The goal of this observational study is to learn if we can identify immune biomarkers in first-void urine and vaginal brush samples in Chlamydia trachomatis (CT) positive adult women. Participants will self-collect a first-void urine sample, self-collect a vaginal brush, and a blood sample will be collected by a healthcare worker. Participants will complete a questionnaire.
To date, clinician-collected blood samples are still the primary methods to monitor immune responses to genital tract infections. Replacing these samples with a specimen that is non-invasive and can be self-collected, such as the initial or first-void urine stream or vaginal brushes, could have important acceptance and feasibility advantages and could facilitate the logistics of clinical trials and future epidemiological or vaccine studies. Moreover, these local samples give more information on the immune response at the site of infection, in the genital tract. Initial results of experiments using first-void urine samples and cervicovaginal brushes for immune response monitoring are promising. However, no standardized method for the detection of (functional) Chlamydia trachomatis (CT)-specific immune responses is available to be used on first-void urine or vaginal samples. Therefore, the aim of this pilot study is to determine feasibility to detect mucosal immune responses in first-void urine and self-collected vaginal samples. Furthermore, we will compare local immune responses with systemic immunity. The primary objectives of this study are: * To explore the feasibility to detect (functional) CT-specific antibodies and CT-specific cellular immune responses in first-void urine or self-collected vaginal samples. * To compare levels of total and CT-specific antibodies in first-void urine and serum. * To compare mucosal and systemic CT-specific cellular immune responses in mucosal mononuclear cells derived from first-void urine or self-collected vaginal samples, and peripheral blood mononuclear cells (PBMCs). A total of 73 female participants will be included in this trial. Women that can be included have to be positive for a Chlamydia trachomatis nuclear acid amplification test (NAAT) on a vaginal or FVU sample, and have not yet been treated with antibiotic therapy. The study described is a low-interventional observational study. Participants will self-collect a first-void urine sample using a 20 mL Colli Pee® device (Novosanis), followed by a vaginal brush (Evalyn® brush, Rovers). Medical personnel at the study site will collect a blood sample (one serum tube and 2 heparin tubes). Furthermore, personal data is collected via a paper-based questionnaire.
Study Type
OBSERVATIONAL
Collection of first-void urine (i.e. the initial stream of urine) with the Colli-Pee device (Novosanis, Belgium) (one sample of approx. 20 mL). Collection of a vaginal brush sample with the Evalyn brush (Rovers Medical Devices, The Netherlands). Collection of blood samples (three blood tubes of approx. 9 mL).
Violett Antwerp
Antwerp, Antwerp, Belgium
RECRUITINGConcentration of total and Chlamydia-specific immunoglobulins in first-void urine and serum samples
Concentration of total and Chlamydia-specific immunoglobulins in first-void urine and serum samples determined using ELISA-based assays and the correlation of antibody titers between both sample types.
Time frame: Within 6 months after study completion
Number of Chlamydia-specific SFCs per million cells
Quantification of antigen-specific cells in cells isolated from first-void urine samples, vaginal brush samples and whole blood samples (PBMC) using ELISpot-based assays.
Time frame: Within 6 months after study completion
Measurement of percentage and median fluorescence intensity (MFI) of immune cell subsets in blood, first-void urine and vaginal brush samples.
Measuring percentage and MFI of immune cell subsets using flow cytometry
Time frame: Within 6 months after study completion.
STI DNA status of first-void urine and vaginal brush samples.
Nuclear acid amplification test for the presence of DNA from different sexually transmitted infections (including Chlamydia, Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhea, Trichomonas vaginalis, Ureaplasma parvum, Ureaplasma urealyticum) to investigate Chlamydia clearance or persistent infection and determine coinfections.
Time frame: Within 6 months after study completion.
Other biomarkers
To test other biomarkers to normalize immune biomarkers measured in primary outcomes (antibody or cellular immune responses), for example total IgG, IgG subclasses, total protein, total human DNA etc.
Time frame: Within 6 months after study completion.
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Enrollment
73