{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T23:53:12Z","timestamp":1769557992451,"version":"3.49.0"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI119164"],"award-info":[{"award-number":["R01AI119164"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U19AI084024"],"award-info":[{"award-number":["U19AI084024"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U19AI113170"],"award-info":[{"award-number":["U19AI113170"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Problem<\/jats:title><jats:p>Chlamydia infections in women can ascend to the upper genital tract, and repeated infections are common, placing women at risk for sequelae. The protective role of anti\u2010chlamydia antibodies to surface exposed antigens in ascending and incident infection is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>A whole\u2010bacterial ELISA was used to quantify chlamydia\u2010specific IgG and IgA in serum and cervical secretions of 151 high\u2010risk women followed longitudinally. Correlations were determined between antibody and cervical burden, and causal mediation analysis investigated the effect of antibody on ascension. We examined the relationship of antibody to incident infection using the marginal Cox model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serum and cervical anti\u2010chlamydia IgG and cervical IgA levels correlated inversely with cervical burden. While lower burden was associated with reduced ascension, causal mediation analysis revealed that the indirect effects of antibody mediated through reductions in bacterial burden were insufficient to prevent ascension. Analysis of women uninfected at enrollment revealed that serum and cervical anti\u2010chlamydia IgG were associated with increased risk of incident infection; hazard ratio increased 3.6\u2010fold (95% CI, 1.3\u201010.3), and 22.6\u2010fold (95% CI, 3.1\u2010165.2) with each unit of serum and cervical IgG, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although anti\u2010chlamydia IgG and IgA correlated with reduced cervical chlamydia burden, they failed to prevent ascension and increased levels of anti\u2010chlamydia IgG were associated with increased risk for incident infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13103","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T04:40:17Z","timestamp":1550637617000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Anti\u2010chlamydia IgG and IgA are insufficient to prevent endometrial chlamydia infection in women, and increased anti\u2010chlamydia IgG is associated with enhanced risk for incident infection"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1507-2202","authenticated-orcid":false,"given":"Toni","family":"Darville","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of North Carolina Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah L.","family":"Albritton","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, and Parasitology Louisiana State University Health Sciences Center New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wujuan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of North Carolina Chapel Hill North 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