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Background  In women,  Chlamydia (C.) trachomatis  upper genital tract infection can cause distal tubal damage and occlusion, increasing the risk of tubal factor subfertility and ectopic pregnancy. Variations, like single nucleotide polymorphisms (SNPs), in immunologically important host genes are assumed to play a role in the course and outcome of a  C. trachomatis  infection. We studied whether genetic traits (carrying multiple SNPs in different genes) in the bacterial sensing system are associated with an aberrant immune response and subsequently with tubal pathology following a  C. trachomatis  infection. The genes studied all encode for pattern recognition receptors (PRRs) involved in sensing bacterial components.    Methods  Of 227 subfertile women, serum was available for  C. trachomatis  IgG antibody testing and genotyping (common versus rare allele) of the PRR genes TLR9, TLR4, CD14 and CARD15/NOD2. In all women, a laparoscopy was performed to assess the grade of tubal pathology. Tubal pathology was defined as extensive peri-adnexal adhesions and/or distal occlusion of at least one tube.    Results  Following a  C. trachomatis  infection (i.e.  C. trachomatis  IgG positive), subfertile women carrying two or more SNPs in  C. trachomatis  PRR genes were at increased risk of tubal pathology compared to women carrying less than two SNPs (73% vs 33% risk). The differences were not statistically significant (P = 0.15), but a trend was observed.    Conclusion  Carrying multiple SNPs in  C. trachomatis  PRR genes tends to result in an aberrant immune response and a higher risk of tubal pathology following a  C. trachomatis  infection. Larger studies are needed to confirm our preliminary findings.

bmc infectious diseases

Do host genetic traits in the bacterial sensing system play a role in the development of Chlamydia trachomatis-associated tubal pathology in subfertile women?