IMMUNOPATHOGENIC IMPACT OF CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE INFECTION ON FEMALE FERTILITY AND VACCINE PERSPECTIVES: A SYSTEMATIC LITERATURE REVIEW
DOI:
https://doi.org/10.56238/levv17n59-025Keywords:
Chlamydia trachomatis, Neisseria gonorrhoeae, Female Infertility, Pelvic Inflammatory Disease, VaccinesAbstract
Objective: To evaluate the main immunopathogenic mechanisms associated with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection, as well as to demonstrate the clinical repercussions of these infections on female fertility and future perspectives for control through vaccines. Methodology: This is a systematic review focused on understanding the structural damage and immune evasion caused by these pathogens in the reproductive tract, in addition to evaluating the relationship between pelvic inflammatory disease (PID) and the reproductive prognosis of patients. The research was guided by the question: "What is the immunopathogenic impact of Chlamydia trachomatis and Neisseria gonorrhoeae infection on female fertility and what are the available vaccine prevention perspectives?". To find answers, searches were conducted in the PubMed database using four descriptors combined with the Boolean term "AND". This resulted in 284 articles. 45 articles were selected for analysis and 17 articles were used to compose the collection. Results: CT and NG infection is a complex and predominantly asymptomatic condition that profoundly impacts reproductive health. The ascent of these bacteria to the upper genital tract triggers PID, resulting in epithelial-mesenchymal transition, irreversible tubal damage, and infertility. Controlling these infections faces enormous challenges due to the sophisticated immune evasion mechanisms of both pathogens, such as inhibition of neutrophil activation, modulation of type I interferon response, and induction of T cell exhaustion, which prevents the formation of lasting immunological memory. Genetic (NAAT) and serological screening tools have contributed to detection, although the high reinfection rate limits their long-term isolated effectiveness. Conclusion: Therefore, it is essential to invest in the development of new preventive technologies. Vaccine platforms focused on mucosal immunity, using nanodiscs and Th1 response-inducing adjuvants, have shown promising potential. It is essential to promote public policies aimed at early diagnosis and the availability of combined vaccines to mitigate the global burden of infertility.
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