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Obstetrics & Gynecology:
Original Research

Immunogenetic Correlates for Chlamydia trachomatis–Associated Tubal Infertility

Cohen, Craig R. MD, MPH; Gichui, Joseph MBChB, MMed; Rukaria, Rachel MBChB, MMed; Sinei, Samuel S. MBChB, MMed; Gaur, Lakshmi K. PhD; Brunham, Robert C. MD

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OBJECTIVE: To understand immunogenetic mechanisms of Chlamydia trachomatis infection and tubal scarring.

METHODS: We measured and compared previously significant human leukocyte antigen (HLA) class II DQ alleles, their linked DRB genes, and polymorphisms in selected cytokine genes (tumor necrosis factor α-308 promoter; transforming growth factor β1-10 and -25 codons; interleukin 10-1082, -819, and -592 promoters; interleukin 6-174 promoter; and interferon γ+874 codon 1) among Kenyan women with confirmed tubal infertility with and without C trachomatis microimmunofluorescence antibody.

RESULTS: Two class II alleles, HLA-DR1*1503 and DRB5*0101, were detected less commonly in C trachomatis microimmunofluorescence seropositive women than in C trachomatis microimmunofluorescence seronegative women with infertility (0% versus 20%; odds ratio [OR] 0.05; 95% confidence interval [CI] 0, 0.7, and 6% versus 26%; OR 0.2; 95% CI 0.02, 1.0, respectively). These alleles are commonly linked as a haplotype at the DRB locus. This finding could not be explained through linkage disequilibrium with the other studied HLA or cytokine genes.

CONCLUSION: These alleles may lead to an immunologically mediated mechanism of protection against C trachomatis infection and associated tubal damage, or alternatively increase risk for tubal scarring due to another cause.

© 2003 The American College of Obstetricians and Gynecologists


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