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

性传播沙眼衣原体感染极为常见 在受感染的妇女中通常会引起输卵管炎。血清流行病学 数据显示沙眼衣原体感染引起的输卵管炎后遗症 如输卵管性不孕症或异位妊娠都伴随着免疫 对衣原体热休克蛋白60(Hsp60)抗原的反应。 动物实验表明衣原体疾病可归因于 衣原体Hsp60抗原的免疫病理反应。免疫 对Hsp60的反应是由基因决定的，并且在小鼠身上连锁 H-2基因的一部分。 根据这些观察，本提案的假设是 通过测定对衣原体Hsp60的抗体反应，人类白细胞抗原基因 在人类中，是临床输卵管炎的危险因素 衣原体宫颈感染。据推测，艾滋病毒感染将中断 这一致病途径是通过降低对Hsp60的免疫反应来实现的。至 根据这一假设，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人)，他们是Pumwani的商业性工作者 肯尼亚内罗毕地区将被跟踪长达四年的时间 沙眼衣原体偶发感染和临床发病情况 输卵管炎。所有女性都将进行人类白细胞抗原分型(标准血清学I类 DR、DP和DQ基因分型的测试和II类)，并有基线 衣原体Hsp60抗体的血清学评价。克隆的 重组衣原体Hsp60和合成肽将用于 不同的血清学形式。样本大小足以检测 如果Hsp60增加了大于或等于1.86的相对风险 抗体与特定的HLA等位基因相关，并检测到 急性时大于或等于1.68的相对风险增加 输卵管炎与对衣原体的抗体反应有关 热休克蛋白60。 这项研究应该确定衣原体的分子和遗传学基础 输卵管炎，并可能有助于确定新的方法来改善治疗或 这种疾病的预防。

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.