ON THE ASSESSMENT AND TREATMENT OF PATIENTS WITH CHRONIC PROSTATITIS IN PERSISTENT UROGENITAL CHLAMYDIOSIS
- Authors: Molochkov V.A.1,2, Aleshkin V.A.3,4, Skirda T.A.3,4, Karaulov A.V.5,6, Molochkova Y.V.1,2, Antonova E.V.7,8
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- 61/2 Shchepkina ul., Moscow, 129110, Russian Federation
- Gabrichevsky Research Institute of Epidemiology and Microbiology
- 10 Admirala Makarova ul., Moscow, 125212, Russian Federation
- I.M. Sechenov First Moscow State Medical University
- 8/2 Trubetskaya ul., Moscow, 119991, Russian Federation
- Shchelkovo Clinic for Skin and Venereal Diseases
- 10 Novaya fabrika ul., Shchelkovo, Moskovskaya oblast', 141100, Russian Federation
- Issue: Vol 44, No 1 (2016)
- Pages: 114-120
- Section: VENEREOLOGY
- URL: https://almclinmed.ru/jour/article/view/316
- DOI: https://doi.org/10.18786/2072-0505-2016-44-1-114-120
- ID: 316
Cite item
Full Text
Abstract
Background: Urogenital chlamydial infection is the most prevalent among sexually transmitted disorders that is associated with high rates of complications (chronic prostatitis, salpingoophoritis, etc.) and adverse outcomes, such as sexual and reproductive dysfunction. In the last years, the frequency of persistent antibiotic-resistant chlamydial infections has been persistently increasing that is diagnosed by immunoenzyme assay of IgG antibodies to the heat shock protein of chlamydia with a molecular weight of 60 KDa (HSP60) and by detection of secretory IgA to Chlamydia trachomatis in the semen plasma. Aim: To assess the rates of persistent chlamydial infection in patients with chronic prostatitis by measurement of serum IgG anti-HSP60 antibodies to C. trachomatis and presence of anti-chlamydial IgG in the semen plasma. Materials and methods: In a prospective study we examined 18 patients with chronic prostatitis, aged from 21 to 58 years. The control group included 30 subjects without chlamydial urogenital disease. Clinical assessment included past history, instrumental investigations, ultrasound examination of prostate and semen vesicles. Serological tests were performed by immunoenzyme analysis in 4 test systems (“Medac”, Germany) to two antigens: a genus-specific chlamydial lipopolysaccharide r-ELISA (anti-chlamydial IgM, IgG and IgA antibodies) and to the main outer membrain protein (МОМР) of C. trachomatis (IgG and IgA). Anti-HSP60 antibodies were measured in the test system with HSP60-IgG-ELISA (“Medac”). The levels of secretory IgA in the seminal fluid were assessed with a test system Chlamydia trachomatis-IgA-pELISA. Results: In 13 (72.2%) of 18 patients the chronic prostatitis was of chlamydial etiology, and in 7 (38.9%) of 18 patients there was an underlying persistent chlamydial infections with concomitant high levels of serum IgG anti-HSP60 C. trachomatis and presence of anti-chlamydial IgA antibodies in the semen plasma. In the control group, IgG anti-chlamydial antibodies were not found. Conclusion: The results obtained confirm the diagnostic value of anti-C. trachomatis IgA antibodies in identification of the etiology of inflammation in the male genital tract. They also indicate a high rate of persistent chlamydial infection in patients with chronic prostatitis and the utility of serology tests for IgG anti-HSP60 C. trachomatis and anti-chlamydial IgA antibodies in the semen plasma.
About the authors
V. A. Molochkov
Moscow Regional Research and Clinical Institute(MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation
Author for correspondence.
Email: derma@monikiweb.ru
MD, PhD, Professor, Mer- ited Scientist, Head of the Dermatovenereology and Dermato-oncology Department Россия
V. A. Aleshkin
Gabrichevsky Research Institute of Epidemiology and Microbiology; 10 Admirala Makarova ul., Moscow, 125212, Russian Federation
Email: derma@monikiweb.ru
PhD, Doctor of Biol. Sci., Professor, Merited Scientist, Director Россия
T. A. Skirda
Gabrichevsky Research Institute of Epidemiology and Microbiology; 10 Admirala Makarova ul., Moscow, 125212, Russian Federation
Email: derma@monikiweb.ru
MD, PhD, Senior Research Fellow Россия
A. V. Karaulov
I.M. Sechenov First Moscow State Medical University; 8/2 Trubetskaya ul., Moscow, 119991, Russian Federation
Email: derma@monikiweb.ru
MD, PhD, Professor, Member-Correspondent of Russian Academy of Sciences, Head of Chair of Clinical Immunology and Allergology Россия
Yu. V. Molochkova
Moscow Regional Research and Clinical Institute(MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation
Email: derma@monikiweb.ru
MD, PhD, Senior Research Fellow, Dermatovenereology and Dermato-oncolo- gy Department Россия
E. V. Antonova
Shchelkovo Clinic for Skin and Venereal Diseases; 10 Novaya fabrika ul., Shchelkovo, Moskovskaya oblast', 141100, Russian Federation
Email: derma@monikiweb.ru
MD, Dermatovenereo- logist
РоссияReferences
- Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2010. Atlanta: U.S. Department of Health and Human Services; 2011.
- Kvien TK, Gaston JS, Bardin T, Butrimiene I, Dijkmans BA, Leirisalo-Repo M, Solakov P, Altwegg M, Mowinckel P, Plan PA, Vischer T; EULAR. Three month treatment of reactive arthritis with azithromycin: a EULAR double blind, placebo controlled study. Ann Rheum Dis. 2004;63(9):1113–9. doi: 10.1136/ard.2003.010710.
- Гомберг МА, Соловьев АМ. Современная тактика лечения больных различными формами урогенитального хламидиоза. Лечащий врач. 2003;(7):50–3.
- Bradshaw CS, Tabrizi SN, Read TR, Garland SM, Hopkins CA, Moss LM, Fairley CK. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J Infect Dis. 2006;193(3):336–45. doi: 10.1086/499434.
- Молочков ВА. Урогенитальный хламидиоз. М.: Бином; 2006. 208 с.
- Летяева ОИ, Гизингер ОА, Зиганшин ОР. Вопросы эффективности и безопасности иммуномодулирующей терапии в лечении хламидийно-герпетической инфекции урогенитального тракта. Вестник дерматологии и венерологии. 2012;(3):65–70.
- Шаткин АА, Попов ВЛ. Взаимодействие хламидий и клетки-хозяина. В: Шаткин АА, ред. Хламидийные инфекции: сборник научных трудов. М.; 1986. с. 5–14.
- Dreesbach K. Review: Chlamydial Heat Shock proteins (cHSP). Berlin: Medac Diagnostic; 2001: 1–19.
- Beatty WL, Morrison RP, Byrne GI. Persistent chlamydiae: from cell culture to a paradigm for chlamydial pathogenesis. Microbiol Rev. 1994;58(4):686–99.
- Караулов АВ, Афанасьева СС, Алешкина ВА, Лапина БА, ред. Хламидийная инфекция. Новые аспекты патогенеза, иммунологии, верификации и лечения инфекции у человека и приматов. М.: Первый МГМУ им. И.М. Сеченова; 2012. 256 с.
- Анкирская АС. Проблемы хронической (персистирующей) хламидийной инфекции. Акушерство и гинекология. 1999;(3):8–10.
- Witkin SS. Immunity to heat shock proteins and pregnancy outcome. Infect Dis Obstet Gynecol. 1999;7(1–2):35–8. doi: 10.1155/ S1064744999000083.
- Михайличенко ВВ, Бойцов АГ, Сельков СА, Есипов АС, Порин АА, Белоусова ЕВ, Рищук СВ. Диагностическая значимость выявления IgA к Chlamydia trachomatis в плазме спермы человека. Terra Medica. 2003;(1):27–8.
- Yoshida K, Kobayashi N, Negishi T. Chlamydia trachomatis infection in the semen of asymptomatic infertile men: detection of the antigen by in situ hybridization. Urol Int. 1994;53(4):217–21.
- Ochsendorf FR, Ozdemir K, Rabenau H, Fenner T, Oremek R, Milbradt R, Doerr HW. Chlamydia trachomatis and male infertility: chlamydia-IgA antibodies in seminal plasma are C. trachomatis specific and associated with an inflammatory response. J Eur Acad Dermatol Venereol. 1999;12(2):143–52. doi: 10.1111/ j.1468-3083.1999.tb01005.x.