Chlamydia trachomatis Infections and Subfertility: Opportunities to Translate Host Pathogen Genomic Data into Public Health - Karger Publishers

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Chlamydia trachomatis Infections and Subfertility: Opportunities to Translate Host Pathogen Genomic Data into Public Health - Karger Publishers

Vol. 16, No. 1-2, 2013

Issue release date: March 2013

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Public Health Genomics 2013;16:50-61
(DOI:10.1159/000346207)

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Paper

Chlamydia trachomatis Infections and Subfertility: Opportunities to Translate Host Pathogen Genomic Data into Public Health Lal J.A.a · Malogajski J.a · Verweij S.P.b · de Boer P.c · Ambrosino E.a · Brand A.a · Ouburg S.b · Morré S.A.a, b aInstitute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Schools CAPHRI (School for Public Health and Primary Care) and GROW (School for Oncology and Developmental Biology), Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht,bLaboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, andcttopstart BV, Bilthoven, The Netherlands Corresponding Author

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 Outline

• Key Words



• Abstract


• Chlamydia trachomatis Infection


• Outline of the Article


• Overview of CT Host Genetic Determinants of Infection


• Pattern Recognition Receptors




• Toll-Like Receptors (TLR)


• C-C Chemokine Receptor Type 5 (CCR5)


• Mannose-Binding Lectin (MBL)


• Human Leukocyte Antigen (HLA)




• Cytokines


• Trait Analyses


• Consortium Approaches: EU Framework Programme EpiGenChlamydia


• Improvement of Subfertility Diagnostics Based on Host Genetics


• PHG Approached and Translation into Public Health


• Conclusions and Future Prospects


• Acknowledgement


• References

• Author Contacts


• Article Information


• Publication Details


• Drug Dosage / Copyright

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  Key Words


• Chlamydia trachomatis


• Genomics


• Host genetic markers


• 
Learning-Adapting-Leveling model


• Molecular diagnostics


• 
Public health genomics


• Stakeholders


• Subfertility


• Translation


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  Abstract
Chlamydia trachomatis (CT) infections in women can result in tubal pathology (TP). Worldwide 10-15% of all couples are subfertile, meaning they did not get pregnant after 1 year. Part of the routine subfertility diagnostics is the Chlamydia Antibody Test (CAT) to decide for laparoscopy or not in order to diagnose TP. The CAT positive and negative predictive value is such that many unneeded laparoscopies are done and many TP cases are missed. Addition of host genetic markers related to infection susceptibility and severity could potentially improve the clinical management of couples who suffer from subfertility. In the present study, the potential translational and clinical value of adding diagnostic host genetic marker profiles on the basis of infection and inflammation to the current clinical management of subfertility was investigated. This review provides an overview of the current state of the art of host genetic markers in relation to CT infection, proposes a new clinical diagnostic approach, and investigates how the Learning-Adapting-Leveling model (LAL, a public health genomic (PHG) model) can be of value and provide insight to see whether these host genetic markers can be translated into public health. This review shows that the preliminary basis of adding host genetic marker profiles to the current diagnostic procedures of subfertility is present but has to be further developed before implementation into health care can be achieved. CT infection is an example in the field of PHG with potential diagnostic to be taken up in the future in the field of subfertility diagnosis with a time line for integration to be dependent on enhanced participation of many stakeholders in the field of PHG which could be advanced through the LAL model.
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