Abstract

Chlamydia trachomatis is the leading cause of bacterial sexually transmitted infections (STIs) and preventable blindness. Untreated, asymptomatic infection as well as frequent re-infection are common and may drive pelvic inflammatory disease, ectopic pregnancy, and infertility. In vivo models of chlamydial infection continue to be instrumental in progress toward a vaccine and further elucidating the pathogenesis of this intracellular bacterium, however significant gaps in our understanding remain. Chlamydial host cell exit occurs via two mechanisms, lysis and extrusion, although the latter has yet to be reported in vivo and its biological role is unclear. The objective of this study was to investigate whether chlamydial extrusions are shed in vivo following infection with multiple strains of Chlamydia. We utilized an established C3H/HeJ murine cervicovaginal infection model with C. trachomatis serovars D and L2 and the Chlamydia muridarum strain MoPn to monitor the (i) time course of infection and mode of host cell exit, (ii) mucosal and systemic immune response to infection, and (iii) gross and histopathology following clearance of active infection. The key finding herein is the first identification of chlamydial extrusions shed from host cells in an in vivo model. Extrusions, a recently appreciated mode of host cell exit and potential means of dissemination, had been previously observed solely in vitro. The results of this study demonstrate that chlamydial extrusions exist in vivo and thus warrant further investigation to determine their role in chlamydial pathogenesis.

Highlights

  • Chlamydia trachomatis is a pathogen of global significance, causing ocular trachoma, and urogenital infections

  • Despite treatment, ongoing complications may arise after infection including pelvic inflammatory disease (PID), endometriosis, tubal scarring, ectopic pregnancy, and potentially cervical cancer (Smith et al, 2001; Brunham and Rey-Ladino, 2005)

  • Chlamydiae are a group of obligate intracellular bacteria that possess a unique biphasic life cycle consisting of two alternating forms: infectious, non-replicative, extracellular elementary bodies (EBs) and non-infectious, metabolically active, replicative reticulate bodies (RBs; Moulder, 1991)

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Summary

Introduction

Chlamydia trachomatis is a pathogen of global significance, causing ocular trachoma, and urogenital infections. Upon the host cell swelling in response to the growing numbers of Chlamydia, the Chlamydia exit the cell by one of two mechanisms: lysis or extrusion (Todd and Caldwell, 1985; Scidmore et al, 1996; Hybiske and Stephens, 2007, 2008; Lutter et al, 2013) for subsequent rounds of infection. Extrusion studies to date have been performed in vitro utilizing many cell types and chlamydial strains (Todd and Caldwell, 1985; Hybiske and Stephens, 2007, 2008; Chin et al, 2012; Lutter et al, 2013; Zuck et al, 2016a,b); the role of extrusions in chlamydial pathogenesis in vivo has not yet been described

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