Abstract

The current study was designed to evaluate the pathogenesis, pathology and immune response of female genital tract infection with Chlamydia trachomatis L2c, the most recently discovered lymphogranuloma venereum strain, using a porcine model of sexually transmitted infections. Pigs were mock infected, infected once or infected and re-infected intravaginally, and samples were obtained for chlamydial culture, gross and microscopic pathology, and humoral and cell-mediated immunity. Intravaginal inoculation of pigs with this bacterium resulted in an infection that was confined to the urogenital tract, where inflammation and pathology were caused that resembled what is seen in human infection. Re-infection resulted in more severe gross pathology than primary infection, and chlamydial colonization of the urogenital tract was similar for primary infected and re-infected pigs. This indicates that primary infection failed to induce protective immune responses against re-infection. Indeed, the proliferative responses of mononuclear cells from blood and lymphoid tissues to C. trachomatis strain L2c were never statistically different among groups, suggesting that C. trachomatis-specific lymphocytes were not generated following infection or re-infection. Nevertheless, anti-chlamydial antibodies were elicited in sera and vaginal secretions after primary infection and re-infection, clearly resulting in a secondary systemic and mucosal antibody response. While primary infection did not protect against reinfection, the porcine model is relevant for evaluating immune and pathogenic responses for emerging and known C. trachomatis strains to advance drug and/or vaccine development in humans.

Highlights

  • Chlamydia trachomatis is an obligate intracellular bacterial pathogen that infects annually over 100 million individuals [1]

  • Since 2003, an ongoing outbreak of lymphogranuloma venereum (LGV) has been observed among men who have sex with men (MSM) in developed countries [13,14,15,16,17,18,19,20,21,22]

  • Because the porcine model represents an appropriate model for studying human C. trachomatis strains [31], the present study aimed to obtain more knowledge about the pathogenesis, pathology and immune response of female genital tract infection and re-infection with C. trachomatis L2c, the most recently discovered LGV strain [31]

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Summary

Introduction

Chlamydia trachomatis is an obligate intracellular bacterial pathogen that infects annually over 100 million individuals [1]. C. trachomatis comprises two biovars: the trachoma biovar which includes ocular and urogenital strains and the lymphogranuloma venereum (LGV) biovar [2, 3]. The ocular serovars A, B, Ba and C are primarily associated with trachoma, the leading cause of preventable blindness in developing countries [5]. The urogenital (D-K, Da, Ia, and Ja) and LGV (L1-L3, L2a, L2b, and L2c) serovars cause sexually transmitted infections. Urogenital infection with serovars D to K, including Da, Ia, and Ja, can result in cervicitis, urethritis and post-infection complications such as pelvic inflammatory disease, ectopic pregnancy, infertility, chronic pelvic pain, epididymitis and infant pneumonia. The LGV serovars cause a more invasive disease called lymphogranuloma venereum. Persistent infections with chronic inflammation arise, resulting in strictures and fistulas of the involved region, which can eventually result in serious complications such as genital elephantiasis, esthiomene and the frozen pelvis syndrome with infertility [9, 10]

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