Use of a commercial assay for detecting the 60 kDa chlamydial heat shock protein in a range of patient groups

EVIDENCE IMPLICATING THE 60 kDa chlamydial heat shock protein (cHSP60) as the critical antigen responsible for stimulating immune-mediated inflammation and disease is quite considerable, mainly through studies reporting an increasing prevalence of cHSP60 antibodies among women with increasing severity of genital Chlamydia trachomatis disease. Women with visually observed chlamydial pelvic inflammatory disease showed a direct correlation between high cHSP60 antibody titers and severe inflammatory manifestations.(1) A number of studies investigating serologic responses of infertile women to cHSP60 have demonstrated a correlation between cHSP60 antibodies and tubal infertility.(2-5) This has led to the development of various commercial and in-house assays for detecting anticHSP60 antibodies as a research and potential diagnostic tool for investigations of infertility and tubal pathology. A recently published letter by Bax et al(6) further suggested the value of a new commercially available cHSP60 assay as a diagnostic tool for predicting pathologic sequelae to urogenital chlamydial infections. This particular study compared women with tubal disease and C. trachomatis serology with control groups of pregnant women (unknown tubal status) and women without tubal pathology. We report on a similar evaluation of the same assay as applied to a wider range of female patient groups presenting with varying histories of C. trachomatis infection, sequelae, and uninfected controls. Four groups of women were sampled in our study: those with a previous history of C. trachomatis infection, those with endometriosis (infertility not resulting from C. trachomatis), uninfected adult females, and uninfected female children.