Immunopathogenesis of chlamydia trachomatis infections in women

Fertil Steril. 2003 Jun;79(6):1273-87. doi: 10.1016/s0015-0282(03)00396-0.


Objective: To develop a model of pathogenesis by which Chlamydia trachomatis progresses from acute to chronic infection, and finally serious disease (salpingitis, tubal occlusion).

Design: Review of current literature located through web-based Medline searches using key words: Chlamydia trachomatis, immunology, cytokines, heat shock protein, infertility.

Result(s): Cell-mediated immune mechanisms appear to be critical in determining whether acute infection is resolved or progresses into chronicity with pathological outcome. What determines the particular immune pathway depends on a range of determinants-HLA subtype and human genetics, cytokine profile, infectious load, route of infection, and endocrinology. A clearer picture of the natural history of chlamydial pathology may assist in providing better predictors of those women who may go on to develop significant sequelae after infection.

Conclusion(s): Predicting those who may develop serious disease, including infertility, may contribute to improved management of such persons during earlier stages of infection and assist in prevention.

Publication types

  • Review

MeSH terms

  • Chaperonin 60 / physiology
  • Chlamydia Infections / etiology
  • Chlamydia Infections / immunology*
  • Chlamydia trachomatis / immunology*
  • Female
  • Genetic Predisposition to Disease
  • Genital Diseases, Female / etiology
  • Genital Diseases, Female / immunology*
  • Histocompatibility Antigens Class I / physiology
  • Humans
  • Hypersensitivity, Delayed / etiology
  • T-Lymphocytes, Cytotoxic / immunology
  • Th1 Cells / immunology
  • Th2 Cells / immunology


  • Chaperonin 60
  • Histocompatibility Antigens Class I