Immunopathogenesis of chlamydia trachomatis infections in women.
OBJECTIVE
To develop a model of pathogenesis by which Chlamydia trachomatis progresses from acute to chronic infection, and finally serious disease (salpingitis, tubal occlusion).


METHODS
Review of current literature located through web-based Medline searches using key words: Chlamydia trachomatis, immunology, cytokines, heat shock protein, infertility.


RESULTS
Cell-mediated immune mechanisms appear to be critical in determining whether acute infection is resolved or progresses into chronicity with pathological outcome. What determines the particular immune pathway depends on a range of determinants-HLA subtype and human genetics, cytokine profile, infectious load, route of infection, and endocrinology. A clearer picture of the natural history of chlamydial pathology may assist in providing better predictors of those women who may go on to develop significant sequelae after infection.


CONCLUSIONS
Predicting those who may develop serious disease, including infertility, may contribute to improved management of such persons during earlier stages of infection and assist in prevention.
Debattista
Joseph
J
Centre for Molecular Biotechnology, Queensland University of Technology, Queensland, Australia. joedebat@powerup.com.au
Timms
Peter
P
Allan
John
J
Allan
Janet
J
D018834:Chaperonin 60 / Q000502:physiology; D002690:Chlamydia Infections / Q000209:etiology / Q000276:immunology*; D002692:Chlamydia trachomatis / Q000276:immunology*; D005260:Female; D020022:Genetic Predisposition to Disease; D005831:Genital Diseases, Female / Q000209:etiology / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000502:physiology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
D018834:Chaperonin 60; D015395:Histocompatibility Antigens Class I