Chlamydia Clinical Trial
Official title:
Antigen-specific Cell Mediated Immune Response to Chlamydia Trachomatis
This is an exploratory study in which the investigators will develop a way to identify the cell responses most strongly associated with protection against chlamydia infection. This study is not driven by a hypothesis.
With more than 90 million new cases annually, Chlamydia trachomatis is the most common
sexually transmitted bacterial disease. Untreated endocervical C. trachomatis infections can
cause pelvic inflammatory disease (PID), a disorder of the endometrium, fallopian tubes, and
adjacent structures that occurs after ascension of the bacterium from the lower to upper
genital tract. Adverse outcomes secondary to C. trachomatis-induced PID include tubal
infertility, ectopic pregnancy, and chronic pelvic pain. Vaccine development has been
identified as essential for control of C. trachomatis infections, and current evidence
suggests that an effective vaccine will likely be based on several C. trachomatis antigens.
Experimental models of infection have identified HSP60, major outer-membrane protein (MOMP),
outer membrane protein 2 (OMP2), and polymorphic membrane protein D (PmpD) as promising
vaccine candidates. A prospective study of Kenyan commercial sex workers found that
production of interferon-gamma (IFN-γ) by peripheral blood cells stimulated with chlamydia
heat-shock protein (HSP60) strongly correlated with protection against incident C.
trachomatis infection. This proposal details an exploratory identification of the
antigen-specific cell mediated immune responses associated with antecedent C. trachomatis
infection in women.
C. trachomatis is an obligate, intracellular, gram-negative microorganism recognized as the
most common bacterial sexually transmitted disease worldwide. The highest rates of infection
with this organism are consistently found among adolescents and young adults. Young women
are also the group most adversely impacted by the effects of C. trachomatis infection on
reproductive health. While approximately 70% of infections with C. trachomatis in young
women are asymptomatic, 20% - 40% of these occult infections will progress from endocervical
inflammation to the development of PID. In addition to its strong association with PID, C.
trachomatis infection is also thought to enhance HIV transmission and contribute to human
papilloma virus induced cervical neoplasia. Although data from both experimental models and
clinical studies suggest that antigen specific CD4+ and CD8+ T cells are required for
optimal control of genital tract chlamydial infections, the current lack of information
regarding the specific C. trachomatis antigens eliciting protective immune responses in
humans hinders vaccine development.
This is an exploratory investigation in which we will develop the methodology needed to
identify the antigen-specific cell mediated immune responses most strongly associated with
protection against incident C. trachomatis infection.
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