title: Chlamydia trachomatis strains and virulence: rethinking links to infection prevalence and disease severity.
abstract: An unanswered question concerning prevalence and disease severity of Chlamydia trachomatis genital infection is whether more prevalent strains or strains more likely to cause serious disease complications are causally associated with specific virulence attributes. The major method for distinguishing chlamydial strains is based on differences in the major outer membrane protein (MOMP). A subset of MOMP serovars (D and E serovars) are easily the most prevalent strains identified worldwide, but MOMP serovar and genovar analyses have not yielded consistent strain-dependent virulence distinctions. Expansion of the definitions of chlamydial strains beyond the MOMP paradigm are needed to better understand virulence properties for this pathogen and how these properties reflect disease severity. Substantive genetic and phenotypic differences have emerged for the 2 major C. trachomatis pathobiotypes associated with either trachoma or sexually transmitted diseases, but differences within the sexually transmitted disease group have not yielded reliable disease severity attributes. A number of candidate virulence factors have been identified, including the polymorphic outer membrane autotransporter family of proteins, the putative large cytotoxin, type III secretion effectors, stress response proteins, and proteins or other regulatory factors produced by the cryptic plasmid. Continued work on development of a chlamydial gene transfer system and application of genomic approaches to large collections of clinical isolates will be required to associate key chlamydial virulence factors with prevalence and disease severity in a definitive way.
authors.affiliation: Department of Molecular Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA. gbyrne@utmem.edu
authors.forename: Gerald I
authors.initials: GI
authors.lastname: Byrne
mesh_terms: D001426:Bacterial Proteins / Q000378:metabolism; D001427:Bacterial Toxins / Q000378:metabolism; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000145:classification / Q000235:genetics / Q000472:pathogenicity* / Q000502:physiology*; D006017:Glycolipids / Q000378:metabolism; D006801:Humans; D008070:Lipopolysaccharides / Q000378:metabolism; D010641:Phenotype; D018272:Porins / Q000235:genetics / Q000378:metabolism; D015995:Prevalence; D013045:Species Specificity; D013312:Stress, Physiological; D037521:Virulence Factors / Q000378:metabolism*
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D006017:Glycolipids; D008070:Lipopolysaccharides; D018272:Porins; D037521:Virulence Factors; C071677:omp1 protein, Chlamydia trachomatis
references.citation: Annu Rev Microbiol. 2000;54:735-74
references.pmid: 11018143
references.citation: Science. 1999 May 21;284(5418):1322-8
references.pmid: 10334981
references.citation: Proc Natl Acad Sci U S A. 1988 Jun;85(11):4000-4
references.pmid: 2453883
references.citation: Mol Microbiol. 2000 Dec;38(5):1048-60
references.pmid: 11123678
references.citation: J Immunol. 1972 Jul;109(1):116-22
references.pmid: 4338437
references.citation: Microbes Infect. 2007 Jul;9(8):947-53
references.pmid: 17544798
references.citation: JAMA. 2001 Jan 3;285(1):47-51
references.pmid: 11150108
references.citation: Infect Immun. 1998 Aug;66(8):3618-25
references.pmid: 9673241
references.citation: Microbes Infect. 2000 Apr;2(4):367-9
references.pmid: 10817638
references.citation: Microbes Infect. 2006 Mar;8(3):604-11
references.pmid: 16527508
references.citation: J Biol Chem. 1997 Apr 18;272(16):10594-600
references.pmid: 9099706
references.citation: Infect Immun. 2009 Jan;77(1):508-16
references.pmid: 19001072
references.citation: Sex Transm Dis. 2007 May;34(5):257
references.pmid: 17483724
references.citation: Infect Immun. 2006 Jan;74(1):578-85
references.pmid: 16369014
references.citation: Curr Microbiol. 2003 Mar;46(3):217-23
references.pmid: 12567246
references.citation: J Med Microbiol. 2004 Aug;53(Pt 8):735-740
references.pmid: 15272059
references.citation: J Bacteriol. 2004 Apr;186(8):2457-65
references.pmid: 15060049
references.citation: J Biol Chem. 2008 Jul 25;283(30):20674-86
references.pmid: 18519569
references.citation: J Bacteriol. 2008 Mar;190(5):1680-90
references.pmid: 18165300
references.citation: J Bacteriol. 2007 Jul;189(13):4739-48
references.pmid: 17449608
references.citation: Proc Natl Acad Sci U S A. 2009 Jan 6;106(1):292-7
references.pmid: 19104068
references.citation: J Bacteriol. 2005 Jan;187(2):443-8
references.pmid: 15629915
references.citation: Microbes Infect. 2000 May;2(6):581-92
references.pmid: 10884608
references.citation: Infect Immun. 1997 Jan;65(1):317-9
references.pmid: 8975931
references.citation: J Infect Dis. 2005 Nov 15;192(10):1836-44
references.pmid: 16235186
references.citation: J Bacteriol. 2006 Jan;188(1):275-86
references.pmid: 16352844
references.citation: Infect Immun. 1998 Apr;66(4):1317-24
references.pmid: 9529048
references.citation: J Clin Invest. 2003 Jun;111(11):1757-69
references.pmid: 12782678
references.citation: Mol Microbiol. 1995 Feb;15(4):617-26
references.pmid: 7783634
references.citation: Mol Biol Evol. 1993 Jul;10(4):892-913
references.pmid: 8355605
references.citation: Infect Immun. 2008 Jun;76(6):2273-83
references.pmid: 18347045
references.citation: Eur J Biochem. 2003 Feb;270(3):440-50
references.pmid: 12542694
references.citation: J Bacteriol. 2007 Jan;189(1):198-206
references.pmid: 17056752
references.citation: Proc Natl Acad Sci U S A. 2001 Nov 20;98(24):13984-9
references.pmid: 11707582
references.citation: J Biol Chem. 2003 May 9;278(19):17314-9
references.pmid: 12600998
references.citation: Mol Microbiol. 1999 Aug;33(4):753-65
references.pmid: 10447885
references.citation: J Infect Dis. 1995 Oct;172(4):1013-22
references.pmid: 7561174
references.citation: Trends Microbiol. 1998 Sep;6(9):370-8
references.pmid: 9778731
references.citation: J Gen Microbiol. 1993 May;139(5):1083-92
references.pmid: 8336105
references.citation: Infect Immun. 2000 Jan;68(1):360-7
references.pmid: 10603409
references.citation: Proc Natl Acad Sci U S A. 2004 Jul 6;101(27):10166-71
references.pmid: 15199184
references.citation: Plasmid. 1990 Mar;23(2):144-8
references.pmid: 2362949
references.citation: J Infect Dis. 1993 Nov;168(5):1236-40
references.pmid: 7901289
references.citation: Sex Transm Dis. 2007 May;34(5):255-6
references.pmid: 17483723
references.citation: J Immunol. 2007 Sep 15;179(6):4027-34
references.pmid: 17785841
references.citation: Infect Immun. 1993 Jun;61(6):2273-6
references.pmid: 8500868
references.citation: J Infect Dis. 1993 Jun;167(6):1379-83
references.pmid: 8501327
references.citation: Fertil Steril. 2002 Jan;77(1):162-6
references.pmid: 11779608
references.citation: J Bacteriol. 2005 Sep;187(18):6466-78
references.pmid: 16159780
references.citation: Proc Natl Acad Sci U S A. 2006 Oct 17;103(42):15599-604
references.pmid: 17028176
references.citation: J Bacteriol. 2001 Oct;183(20):5997-6008
references.pmid: 11567000
references.citation: J Exp Med. 1944 May 1;79(5):463-86
references.pmid: 19871382
references.citation: Science. 1998 Oct 23;282(5389):754-9
references.pmid: 9784136
references.citation: Emerg Infect Dis. 1996 Oct-Dec;2(4):270-88
references.pmid: 8969244
references.citation: Infect Immun. 1998 Dec;66(12):6010-3
references.pmid: 9826386
references.citation: Infect Immun. 1985 May;48(2):573-5
references.pmid: 3988347
references.citation: PLoS Pathog. 2008 Mar;4(3):e1000014
references.pmid: 18383626
references.citation: Mol Microbiol. 1997 Jul;25(2):351-9
references.pmid: 9282747
references.citation: J Infect Dis. 2001 Oct 1;184(7):879-84
references.pmid: 11528595
references.citation: J Immunol. 2000 Jan 1;164(1):13-7
references.pmid: 10604986
references.citation: Infect Immun. 2000 Jan;68(1):303-9
references.pmid: 10603402
references.citation: Genome Res. 2007 Jan;17(1):50-60
references.pmid: 17090662
references.citation: Infect Immun. 2001 Mar;69(3):1231-43
references.pmid: 11179284
references.citation: Mol Microbiol. 2006 Jan;59(2):541-50
references.pmid: 16390448
references.citation: J Bacteriol. 1987 Sep;169(9):3879-85
references.pmid: 3040664
references.citation: Proc Natl Acad Sci U S A. 2006 Jan 17;103(3):750-5
references.pmid: 16407127
references.citation: Cell Microbiol. 1999 Sep;1(2):119-30
references.pmid: 11207546
references.citation: Infect Immun. 1986 Aug;53(2):347-51
references.pmid: 3089936
references.citation: Infect Immun. 2004 Dec;72(12):7063-72
references.pmid: 15557630
references.citation: Infect Immun. 2003 Mar;71(3):1200-8
references.pmid: 12595433
references.citation: Infect Immun. 2000 Oct;68(10):5473-9
references.pmid: 10992442
references.citation: Am J Ophthalmol. 1970 Sep;70(3):367-74
references.pmid: 4915925