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，有证据表明它可能是女性的重要病原体。在两项研究中，它与粘液脓性宫颈炎有关。妇女细菌性性传播感染的主要并发症是上生殖道感染，导致盆腔炎和输卵管瘢痕，进而导致异位妊娠和/或不孕。有一些报告表明，M。生殖器也会引起这些并发症，但这些研究并没有得出一致的结果。一项血清学研究表明， 该生物体与“输卵管因素”不育有关。如果事实证明这是真的，那么M。生殖器感染将被列入重大细菌性传播感染的名单，应通过有效治疗有症状的个人及其性伴侣以及筛查和治疗无症状的高危妇女和男子来预防。我们将在本研究的前两个目标中解决这个重要问题，具体如下：1。我们将使用我们成熟的MG PCR检测和使用重组M.生殖器脂蛋白抗原。2.我们将对参加一项随机不孕症预防治疗试验的高风险不孕症妇女进行研究。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中获得的标本来研究这种生物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.