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Infect. Immun., 06 1997, 2175-2182, Vol 65, No. 6
WC Van Voorhis, LK Barrett, YT Sweeney, CC Kuo and DL Patton
Chlamydia trachomatis-associated female infertility and ectopic pregnancy
are caused by postinflammatory fibrosis and scarring of the upper genital
tract. Scarring of the upper genital tract is associated with multiple
infectious episodes with C. trachomatis. To study the immune response that
occurs with multiple infections of C. trachomatis in the female upper
genital tract, a Macaca nemestrina model was used. Subcutaneous pockets
containing autologous salpingeal tissue implants were inoculated three
times with C. trachomatis. The inflammation after three inoculations was
associated with a mononuclear infiltrate dominated by CD8 T-cell
lymphocytes. Perforin mRNA was induced in infected pockets, demonstrating
that activated cytolytic lymphocytes were present in the lesions. Fibrosis,
as evidenced by fibroblast proliferation and connective tissue deposition,
was observed by the third infection. Cytokine mRNAs induced by repeated
chlamydial infection included gamma interferon, interleukin-2 (IL-2), IL-6,
and IL- 10 mRNAs, but IL-4 mRNA was not induced. Nearly identical findings
were found in macaque fallopian tubes infected in situ repeatedly with C.
trachomatis, validating the subcutaneous pocket model of chlamydial
salpingitis. However, it was not possible to evaluate if there was an
induction of perforin mRNA in infected salpingeal tubes in situ, because
there was a high basal level of perforin mRNA in these tissues. These
results suggest that repeated chlamydial infection of the female upper
genital tract leads to CD8 T-cell predominance, a Th1-like cytokine milieu,
and these inflammatory changes are associated with progression to fibrosis
associated with female infertility.
Copyright © 1997, American Society for Microbiology
Repeated Chlamydia trachomatis infection of Macaca nemestrina fallopian tubes produces a Th1-like cytokine response associated with fibrosis and scarring
Department of Medicine, University of Washington, Seattle 98195, USA. wesley@u.washington.edu
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