Aspects of reproductive biology that influence the distribution and spread of Chlamydia trachomatis within the female genital tract: a new paradigm.
Critical to evaluating Chlamydia trachomatis vaccine candidates is the availability of appropriate animal models. At a minimum, models must mimic the essential features of transmission and disease progression that contribute to the severe outcomes associated with upper genital tract infection. Existing models, whether mouse, pig or nonhuman primate, are based on the generally accepted premise that upper genital tract infection, when it occurs, is an event subsequent to cervical infection. However, what this simple paradigm overlooks are many features of reproductive biology that could influence both the initial distribution and subsequent spread of C. trachomatis within the female genital tract, as well as the immune responses made at these site(s) of infection. A review of the literature strongly suggests that the menstrual cycle and coitusrelated phenomena are likely to have a profound effect on the course and outcome of female genital tract infection with C. trachomatis. Although the new paradigm that emerges raises concerns about the adequacy of existing animal models, it also suggests ways to modify these models to better mimic the complexities of human infection and therefore serve as appropriate models in which to test the safety and efficacy of vaccine candidates against C. trachomatis infection in women.
Lyons
J M
JM
Department of Immunology, City of Hope National Medical Center, Duarte, California 91711, USA. jlyons001@msn.com
Morré
S A
SA
Land
J A
JA
D000818:Animals; D002690:Chlamydia Infections / Q000209:etiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification* / Q000502:physiology; D005260:Female; D005836:Genitalia, Female / Q000382:microbiology*; D006801:Humans; D008598:Menstruation; D012661:Semen / Q000502:physiology; D012725:Sexual Behavior