Ricerca di anticorpi IgA anti-Chlamydia trachomatis nel liquido seminale mediante un test ELISA sperimentalmente modificato

Chlamydia trachomatis (Ct) is a relevant agent of male genital tract infections and some correlated complications, such as epididymitis. The diagnosis of infection by the highly sensitive nucleic amplification test is hampered on semen specimen because of many inhibitory factors. Instead, a reliable serologic test able to demontrate the involvement of the upper genital tract should be of clinical utility. Two group of a total of 505 male patients, suspected for infertility and/or genital infections were examined for detecting direct and serologic markers of chlamydia on urethral swabs, semen and serum specimen, respectively. By the amplified nucleic DNA-Chlamydia trachomatis LCR test (“gold standard”), a total of 16 patients resulted as positives. On the semen specimen a positive detection of specific Ct-IgA antibodies was obtained by the ELISA and the referenced MIF test in 15 patients, thus demonstrating a local immune response to Chlamydia infection.Neverthless, a few of these Ct-IgA positive patients resulted with negative DNA-Ct detection and with Ct-IgA negative results in serum. The significance of the study point out on the previous demonstrated local immune response, often without detection of circulating specific IgG and/or IgA anti-Ct antibodies. Furthermore, is emphasized that the presence of Ct-IgA on semen may not correlate with the amplified direct test results, due to the fact that the infection can already has ascended to the epididymis, and thus escapes from peripheric direct detection. On the basis of the above experienced results, the local specific Ct-IgA antibodies detection seems to be a precious marker of a especially silent ongoing Chlamydia infection.