The Role of Mycoplasma Genitalium in Infertility

生殖支原体已被发现与男性非淋菌性尿道炎有关，有证据表明，它可能也是女性的一种重要病原体。在两项研究中，它与粘液性化脓性宫颈炎症有关。细菌性传播感染在女性中的主要并发症是上生殖道感染，导致盆腔炎和输卵管瘢痕形成，进而导致异位妊娠和/或不孕。有一些报告表明，生殖支原体也会导致这些并发症，但这些研究并没有得出一致的结果。一项血清学研究表明 这种有机体与“输卵管因素”不孕症有关。如果事实证明这是真的，那么生殖支原体将被添加到重要细菌性传播感染名单中，应该通过对有症状的个人及其性伴侣进行有效治疗以及对无症状的高危男女进行筛查和治疗来预防这些感染。我们将在这项研究的前两个目标中解决这一重要问题如下：1.我们将研究一组来自新奥尔良STI高危人群的有输卵管疾病和无输卵管疾病的不孕不育妇女，使用我们建立的MG PCR方法和我们将开发的重组生殖支原体脂蛋白抗原的特异性血清学试验。2.开展不孕不育高危人群随机预防治疗试验研究。最后， 在第三个目标中，我们将使用从慢性感染的黑猩猩和人类获得的标本来研究这种有机体可能用来逃避宿主免疫系统的遗传机制。

Mycoplasma genitalium has been found to be associated with nongonococcal urethritis in men and there is some evidence to suggest that it may be a significant pathogen in women as well. It has been associated with mucopurulent cervictis in two studies. The major complication of bacterial STIs in women is infection of the upper genital tract resulting in pelvic inflammatory disease (PID) and fallopian tube scarring, which in turn cause ectopic pregnancy and/or infertility. There are a few reports suggesting that M. genitalium also causes these complications but these studies have not yielded consistent results. One serologic study suggests that the organism is associated with "tubal factor" infertility. If this should in fact turn out to be true then M. genitalium will be added to the list of significant bacterial STIs that should be prevented through effective treatment of symptomatic individuals and their sexual partners and by screening and treatment of asymptomatic high risk women and men. We will address this important issue in the first two Aims of this study as follows: 1. We will study a group of infertile women with and without fallopian tube disease drawn from a high STI risk population in New Orleans using our well established MG PCR assay and a specific serologic assay using recombinant M. genitalium lipoprotein antigens that we will develop. 2. We will study women at high risk of becoming infertile enrolled in a randomized infertility prevention treatment trial. Finally, in the third Aim we will study genetic mechanisms that this organism may use to escape the host immune system using specimens obtained from chronically infected chimpanzees and humans.