Correlating Chlamydia trachomatis infectious load with urogenital ecological success and disease pathogenesis

被引:65
作者
Gomes, JP
Borrego, MJ
Atik, B
Santo, I
Azevedo, J
de Sá, AB
Nogueira, P
Dean, D
机构
[1] Inst Nacl Saude, Ctr Bacteriol, P-1649016 Lisbon, Portugal
[2] Childrens Hosp, Oakland Res Inst, Oakland, CA 94609 USA
[3] Ctr Saude Lapa, DST, P-1200831 Lisbon, Portugal
[4] Inst Med Prevent, Fac Med Lisbon, P-1649028 Lisbon, Portugal
[5] Inst Nacl Saude, Observ Nacl Saude, P-1649016 Lisbon, Portugal
[6] Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA
关键词
recurrence; pathogenesis; chlamydial load; real-time PCR; STD;
D O I
10.1016/j.micinf.2005.05.014
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The association of infectious burden of Chlamydia trachomatis with patient characteristics and clinical disease may have implications for understanding disease pathogenesis. We examined chlamydial load from 171 urine samples where load was based on copy number of organisms per copy number of eukaryotic cells derived by real-time quantitative PCR. High-(E, F, G) and low-prevalence (la, H, J, Ja) genotypes in the population had similar loads, suggesting a similar propensity for replicating in vivo, despite their differential ecological success. Symptomatic and asymptomatic patients also had similar chlamydial loads, indicating that virulence differences are likely not associated with variations in replication. There was a significant difference in genotypes by age for F (< 31 years; P = 0.031) and for H where the mean age was lower than for the most prevalent genotype, E (P = 0.013). Also, men had a significantly lower load than women when the genotype was F (P = 0.042), although there was no significant difference in load between partners. Patients with recurrent chlamydial infections had a significant reduction in load with each subsequent episode regardless of genotype (P = 0.007), suggesting that immune defenses do not block chlamydial entry but may impact replication. Additionally, the probability of being infected with J was 7.7-fold higher in patients with prior chlamydial infections (P = 0.016), and although the loads were lower when compared with patients without prior infection, the results did not reach statistical significance. These findings suggest that chlamyclial burden could be an important marker for recurrence and host immune response, which would facilitate pathogenesis research. (c) 2005 Elsevier SAS. All rights reserved.
引用
收藏
页码:16 / 26
页数:11
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