HLA ANTIGEN AND ANTIBODY RESPONSE TO C TRACHOMATIS--RISK FOR C SALPINGITIS

性传播的沙眼衣原体感染极为常见 并且通常在受感染的妇女中产生输卵管炎。 血清学 数据表明，沙眼衣原体感染的输卵管炎后后遗症 如输卵管性不孕或异位妊娠都伴有免疫性 对衣原体热休克蛋白60（hsp 60）抗原的反应。 动物实验表明，衣原体疾病可归因于 对衣原体hsp 60抗原的免疫病理学应答。 免疫 对热休克蛋白60的反应是由基因决定的， 部分为H-2位点。 根据这些观察，本提案的假设是： HLA基因，通过确定抗体对衣原体hsp 60的反应， 在人类中，是临床输卵管炎的危险因素， 宫颈衣原体感染 据推测，艾滋病毒感染会中断 通过减少对HSP 60的免疫应答来抑制这一致病途径。 到 为了解决这一假设，300名妇女（约200名艾滋病毒感染者和 100名未感染艾滋病毒的妇女），她们是普姆瓦尼的商业性工作者 肯尼亚内罗毕区将进行长达四年的随访， 沙眼衣原体的偶发感染和临床 输卵管炎 所有女性将进行HLA分型（标准血清学I类） 测试和II类DR，DP和DQ寡分型），并有基线 衣原体hsp 60抗体的血清学评价。 克隆 重组衣原体hsp 60和合成肽将用于 多种血清学形式。 样本量足以检测 如果HSP 60，则相对风险增加大于或等于1.86 抗体与特定的HLA等位基因相关， 如果是急性，相对风险增加大于或等于1.68 输卵管炎与衣原体抗体反应有关 hsp60。 这项研究应该明确衣原体感染的分子和遗传基础 输卵管炎，并可能有助于确定新的方法，以改善治疗或 预防这种疾病。

Sexually transmitted Chlamydia trachomatis infection is extremely common and commonly produces salpingitis in infected women. Seroepidemiologic data suggest that post-salpingitis sequela of C.trachomatis infection such as tubal infertility or ectopic pregnancy are accompanied by immune responses to the chlamydial heat shock protein 60 (hsp60) antigen. Animal experiments suggest that chlamydial disease is attributable to immunopathologic responses to the chlamydial hsp60 antigen. Immune responses to hsp60 are genetically determined and in the mouse linked in part to the H-2 locus. Based on these observations, the hypothesis of the present proposal is that HLA genes, by determining antibody responses to the chlamydial hsp60 in humans, are a risk factor for clinical salpingitis following chlamydial cervical infection. HIV infection is speculated to interrupt this pathogenetic pathway by reducing immune responses to hsp60. To address this hypothesis, 300 women (approximately 200 HIV infected and 100 HIV uninfected) who are commercial sex workers in the Pumwani district of Nairobi, Kenya will be followed for up to four years for incident infections with c.trachomatis and for the occurrence of clinical salpingitis. All women will be HLA typed (class I by standard serologic tests and class II by DR, DP and DQ oligotyping) and have baseline serologic evaluation for antibodies to chlamydial hsp60. Cloned recombinant chlamydial hsp60 and synthetic peptides will be used in a variety of serologic formats. The sample size is sufficient to detect a increased relative risk of greater than or equal to 1.86 if hsp60 antibodies are correlated with a specific HLA allele and to detect an increased relative risk of greater than or equal to 1.68 if acute salpingitis is associated with an antibody response to the chlamydial hsp60. This study should define the molecular and genetic basis for chlamydial salpingitis and may help define new approaches to improved treatment or prevention of this disease.