Clinical Activity and Polymerase Chain Reaction Evidence of Chlamydial Infection after Repeated Mass Antibiotic Treatments for Trachoma

Keenan, Jeremy D.; Lakew, Takele; Alemayehu, Wondu; Melese, Muluken; Porco, Travis C.; Yi, Elizabeth; House, Jenafir; Zhou, Zhaoxia; Ray, Kathryn J.; Acharya, Nisha R.; Whitcher, John P.; Gaynor, Bruce D.; Lietman, Thomas M.

doi:10.4269/ajtmh.2010.09-0315

Cited by 43 publications

(39 citation statements)

References 22 publications

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“…4 Mass azithromycin distribution subsequently occurred at months 0, 6, 12, and 18. The mean prevalence of ocular chlamydia in children during posttreatment biannual monitoring visits was 5.1% (95% confidence interval, 3.6%-6.6%).…”

Section: Resultsmentioning

confidence: 98%

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Slow Resolution of Clinically Active Trachoma Following Successful Mass Antibiotic Treatments

Keenan¹

2011

Arch Ophthalmol

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Section: Resultsmentioning

confidence: 98%

“…2,3 Clinically active trachoma was defined as follicular trachoma and/or intense inflammatory trachoma according to the World Health Organization's simplified grading system. 1 Clinical examiners were trained and validated against gold-standard examiners as described previously 4 .…”

Section: Methodsmentioning

confidence: 99%

Slow Resolution of Clinically Active Trachoma Following Successful Mass Antibiotic Treatments

Keenan¹

2011

Arch Ophthalmol

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“…10 -13 Using the WHO simplified grading scheme for trachoma assessment, approximately 50% to 90% of those with TI and 30% to 50% of those with TF have concomitant infection, 14 with even lower rates after MDA. 8,11,15,16 Even if free of infection, communities with TF prevalence Ն10% will continue another series of rounds of MDA in compliance with WHO guidelines.…”

mentioning

confidence: 92%

Can Clinical Signs of Trachoma Be Used after Multiple Rounds of Mass Antibiotic Treatment to Indicate Infection?

Muñoz

Stare

Mkocha³

et al. 2011

Invest. Ophthalmol. Vis. Sci.

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“…The signs of inflammation and the detection of chlamydial infection may show only a relatively weak correlation, particularly in low-prevalence settings (8,9,60). This relationship weakens after the introduction of antibiotic treatment (28). Nonchlamydial bacterial pathogens have been associated with signs of active trachoma in a low-prevalence setting and in adults with established scarring (9,10,25).…”

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confidence: 99%

Active Trachoma Is Associated with Increased Conjunctival Expression ofIL17Aand Profibrotic Cytokines

et al. 2011

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The immunological basis of scarring trachoma is not well understood. It is unclear whether it is driven primarily through cell-mediated adaptive or epithelial-cell-derived innate responses. The purpose of this study was to investigate the expression of the inflammatory and fibrogenic mediators which may be involved. We conducted a cross-sectional survey of children living in an untreated trachoma-endemic community in Tanzania. The children were examined for signs of trachoma, and swabs were collected for bacteriological culture and RNA and DNA isolation. Chlamydia trachomatis was detected by the Amplicor PCR test. The expression of the following genes was measured by quantitative reverse transcription-PCR (RT-PCR): S100A7, IL1B, IL17A, IL23A, CXCL5, CCL18, TLR2, NLRP3, KLRD1, CTGF, and MMP9. Four hundred seventy children under the age of 10 years were included. Follicular trachoma (TF) was detected in 65 children (14%), C. trachomatis was detected in 25 (5%), and bacterial pathogens were cultured in 161 (34%). TF was associated with significantly increased expression of S100A7, IL17A, CCL18, CXCL5, and CTGF. Expression was increased further in the presence of papillary inflammation. Nonchlamydial bacterial infection was associated with increased expression of IL17A, CXCL5, CCL18, and KLRD1. IL17A expression was associated with increased expression of S100A7, CXCL5, CCL18, KLRD1, and CTGF. These data are consistent with a role for IL-17A in orchestrating the proinflammatory response in trachoma. Its activity may be promoted either as part of the cell-mediated response or through innate pathways. It may drive a range of proinflammatory factors leading to excessive tissue damage and repair involving fibrosis.

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Clinical Activity and Polymerase Chain Reaction Evidence of Chlamydial Infection after Repeated Mass Antibiotic Treatments for Trachoma

Cited by 43 publications

References 22 publications

Slow Resolution of Clinically Active Trachoma Following Successful Mass Antibiotic Treatments

Slow Resolution of Clinically Active Trachoma Following Successful Mass Antibiotic Treatments

Can Clinical Signs of Trachoma Be Used after Multiple Rounds of Mass Antibiotic Treatment to Indicate Infection?

Active Trachoma Is Associated with Increased Conjunctival Expression ofIL17Aand Profibrotic Cytokines

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