The aim of this study was to evaluate the prevalence of serum immunoglobulin (Ig)G and IgA antibodies to recombinant chlamydial 60 kDa heat shock protein (C-hsp60) and to assess the prevalence of serum IgG antibodies to recombinant chlamydial 70 kDa heat shock protein (C-hsp70) in Chlamydia-associated chronic salpingitis and/or salpingitis isthmica nodosa with tubal occlusion. Infertile patients (n =34) with Chlamydia-associated, histologically documented chronic salpingitis and/or salpingitis isthmica nodosa and bilateral tubal occlusions (group I) were compared with infertile patients (n = 19) without tubal occlusions (group II). The prevalence of chlamydial antigen in endocervical, urethral and urine samples was low in both groups. The median chlamydial serum IgG and IgA antibody titres were significantly higher in group I than in group II (P < 0.0001 and P = 0.0002 respectively). Serum IgG antibodies to C-hsp60 and C-hsp70 were detected in 24 out of 34 patients (71%) in group I compared with 10 out of 19 (53%) and nine out of 19 (47%) patients in group II (not significantly different). There was a significant difference (P = 0.035) between the prevalences of serum IgA antibodies to C-hsp60 in groups I (seven out of 34 patients; 21%) and II (none of the 19 patients). The association between the presence of serum IgA antibodies to C-hsp60 and Chlamydia-associated chronic salpingitis and/or salpingitis isthmica nodosa with tubal occlusion underlies the significance of chlamydial 60 kDa heat shock protein in the pathogenesis of tubal infertility.
Adult Antibodies, Anti-Idiotypic