Subject(s)
Alveolar Bone Loss/diagnosis , Carcinoma, Verrucous/diagnosis , Maxillary Neoplasms/diagnosis , Tooth Exfoliation/diagnosis , Alveolar Bone Loss/complications , Biopsy , Carcinoma, Verrucous/complications , Carcinoma, Verrucous/pathology , Diagnosis, Differential , Humans , Male , Maxillary Neoplasms/complications , Maxillary Neoplasms/pathology , Middle Aged , Tooth Exfoliation/complicationsABSTRACT
The native plasmid of both Chlamydia muridarum and Chlamydia trachomatis has been shown to control virulence and infectivity in mice and in lower primates. We recently described the development of a plasmid-based genetic transformation protocol for Chlamydia trachomatis that for the first time provides a platform for the molecular dissection of the function of the chlamydial plasmid and its individual genes or coding sequences (CDS). In the present study, we transformed a plasmid-free lymphogranuloma venereum isolate of C. trachomatis, serovar L2, with either the original shuttle vector (pGFP::SW2) or a derivative of pGFP::SW2 carrying a deletion of the plasmid CDS5 gene (pCDS5KO). Female mice were inoculated with these strains either intravaginally or transcervically. We found that transformation of the plasmid-free isolate with the intact pGFP::SW2 vector significantly enhanced infectivity and induction of host inflammatory responses compared to the plasmid-free parental isolate. Transformation with pCDS5KO resulted in infection courses and inflammatory responses not significantly different from those observed in mice infected with the plasmid-free isolate. These results indicate a critical role of plasmid CDS5 in in vivo fitness and in induction of inflammatory responses. To our knowledge, these are the first in vivo observations ascribing infectivity and virulence to a specific plasmid gene.
Subject(s)
Chlamydia Infections/microbiology , Chlamydia Infections/pathology , Chlamydia trachomatis/pathogenicity , Lymphogranuloma Venereum/microbiology , Lymphogranuloma Venereum/pathology , Plasmids , Virulence Factors/metabolism , Animals , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Chlamydia trachomatis/genetics , Disease Models, Animal , Female , Gene Deletion , Mice , Virulence Factors/geneticsABSTRACT
RESULTS: Treatment of patients with osteoradionecrosis (ORN) of the mandible associated with pathologic fractures usually consists of a continuity resection of the mandible, leading to severe impairment of the patient's health and quality of life. Conservative treatment may be alternatively attempted; however, it is not usually employed. Here, we report a successful conservative treatment of ORN associated with pathologic fracture. A 48-year-old black man who had undergone radiotherapy for a squamous cell carcinoma in the tongue 6 years previously sought care complaining of facial swelling and draining episodes. Since the patient was fiercely resistant to any kind of hospital-based therapy, a conservative approach was proposed. Daily irrigations with 2% potassium iodate, followed by 3% oxygenated water, were performed by the patient at his house. In addition, local cleaning and debridement were weekly performed at our dental clinic. Systemic antibiotics were also administered. Throughout the therapy course, bone fragments were spontaneously exfoliated. Resolution of the ulcer and fracture was observed after 6 weeks of treatment. This report shows that ORN may be conservatively managed in specific situations, with good cosmetic and functional
