ABSTRACT
Chlamydia trachomatis causes both trachoma and sexually transmitted infections. These diseases have similar pathology and potentially similar genetic predisposing factors. We aimed to identify polymorphisms and pathways associated with pathological sequelae of ocular Chlamydia trachomatis infections in The Gambia. We report a discovery phase genome-wide association study (GWAS) of scarring trachoma (1090 cases, 1531 controls) that identified 27 SNPs with strong, but not genome-wide significant, association with disease (5 × 10(-6) > P > 5 × 10(-8)). The most strongly associated SNP (rs111513399, P = 5.38 × 10(-7)) fell within a gene (PREX2) with homology to factors known to facilitate chlamydial entry to the host cell. Pathway analysis of GWAS data was significantly enriched for mitotic cell cycle processes (P = 0.001), the immune response (P = 0.00001) and for multiple cell surface receptor signalling pathways. New analyses of published transcriptome data sets from Gambia, Tanzania and Ethiopia also revealed that the same cell cycle and immune response pathways were enriched at the transcriptional level in various disease states. Although unconfirmed, the data suggest that genetic associations with chlamydial scarring disease may be focussed on processes relating to the immune response, the host cell cycle and cell surface receptor signalling.
Subject(s)
Chlamydia trachomatis/immunology , Conjunctivitis, Inclusion/etiology , Conjunctivitis, Inclusion/pathology , Genome-Wide Association Study , Immunity, Innate , Adult , Computational Biology/methods , Conjunctivitis, Inclusion/metabolism , Disease Susceptibility , Female , Fibrosis , Gene Ontology , Gene Regulatory Networks , Genomics/methods , Humans , Male , Middle Aged , Models, Biological , Polymorphism, Single Nucleotide , Signal TransductionABSTRACT
PURPOSE: To report a patient who was diagnosed with combined adult inclusion conjunctivitis (AIC) and mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS: This is a case report. RESULTS: An 18-year-old male patient presented with chronic conjunctivitis and giant follicles. Evaluation by chlamydial antigen assay was positive. Conjunctival biopsy for the immunohistochemical stain and polymerase chain reaction of the left eye showed MALT lymphoma. CONCLUSIONS: MALT lymphoma can masquerade as other ocular surface diseases. Chlamydial infection causes chronic inflammation of the conjunctiva. Both of these diseases should be considered as a differential diagnosis of refractory follicular conjunctivitis. It is worthy of further study to determine whether chronic inflammation resulting from chlamydial infection increases the risk of MALT lymphoma or it is coincidental.
Subject(s)
Conjunctival Neoplasms/complications , Conjunctivitis, Inclusion/complications , Lymphoma, B-Cell, Marginal Zone/complications , Adolescent , Antigens, Bacterial/analysis , Chlamydia/immunology , Conjunctival Neoplasms/metabolism , Conjunctival Neoplasms/pathology , Conjunctivitis, Inclusion/diagnosis , Conjunctivitis, Inclusion/metabolism , Conjunctivitis, Inclusion/pathology , Humans , Immunohistochemistry , Lymphoma, B-Cell, Marginal Zone/metabolism , Lymphoma, B-Cell, Marginal Zone/pathology , MaleABSTRACT
38 newborns with purulent conjunctivitis were treated with oral erythromycin ethylsuccinate 25 mg/kg every 12 h for 14 days. 3-4 days after initiation of therapy, erythromycin levels in serum and tear fluid were measured 1 and 12 h after the administration of erythromycin. The level of erythromycin in tear fluid was significantly higher than that in serum 1 and 12 h after administration of the antibiotic. On both occasions the concentrations of erythromycin in tear fluid and in serum exceeded the minimum inhibitory concentration (MIC) in vitro for Chlamydia trachomatis.
