Trachoma: protective and pathogenic ocular immune responses to Chlamydia trachomatis.

Abstract:

:Trachoma, caused by Chlamydia trachomatis (Ct), is the leading infectious blinding disease worldwide. Chronic conjunctival inflammation develops in childhood and leads to eyelid scarring and blindness in adulthood. The immune response to Ct provides only partial protection against re-infection, which can be frequent. Moreover, the immune response is central to the development of scarring pathology, leading to loss of vision. Here we review the current literature on both protective and pathological immune responses in trachoma. The resolution of Ct infection in animal models is IFNγ-dependent, involving Th1 cells, but whether this is the case in human ocular infection still needs to be confirmed. An increasing number of studies indicate that innate immune responses arising from the epithelium and other innate immune cells, along with changes in matrix metalloproteinase activity, are important in the development of tissue damage and scarring. Current trachoma control measures, which are centred on repeated mass antibiotic treatment of populations, are logistically challenging and have the potential to drive antimicrobial resistance. A trachoma vaccine would offer significant advantages. However, limited understanding of the mechanisms of both protective immunity and immunopathology to Ct remain barriers to vaccine development.

journal_name

PLoS Negl Trop Dis

authors

Hu VH,Holland MJ,Burton MJ

doi

10.1371/journal.pntd.0002020

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

e2020

issue

2

eissn

1935-2727

issn

1935-2735

pii

PNTD-D-12-00752

journal_volume

7

pub_type

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