We previously identified 18 stimulatory Chlamydia trachomatis major outer membrane protein (MOMP) peptides containing at least 23 epitopes presented with various HLA class II allotypes. Only one peptide contained an epitope localized in a variable segment (VS2). Continued studies reported here identified a total of five VS peptides containing T-cell epitopes that are distributed among MOMPs VS1, VS2, and VS4. Only MOMP-primed T-cell cultures from subjects infected with serovar E responded to the serovar E VS peptides, while the response of such cultures to constant-segment peptides was independent of the infecting serovar. Furthermore, MOMP-primed T cells proliferated in response only to the VS peptides encoded in serovar E but not to the corresponding peptides derived from serovar F, I, or J, confirming that these responses were serovar specific.Chlamydia trachomatis causes ocular and genital tract infections worldwide. In the United States, the annual cost of treating sexually transmitted diseases caused by C. trachomatis is billions of dollars (9). Effective preventive measures against C. trachomatis infections are not yet available, due in part to insufficient understanding of human immune responses to C. trachomatis. Evidence for protective immunity against C. trachomatis is scant and inconclusive. However, earlier studies have suggested that short-lived immunity develops after an episode of chlamydial infection (1,10,12) and that protection may be serovar specific (reviewed in reference 8); while reinfection with C. trachomatis is common, it is usually not with serovars of preceding infections. Consequently, many immunological studies of human genital tract infections have been focused on the major outer membrane protein (MOMP) because C. trachomatis serovars are defined by serological variation in this protein. In humans, MOMP elicits C. trachomatisneutralizing antibodies that recognize its surface-exposed variable segments (VSs), where amino acid sequences vary substantially among serovars (4). Therefore, some have speculated that B-cell responses directed toward serovar-specific epitopes located in VSs of MOMP are a critical component of protective immunity (16)(17)(18).Because of the role of T helper (Th) cells in priming and maintaining B-cell responses, we have investigated HLA class II-restricted Th cell responses to MOMP in humans genitally infected with C. trachomatis, focusing on commonly involved serovar E. The main results of our first study (14) were that (i) in vitro priming of peripheral blood mononuclear cells (PBMC) with MOMP yielded MOMP-specific Th cell cultures from 83% of serovar E-infected subjects; (ii) proliferative responses of T-MOMPЈ cultures to synthetic peptides localized at least 23 Th cell epitopes, and T-MOMPЈ cultures from most subjects responded to multiple epitopes; (iii) multiple HLA-DR and other HLA class II molecules were used to present the MOMP epitopes to the Th cells; and (iv) remarkably, 22 of the 23 epitopes were distributed among the five MOMP constant segments ...