulate body represent evolutionary adaptations to extracellular and intracellular environments. INTRACELLULAR PERSISTENCE OF CHLAMYDIA: Predisposition of Chlamydia to persist within the host cell has been recognized as a major factor in the pathogenesis of chlamydial disease. The persistence implies a long-term association between chlamydiae and their host cell that may not manifest as clinically recognizable disease. The ability of chlamydia to remain within one morphological state for a long time in response to exogenous factors suggests an innate ability of these organisms to persist intracellulary in a unique developmental form. Chlamydiae induce interferon gamma and exhibit growth inhibition in their presence. While the high levels of interferon gamma completely restrict the development of chlamydia, its low levels induce the development of morphologically aberrant intracellular forms. The persistent forms contain reduced levels of major outer membrane protein but high levels of chlamydial heat shock protein. CONCLUSION: Immunopathogenesis of chlamydial infection is one of the main focal points of current research into Chlamydia. Chlamydial infections are highly prevalent, usually asymptomatic and associated with serious sequelae. Screening programmes are the most important in the prevention of a long-term sequele.