Innate immune responses and modified extra-cellular matrix regulation characterize bacterial infection and cellular/connective tissue changes in scarring trachoma.


Hu, VH; Weiss, HA; Ramadhani, AM; Tolbert, SB; Massae, P; Mabey, DC; Holland, MJ; Bailey, RL; Burton, MJ; (2011) Innate immune responses and modified extra-cellular matrix regulation characterize bacterial infection and cellular/connective tissue changes in scarring trachoma. Infection and immunity, 80 (1). pp. 121-30. ISSN 0019-9567 DOI: https://doi.org/10.1128/IAI.05965-11

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Abstract

: Trachoma is the most common infectious cause of blindness and a major public health problem in many developing countries. It is caused by recurrent ocular infection with Chlamydia trachomatis in childhood, with conjunctival scarring seen later in life. The pathogenesis of trachomatous scarring, however, is poorly understood, and this study was carried out to investigate the immunofibrogenic correlates of trachomatous conjunctival scarring. A case-control study of 363 cases with conjunctival scarring and 363 control participants was conducted. Investigations included in vivo confocal microscopy (IVCM) assessment, quantitative real-time PCR gene expression, C. trachomatis detection, and nonchlamydial bacterial culture. Trachomatous scarring was found to be strongly associated with a proinflammatory, innate immune response with increased expression of psoriasin, interleukin-1β, tumor necrosis factor alpha, defensin-β4A, chemokine ligand 5, and serum amyloid A1. There was also differential expression of various modifiers of the extracellular matrix, including metalloproteinases 7, 9, 10, and 12, tissue inhibitor of matrix metalloproteinase 1, and secreted protein acidic cystein-rich-like 1. The expression of many of these genes was also significantly associated with the presence of nonchlamydial bacterial infection. These infections had a marked effect on conjunctival immune processes, including an increased inflammatory infiltrate and edema seen with IVCM. This study supports the possibility that the immunofibrogenic response in scarring trachoma is partly stimulated by nonchlamydial bacterial infection, which is characterized by the expression of innate factors.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 22038912
Web of Science ID: 298402500013
URI: http://researchonline.lshtm.ac.uk/id/eprint/18525

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