Viability of chlamydia trachomatis in fallopian tubes of patients with ectopic pregnancy

Gérard, Hervé C.; Branigan, Patrick; Balsara, Gulnar; Heath, Christine; Minassian, Shahab; Hudson, Alan P.

doi:10.1016/s0015-0282(98)00304-5

Cited by 37 publications

(23 citation statements)

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“…Similar findings were reported by five previous studies that were unable to detect C. trachomatis DNA in 189 tubal samples collected from EP patients with positive serological markers of C. trachomatis (5,8,19,37,50). In contrast, C. trachomatis DNA was found in 0.03 to 70% of the cases in another five studies (4,15,33,47,70). One explanation for the nondetection of chlamydial DNA in our case group could be the small sample size.…”

Section: Vol 16 2009 Activin and Inos In C Trachomatis-infected Wosupporting

confidence: 89%

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confidence: 99%

“…Detection rates of chlamydial DNA have varied considerably in different studies of fallopian tubes from patients with EP (range, 0.03 to 70%; mean, 26%) (4,15,33,47,70). Chlamydial mRNA was also detected by reverse transcription-PCR (RT-PCR) in one study that included 10 patients, and the authors suggested that their results indicated the presence of metabolically active C. trachomatis organisms (15). However, several other studies that included a total of 189 patients were unable to detect chlamydia using both cell culture and PCR in tubal tissue from ectopic pregnancies, although serological markers indicated prior chlamydial infections in many of these cases (5,8,19,37,50).…”

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Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

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Al-Azemi

Geary

et al. 2009

Clin Vaccine Immunol

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Chlamydia trachomatis infection can lead to pelvic inflammatory disease, ectopic pregnancy (EP), infertility, and chronic pelvic pain in women. Activins and inducible nitric oxide synthase (iNOS) are produced by the human fallopian tube, and we speculate that tubal activins and iNOS may be involved in the immune response to C. trachomatis in humans and their pathological alteration may result in tubal pathology and the development of EP. Blood and fallopian tubes were collected from 14 women with EP. Sera were analyzed by enzyme-linked immunosorbent assay to detect antibodies against chlamydial heat shock protein 60 (chsp60) and the major outer membrane protein of C. trachomatis. Confirmation of C. trachomatis serology was made using the microimmunofluorescence test. The patients were classified into three groups according to their serological results, and immunohistochemistry and quantitative reverse transcription-PCR were performed to investigate the expression of candidate molecules by tubal epithelial cells among the three groups. This is the first study to show an increase in the expression of activin ␤A subunit, type II receptors, follistatin, and iNOS within the human fallopian tube of EP patients who were serologically positive for C. trachomatis. A similar expression profile was observed in the fallopian tubes with detectable antibodies only against chsp60. These results were shown at the mRNA and protein levels. We suggest that tubal activin A, its type II receptors, follistatin, and NO could be involved in the microbial-mediated immune response within the fallopian tube, and their pathological expression may lead to tubal damage and the development of EP.

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Section: Vol 16 2009 Activin and Inos In C Trachomatis-infected Wosupporting

confidence: 89%

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confidence: 99%

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confidence: 99%

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Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

Refaat

Al-Azemi

Geary

et al. 2009

Clin Vaccine Immunol

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“…Chronic chlamydial infections are often characterized by culture negativity, although viability has been demonstrated in this state also. This was shown by detection of unprocessed rRNA transcripts and mRNA from chlamydial genes in synovial tissue of patients with reactive arthritis and tubal specimens from women with tubal factor infertility (20,21,32).The antimicrobial activity of antibiotics against chlamydia or any other organism is usually verified by determination of the MIC and minimal bactericidal concentration (MBC). For C. trachomatis, such in vitro susceptibility testing indicated good activity for ciprofloxacin (22,38,45,46,49).…”

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Persistence ofChlamydia trachomatisIs Induced by Ciprofloxacin and Ofloxacin In Vitro

Dreses-Werringloer

Padubrin

Jürgens‐Saathoff

et al. 2000

Antimicrob Agents Chemother

113

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An in vitro cell culture model was used to investigate the long-term effect of ciprofloxacin and ofloxacin on infection with Chlamydia trachomatis. Standard in vitro susceptibility testing clearly indicated successful suppression of chlamydial growth. To mimic better in vivo infection conditions, extended treatment with the drugs was started after infection in vitro had been well established. Incubation of such established chlamydial cultures with ciprofloxacin and ofloxacin not only failed to eradicate the organism from host cells, but rather induced a state of chlamydial persistence. This state was characterized by the presence of nonculturable, but fully viable, bacteria and the development of aberrant inclusions. In addition chlamydia exhibited altered steadystate levels of key chlamydial antigens, with significantly reduced major outer membrane protein and near constant hsp60 levels. Resumption of overt chlamydial growth occurred after withdrawal of ciprofloxacin, confirming the viability of persisting chlamydia. In vitro ciprofloxacin results are consistent with clinical data, thereby providing an explanation for treatment failures of ciprofloxacin. Parallel in vitro studies with ofloxacin suggest a better correlation between clinical and laboratory-defined efficacy, although the clinical studies on which this assessment is based did not include monitoring of chlamydial persistence. The data presented here clearly demonstrate that under at least some circumstances, standard determination of MICs and minimal bactericidal concentrations for C. trachomatis allows no more than a simple definition of whether an antibiotic has some anti chlamydial activity; however, such testing is not always sufficient to verify that the antibiotic will eliminate the organism in vivo.Chlamydia trachomatis is an obligate intracellular bacterial parasite whose life cycle involves alternation between the infectious extracellular, metabolically inactive elementary body (EB) form and the intracellular, metabolically active reticulate body form; the latter is the vegetative growth stage of the organism. Depending on the specific serovar involved, human infection with C. trachomatis causes a variety of ocular, pulmonary, and genital diseases. Genital infection with chlamydial serovars D to K is considered to be of major public health importance, since C. trachomatis is the most common sexually transmitted bacterium worldwide (54). Further, acute urogenital infections can progress to persistent infection, which in turn may initiate a pathogenic process leading to chronic diseases, including pelvic inflammatory disease, ectopic pregnancy, tubal factor infertility, and chlamydia-induced arthritis (12, 53). Importantly, C. trachomatis has been shown to be fully viable and metabolically active in both the acute and chronic, persistent infection state. In acute infections, the bacterium can be recovered usually by standard laboratory culture. Chronic chlamydial infections are often characterized by culture negativity, although viability has...

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Sexually Transmitted Infections

Greenhouse¹

2018

Dewhurst's Textbook of Obstetrics &Amp; Gynaecology

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Viability of chlamydia trachomatis in fallopian tubes of patients with ectopic pregnancy

Cited by 37 publications

References 5 publications

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

Persistence ofChlamydia trachomatisIs Induced by Ciprofloxacin and Ofloxacin In Vitro

Sexually Transmitted Infections

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