{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T11:28:50Z","timestamp":1769513330444,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T00:00:00Z","timestamp":1569369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["1285975"],"award-info":[{"award-number":["1285975"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research grants from Helsinki and Uusimaa Hospital District","award":["2017244"],"award-info":[{"award-number":["2017244"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Chlamydia trachomatis IgG antibody testing (CAT) has been used as a screening test for tubal factor infertility (TFI), but as the CAT is only a marker of a past exposure to C. trachomatis and not of late sequelae, the positive predictive value (PPV) of the test is low. The persistence of C. trachomatis in the upper genital tract has been suggested as one of the key mechanisms in the development of TFI. Serum antibodies against C. trachomatis TroA and HtrA, proteins expressed specifically during persistent infection, have been suggested as novel biomarkers for TFI diagnostics. We studied serum IgG antibody responses against C. trachomatis TroA, HtrA and MOMP in 79 subfertile women, of whom 28 had laparoscopically proven TFI. We confirmed that the accuracy of CAT in diagnosing TFI is low, whereas TroA IgG and HtrA IgG are more accurate tests in detecting tubal occlusion and pelvic adhesions. However, the sensitivity and negative predictive value (NPV) of TroA IgG and HtrA IgG are still too low to justify their use as a screening test in clinical practice. Individual immunogenetic profiles combined with TroA and HtrA antibody responses might identify women with the highest risk for developing late complications after C. trachomatis infection.<\/jats:p>","DOI":"10.3390\/microorganisms7100391","type":"journal-article","created":{"date-parts":[[2019,9,26]],"date-time":"2019-09-26T03:06:51Z","timestamp":1569467211000},"page":"391","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predictive Values of Serum Chlamydia trachomatis TroA and HtrA IgG Antibodies as Markers of Persistent Infection in the Detection of Pelvic Adhesions and Tubal Occlusion"],"prefix":"10.3390","volume":"7","author":[{"given":"Tiina","family":"Rantsi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, FI-00029 HUS, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolande A.","family":"Land","sequence":"additional","affiliation":[{"name":"Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine &amp; Life Sciences, University of Maastricht, 6229 ER Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e4ivi","family":"Joki-Korpela","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, FI-00029 HUS, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2092-0002","authenticated-orcid":false,"given":"Sander","family":"Ouburg","sequence":"additional","affiliation":[{"name":"Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine &amp; Life Sciences, University of Maastricht, 6229 ER Maastricht, The Netherlands"},{"name":"VU University Medical Center, Department of Medical Microbiology &amp; Infection Control, Laboratory of Immunogenetics, 1081 HZ Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4428-7536","authenticated-orcid":false,"given":"Kati","family":"Hokynar","sequence":"additional","affiliation":[{"name":"Department of Virology, University of Helsinki and Helsinki University Hospital, FI-00014 Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorma","family":"Paavonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, FI-00029 HUS, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aila","family":"Tiitinen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, FI-00029 HUS, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7413-6793","authenticated-orcid":false,"given":"Mirja","family":"Puolakkainen","sequence":"additional","affiliation":[{"name":"Department of Virology, University of Helsinki and Helsinki University Hospital, FI-00014 Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Newman, L., Rowley, J., Vander Hoorn, S., Wijesooriya, N.S., Unemo, M., Low, N., Stevens, G., Gottlieb, S., Kiarie, J., and Temmerman, M. (2015). Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0143304"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S104","DOI":"10.1086\/652402","article-title":"Duration of untreated, uncomplicated Chlamydia trachomatis genital infection and factors associated with chlamydia resolution: A review of human studies","volume":"201","author":"Geisler","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/humupd\/5.5.433","article-title":"Chlamydia trachomatis: Impact on human reproduction","volume":"5","author":"Paavonen","year":"1999","journal-title":"Hum. Reprod. Update"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/00001432-200402000-00010","article-title":"Tubal factor infertility, with special regard to chlamydial salpingitis","volume":"17","author":"Mardh","year":"2004","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_5","unstructured":"National Collaborating Centre for Women\u2019s and Children\u2019s Health (2013). National Institute for Health and Clinical Excellence: Guidance. Fertility: Assessment and Treatment for People with Fertility Problems, Royal College of Obstetricians & Gynaecologists."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1093\/humrep\/deu024","article-title":"Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review with meta-analysis","volume":"29","author":"Boutin","year":"2014","journal-title":"Hum. Reprod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1093\/humrep\/deh710","article-title":"Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility","volume":"20","author":"Land","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1093\/humrep\/del014","article-title":"Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility","volume":"21","author":"Tiitinen","year":"2006","journal-title":"Hum. Reprod."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/humupd\/dmq060","article-title":"Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis","volume":"17","author":"Broeze","year":"2011","journal-title":"Hum. Reprod. Update"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1093\/humrep\/den237","article-title":"Screening strategies for tubal factor subfertility","volume":"23","author":"Lardenoije","year":"2008","journal-title":"Hum. Reprod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1128\/CMR.00035-15","article-title":"Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women","volume":"28","author":"Menon","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3382","DOI":"10.1016\/j.febslet.2007.06.039","article-title":"The temperature activated HtrA protease from pathogen Chlamydia trachomatis acts as both a chaperone and protease at 37 degrees C","volume":"581","author":"Huston","year":"2007","journal-title":"FEBS Lett."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2884","DOI":"10.1099\/mic.0.030247-0","article-title":"Chlamydia trachomatis YtgA is an iron-binding periplasmic protein induced by iron restriction","volume":"155","author":"Miller","year":"2009","journal-title":"Microbiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S88","DOI":"10.1086\/652394","article-title":"Chlamydia trachomatis persistence in vitro: An overview","volume":"201","author":"Wyrick","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s10096-016-2769-7","article-title":"Antibody to Chlamydia trachomatis proteins, TroA and HtrA, as a biomarker for Chlamydia trachomatis infection","volume":"36","author":"Hokynar","year":"2017","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1007\/s10096-018-3276-9","article-title":"Serum antibody response to Chlamydia trachomatis TroA and HtrA in women with tubal factor infertility","volume":"37","author":"Rantsi","year":"2018","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e13051","DOI":"10.1111\/aji.13051","article-title":"Predicting tubal factor infertility by using markers of humoral and cell-mediated immune response against Chlamydia trachomatis","volume":"80","author":"Rantsi","year":"2018","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1093\/humrep\/13.4.1094","article-title":"How to use Chlamydia antibody testing in subfertility patients","volume":"13","author":"Land","year":"1998","journal-title":"Hum. Reprod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/S0015-0282(16)57556-6","article-title":"The revised American Fertility Society classification of endometriosis: reproducibility of scoring. ZOLADEX Endometriosis Study Group","volume":"63","author":"Rock","year":"1995","journal-title":"Fertil. Steril."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/S0015-0282(97)81435-5","article-title":"The accuracy of serum chlamydial antibodies in the diagnosis of tubal pathology: A meta-analysis","volume":"67","author":"Mol","year":"1997","journal-title":"Fertil. Steril."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1093\/humrep\/deg347","article-title":"Tubal damage in infertile women: Prediction using chlamydia serology","volume":"18","author":"Akande","year":"2003","journal-title":"Hum. Reprod."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s00404-009-1225-7","article-title":"The relationship between serum Chlamydia antibody levels and severity of disease in infertile women with tubal damage","volume":"281","author":"Gordon","year":"2010","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ajog.2016.08.008","article-title":"Sexually transmitted diseases and infertility","volume":"216","author":"Tsevat","year":"2017","journal-title":"Am. J. Gynecol. Obstet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1093\/humupd\/dml030","article-title":"Chlamydia trachomatis-associated tubal factor subfertility: Immunogenetic aspects and serological screening","volume":"12","author":"Morre","year":"2006","journal-title":"Hum. Reprod. Update"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1086\/597620","article-title":"Cytokine polymorphisms and severity of tubal damage in women with Chlamydia-associated infertility","volume":"199","author":"Tiitinen","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.1086\/652398","article-title":"Chlamydia trachomatis strains and virulence: Rethinking links to infection prevalence and disease severity","volume":"201","author":"Byrne","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3061","DOI":"10.1093\/humrep\/der307","article-title":"Chlamydia trachomatis IgG seropositivity is associated with lower natural conception rates in ovulatory subfertile women without visible tubal pathology","volume":"26","author":"Coppus","year":"2011","journal-title":"Hum. Reprod."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/7\/10\/391\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:23:52Z","timestamp":1760189032000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/7\/10\/391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,25]]},"references-count":27,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,10]]}},"alternative-id":["microorganisms7100391"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms7100391","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,25]]}}}