SEROLOGICAL RESPONSES OF PATIENTS WITH ECTOPIC PREGNANCY TO EPITOPES OF THE CHLAMYDIA-TRACHOMATIS 60 KDA HEAT-SHOCK-PROTEIN

Clinical and histopathological correlations of immunoreactivity to Chl amydia trachomatis and to epitopes of the C.trachomatis 60 kDa heat sh ock protein (hsp60) among women with ectopic pregnancy were evaluated in a case-control study. Serological responses to 13 synthetic peptide s corresponding to major epitopes of the chlamydial hsp60 were determi ned in 67 women treated for ectopic pregnancy and 45 women with uncomp licated pregnancy in utero, Plasma cell salpingitis was detected in 29 (43.3%) of the ectopic patients. Its presence correlated with antibod ies to two hsp60 epitopes, encompassing amino acids 260-271 and 411-42 2 (P = 0.02), Antibodies to these two epitopes, along with five other epitopes, also correlated with peritubal adhesion formation in ectopic pregnant patients (P < 0.01). Antibodies to epitopes 260-271 and 188- 199 also correlated with a history of pelvic inflammatory disease (PID ; P = 0.05). Patients with ectopic pregnancy were also more likely tha n their intrauterine pregnant controls to have present anti-chlamydial immunoglobulin G (P < 0.005). Women positive for both C.trachomatis a nd hsp60 epitope antibodies had an increased prevalence over controls of salpingitis, pelvic adhesions or history of PID (P < 0.05), In cont rast, patients who were positive for only C.trachomatis antibodies or only hsp60 epitope antibodies did not differ from antibody-negative pa tients in each of these categories.