Chlamydia trachomatis monomer/polymer Key words : chlamydial urogenital infection monomeric IgA, polymeric IgA, serum IgA specific for C. trachomatis,

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1 Chlamydia trachomatis monomer/polymer Key words : chlamydial urogenital infection monomeric IgA, polymeric IgA, serum IgA specific for C. trachomatis,

2 Fig. 1 Assay Procedures of C. trachomatis Specific IgA (polymer & monomer) Titer in Serum

3 C. trachomatis Fig. 2 Correlation between Titer of IgA and Titer of IgG to C. trachomatis Male Cases (IgG Titer) Female Cases (IgA titer) Fig. 3 Titer of C. trachomatis Specific IgA in Male Cases-Polymer and Momoner- Serum Specific IgA(+) & IgG(+)) <Acute stage> Male chlamydial Urethritis (8 cases) <Chronic stage> Non-Bactdrial Chronic Prostatitis (5 cases) [ IgA : polymer œ monomer] Fig. 4 Titer of C. trachomatis Specific IgA in Female Cases Polymer and Monomer- C. trachomatis(+), Serum Specific IgA(+) & IgG(+) l Chlamydial Cervicitis (4 cases) Pregnant Women (4 cases) Prostitute (7 cases)

4 Table 1 Serum IgA Level and Ratio of monomeric/polymeric Infection IgA (non-specific) in Urogenital Chlamydial cases: Serum specific IgA (+) & IgG (+) l Fig. 5 Ratio of monomeric/polymeric IgA Titer to C. trachomatis in Urogenital Chlamydial Infection Male polymeric IgA titer to C. trachomatis ( 4) polymeric IgA titer to C. trachomatis (< 4 ) Female In the determination of m/p ratio,polymeric IgA titer was regarded as 1, when its titer was less than 4. Monomeric IgA titer was regarded as 128, when its titer was equal to and more than 128.

5 Fig. 6 Correlation between Titer of Polymeric polymeric IgA Titer to C. trachomatis IgA and Ratio of monomeric/ Male Cases Female Cases (Titer of polymer IgA)

6 Fig. 7 Correlation between Ratio of monomeric/polymeric IgA Titer and Titer of IgG to C. trachomatis Male Cases Female Cases (Ratio of m/p in IgA)

7 Fig. 8 Changes of Titer of C. trachomatis Specific IgA & IgG Antibodies in Male Cases \ Polymer and Monomer \ <Acute stage> Male Chlamydial Urethritis Fig. 9 Changes of Titer of C. trachomatis Specific IgA & IgG Antibodies in Female Cases

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10 9) Ponzi, A.N., Merlino, C., Angeretti, A. & Penna, R.: Virus-specific polymeric immunoglobulin A antibodies in serum from patients with rubella, measles, varicella, and herpes zoster virus infection. J. Clin. Miecrobiol., 22 : 15) Piura, B., Sarov, I., Sarov, B., Kleinman, D., Chiam, W. & Insler, V.: Serum IgG and IgA antibodies specific for C. trachomatis in salpingitis patients as determined by the immunoper- oridase assay. Eur. J. Epidemiol., 1 : , ) Levitt, D. & Barol, J.: The immunology of Chlamydia. Immunology Today, 8 : 246 \251, ) Kutteh, W.H., Koopman, W.J., Monly, M.E., et 17) Rank, R.G.: Role of the immune response. In Microbiology of Chlamydia. (Barron, A.L., ed.), p , CRC Press, Florida, al. : Production of predominantly polymeric IgA by human peripheral blood lymphocytes 18) Rank, R.G., White, H.J. & Barron, A.L.: stimulated in vitro with mitogen. J. Exp. Med., Humoral immunity in the resolution of genital 152 : 1424, infection in female guinea pigs inclusion conjunctivitis. Infect. Immun., 26 : , ) Rank, R.G. & Barron, A.L.: Humoral immune response in acquired immunity to chlamydial genital infection of female guinea pig. Infect. Immun., 39 : , ) Williams, D.M., et al. : Antibody in host defense against mouse pneumonitis agent (Murine Chlamydia trachomatis). Infect. Immun., 45 : , ) Caldwell, H.D. & Petty, L.J. : Neutralization

11 of Chlamydia trachomatis infectivity with antibodies to the major outer membrane protein. Infect. Immun., 38 : , ) Peeling, R., Maclean, I.W. & Brunham, R.C. : In vitro neutralization of Chlamydia trachomatis with monoclonal antibody to an epitope on the major outer membrane protein. Infect. Immun., 46 : , ) Williams, D.M., et al. : The rule of antibody in host defense against the agent of mouse pneumonitis. J. Infect. Dis., 145 : , ) Rothermel, C.D., Rubin, B.Y. & Muttay, H.W. : Gamma interferon is the factor in lymphkine that activates human macrophages to inhibit intracellucular Chlamydia psittaci replication. J. Immunol., 131 : , ) Byrne, G.I., Lehmann, L.K. & Landy, G.J. : Induction of tryptophan catabolism is the mechanism for gamma interferon-mediated inhibition of intracellular Chlamydia psittaci replication in T24 cells. Infect. Immun., 53 : ) Sarov, I., Insler, B., Cevenini, R., Rumpianesi, F., Donati, H., Kleiman, D., Piura, B., Liebermay, J., Kimmel, N., Friedman, M. & Placa, M.: Specific serum IgA antibodies in the diagnosis of active viral and chlamydial infections. In New Horizons in Microbiology (Sanna, A., Morace, G., ed.), p , Elsevier Biomedical Press, Amsterdam, ) Mestecky, J. & McGhee, J.R. : Immunoglobulin A (IgA)-Molecular and cellular interactions involved in IgA biosynthesis and immune response. Adv. Immunol., 40 : , ) Tomasi, T. & Grey, H.M. : Structure of immunoglobulin A. Prog. Allergy, 16: , 1972.

12 Analysis of the Monomeric IgA to Polymeric IgA Ratio in Specific IgA Antibodies for Chlamydia trachomatis Kenji HAYASHI & Yoshiaki KUMAMOTO Department of Urology, Sapporo Medical College Toshimitsu HIRANE Department of Internal Medicine (Section 1), Sapporo Medical College Antibody titers of monomeric and polymeric types of serum specific IgA for Chlamydia trachomatis were measured by indirect immunoperoxidase assay (Savyon kit) in male and female cases with various chlamydial urogenital infections. From these results, the ratio of monomeric to polymeric IgA (m/p ratio) was determined. All cases were positive for specific IgA and IgG antibodies for C. trachomatis, and the antigen was also detected in all of cases except for those with prostatitis. 1. Study in males: The m/p ratio (mean } S.E.) was 2.6 } 1.0 in acute chlamydial urethritis and 8.0 } 2.2 in chronic non-bacterial prostatitis. The result indicated monomeric IgA-predominance in the chronic stage. 2. Study in females: The m/p ratio was 5.0 } 1.9 in subacute chlamydial cervicitis, while it was 8.5 } 2.9 in pregnant women considered to have chronic chlamydial infection. The rate was 31.5 } 16.8 in prostitutes considered to have repeated chlamydial infections. The result suggested that monomeric IgA was predoninant in patients with chronic and repeated infections. 3. As for sequential changes of IgA antibody titer, polymeric IgA alone decreased after treatment of acute chlamydial urethritis. However monomeric IgA decreased in chronic infection such as prostatitis, and a similar change was shown in IgG antibody. 4. These results suggest that polymeric IgA is predominant in the acute stage of chlamydial infections, while monomeric IgA predominates in the chronic stage.

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