ABSTRACT
This chapter reviews the evidence that immune sensitization to the chlamydial 57-kDa hsp is involved in infertility-related sequelae. High-titer antibody to the chlamydial-kDa heat shock protein (hsp) was most prevalent in women who were infertile owing to fallopian tube occlusion and in women with pelvic inflammatory disease who had an ectopic pregnancy. The majority of women whose fertility is impaired owing to occlusion of the fallopian tubes have never been diagnosed as having a sexually transmitted disease and have never experienced symptoms consistent with a diagnosis of an upper genital tract infection. The conservation of protein epitopes between an infectious microorganism and its host provides an opportunity for the induction of infection-induced autoimmune responses. To test whether chlamydial salpingitis induced sensitization to conserved epitopes, patients' peripheral blood lymphocytes were tested for their ability to respond to five synthetic peptides corresponding to regions of identity or near identity.
