An artificial glycoconjugate containing, as a ligand, the deacylated carbohydrate backbone of a recombinant Chlamydia-specific lipopolysaccharide was used as a solid-phase antigen in ELISA to measure antibodies against chlamydial LPS. The specificity and reproducibility of the assay was shown by using a panel of prototype monoclonal antibodies representing the spectrum of antibodies also occurring in patient sera. These mAbs recognized Chlamydia-specific epitopes [alpha 2-->8-linked disaccharide of 3-deoxy-D-manno-octulosonic acid (Kdo) or the trisaccharide alpha Kdo-(2-->8)-alpha Kdo-(2-->4)-alpha Kdo] or those shared between chlamydial and Re-type LPS (alpha Kdo, alpha 2-->4-linked Kdo disaccharide). The assay was used to measure IgG, IgA and IgM antibodies against chlamydial LPS in patients with genital or respiratory tract infections. In comparison to the results obtained with sera from blood donors, it became evident that both types of infection result in significant changes in the profile of LPS antibodies.

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Serum samples of 217 patients with ectopic pregnancy (e.p.) and of 152 women with intrauterine pregnancy (i.u.p.) were examined for their antibody content to chlamydia trachomatis by means of the indirect immunofluorescence technique. In 81% of the sera of patients with e.p., antibody could be detected, while patients with i.u.p. revealed antibody in 39%. Titres greater than or equal to 1:128 were found in 49% (e.p.) and in only 11% (i.u.p.) respectively; so they possess a high diagnostic value. These results show significant differences in the behaviour of antibodies in both groups of patients and are illustrated in 2 charts. Anamnestic data showed 54% of the patients with e.p. (i.e. adnexitis 23%, gonorrhea 12.3%, previous e.p. 18.4%); the mean age was 29 years. Affected tubes may lose their physiological function, possibly resulting in an ectopic pregnancy. The level of antibody in the serum remains stabile for many years, this enables a retrospective diagnosis of chlamydial infections. An early diagnosis and treatment, including the partners, represent the best way for prevention of complications.

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