Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes
Chlamydia trachomatis, the most common bacterial sexually transmitted infection worldwide, is responsible for considerable health burden due to its significant sequelae. There are growing concerns about chlamydial treatment and management due to widely documented increasing burden of repeat infectio...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1012835/full |
| _version_ | 1811194664225603584 |
|---|---|
| author | Wilhelmina M. Huston Amba Lawrence Bryan A. Wee Mark Thomas Peter Timms Lenka A. Vodstrcil Lenka A. Vodstrcil Anna McNulty Ruthy McIvor Karen Worthington Basil Donovan Samuel Phillips Marcus Y. Chen Marcus Y. Chen Christopher K. Fairley Jane S. Hocking |
| author_facet | Wilhelmina M. Huston Amba Lawrence Bryan A. Wee Mark Thomas Peter Timms Lenka A. Vodstrcil Lenka A. Vodstrcil Anna McNulty Ruthy McIvor Karen Worthington Basil Donovan Samuel Phillips Marcus Y. Chen Marcus Y. Chen Christopher K. Fairley Jane S. Hocking |
| author_sort | Wilhelmina M. Huston |
| collection | DOAJ |
| description | Chlamydia trachomatis, the most common bacterial sexually transmitted infection worldwide, is responsible for considerable health burden due to its significant sequelae. There are growing concerns about chlamydial treatment and management due to widely documented increasing burden of repeat infections. In the current study, a cohort study design of 305 women with urogenital chlamydial infections demonstrated that 11.8% of women experienced repeat infections after treatment with azithromycin. The chlamydial DNA load measured by quantitative PCR was higher in women who experienced a repeat infection (p = 0.0097) and repeat infection was associated with sexual contact. There was no genomic or phenotypic evidence of azithromycin resistance within the chlamydial isolates. During repeat infection, or repeat positive tests during follow up, vaginal chlamydial gene expression (ompA, euo, omcB, htrA, trpAB) was markedly higher compared to baseline, and two of the selected immune genes analyzed had significantly lower expression at the time of repeat infection. Overall, there are two implications of these results. The results could be generalized to all recent infections, or repeat positive events, and indicate that chlamydial infections are have higher transcriptional activity of select genes early in the infection in women. Alternatively, after azithromycin treatment, repeat infections of Chlamydia may be more transcriptionally active at certain genes, and there may be post-treatment immunological alterations that interplay into repeat exposures establishing an active infection. The potential that recent infections may involve a higher level of activity from the organism may have implications for management by more regular testing of the most at risk women to reduce the risk of sequelae. |
| first_indexed | 2024-04-12T00:30:34Z |
| format | Article |
| id | doaj.art-04faf6529dec426982a6acb894439c43 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-12T00:30:34Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-04faf6529dec426982a6acb894439c432022-12-22T03:55:20ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-10-011010.3389/fpubh.2022.10128351012835Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genesWilhelmina M. Huston0Amba Lawrence1Bryan A. Wee2Mark Thomas3Peter Timms4Lenka A. Vodstrcil5Lenka A. Vodstrcil6Anna McNulty7Ruthy McIvor8Karen Worthington9Basil Donovan10Samuel Phillips11Marcus Y. Chen12Marcus Y. Chen13Christopher K. Fairley14Jane S. Hocking15Faculty of Science, University of Technology Sydney, Ultimo, NSW, AustraliaInstitute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, AustraliaInstitute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, AustraliaFaculty of Science, University of Technology Sydney, Ultimo, NSW, AustraliaBioinnovation Centre, University of the Sunshine Coast, Sippy Downs, QLD, AustraliaMelbourne Sexual Health Centre, Central Clinical School, Monash University, Carlton, VIC, AustraliaCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, AustraliaSydney Sexual Health Centre, Sydney, NSW, AustraliaSydney Sexual Health Centre, Sydney, NSW, AustraliaMelbourne Sexual Health Centre, Alfred Health, Carlton, VIC, AustraliaKirby Institute, University of New South Wales, Kensington, NSW, AustraliaBioinnovation Centre, University of the Sunshine Coast, Sippy Downs, QLD, AustraliaMelbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia0Australia and Melbourne Sexual Health Centre, Carlton, VIC, AustraliaMelbourne Sexual Health Centre, Alfred Health, Carlton, VIC, AustraliaCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, AustraliaChlamydia trachomatis, the most common bacterial sexually transmitted infection worldwide, is responsible for considerable health burden due to its significant sequelae. There are growing concerns about chlamydial treatment and management due to widely documented increasing burden of repeat infections. In the current study, a cohort study design of 305 women with urogenital chlamydial infections demonstrated that 11.8% of women experienced repeat infections after treatment with azithromycin. The chlamydial DNA load measured by quantitative PCR was higher in women who experienced a repeat infection (p = 0.0097) and repeat infection was associated with sexual contact. There was no genomic or phenotypic evidence of azithromycin resistance within the chlamydial isolates. During repeat infection, or repeat positive tests during follow up, vaginal chlamydial gene expression (ompA, euo, omcB, htrA, trpAB) was markedly higher compared to baseline, and two of the selected immune genes analyzed had significantly lower expression at the time of repeat infection. Overall, there are two implications of these results. The results could be generalized to all recent infections, or repeat positive events, and indicate that chlamydial infections are have higher transcriptional activity of select genes early in the infection in women. Alternatively, after azithromycin treatment, repeat infections of Chlamydia may be more transcriptionally active at certain genes, and there may be post-treatment immunological alterations that interplay into repeat exposures establishing an active infection. The potential that recent infections may involve a higher level of activity from the organism may have implications for management by more regular testing of the most at risk women to reduce the risk of sequelae.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1012835/fullChlamydiasexually transmitted infectionrepeat infectionsgenomicsgene expressionazithromycin |
| spellingShingle | Wilhelmina M. Huston Amba Lawrence Bryan A. Wee Mark Thomas Peter Timms Lenka A. Vodstrcil Lenka A. Vodstrcil Anna McNulty Ruthy McIvor Karen Worthington Basil Donovan Samuel Phillips Marcus Y. Chen Marcus Y. Chen Christopher K. Fairley Jane S. Hocking Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes Frontiers in Public Health Chlamydia sexually transmitted infection repeat infections genomics gene expression azithromycin |
| title | Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes |
| title_full | Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes |
| title_fullStr | Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes |
| title_full_unstemmed | Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes |
| title_short | Repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes |
| title_sort | repeat infections with chlamydia in women may be more transcriptionally active with lower responses from some immune genes |
| topic | Chlamydia sexually transmitted infection repeat infections genomics gene expression azithromycin |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1012835/full |
| work_keys_str_mv | AT wilhelminamhuston repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT ambalawrence repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT bryanawee repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT markthomas repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT petertimms repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT lenkaavodstrcil repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT lenkaavodstrcil repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT annamcnulty repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT ruthymcivor repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT karenworthington repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT basildonovan repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT samuelphillips repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT marcusychen repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT marcusychen repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT christopherkfairley repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes AT janeshocking repeatinfectionswithchlamydiainwomenmaybemoretranscriptionallyactivewithlowerresponsesfromsomeimmunegenes |