RESUMO
BACKGROUND: Oral preexposure prophylaxis (PrEP) has been established as a pivotal strategy in HIV prevention. However, bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis and Neisseria gonorrhoeae, are also highly prevalent. Although the presence of STI-related mucosal lesions is a known risk factor for HIV acquisition, the potential increase in risk associated with asymptomatic STIs is not completely understood. Recent data demonstrated higher T-cell activation is a risk factor for sexually acquired HIV-1 infection. We examined the effect of asymptomatic C. trachomatis and N. gonorrhoeae anorectal infection on systemic immune activation, potentially increasing the risk of HIV acquisition. METHODS: We analyzed samples from participants of PrEP Brasil, a demonstration study of daily oral emtricitabine/tenofovir disoproxil fumarate HIV PrEP among healthy MSM, for T-cell activation by flow cytometry. We included 34 asymptomatic participants with anorectal swab for C. trachomatis and/or N. gonorrhoeae infection, whereas negative for other STIs, and 35 controls. RESULTS: We found a higher frequency of human leukocyte antigen DRCD38 CD8 T cells (1.5 vs. 0.9%, Pâ<â0.005) and with memory phenotype in the group with asymptomatic C. trachomatis and/or N. gonorrhoeae infection. Exhaustion and senescence markers were also significant higher in this group. No difference was observed in the soluble CD14 levels. CONCLUSION: Our findings suggest asymptomatic anorectal C. trachomatis and/or N. gonorrhoeae increase systemic immune activation, potentially increasing the risk of HIV acquisition. Regular screening and treatment of asymptomatic STIs should be explored as adjuvant tools for HIV prevention.
Assuntos
Linfócitos T CD8-Positivos/imunologia , Infecções por Chlamydia/patologia , Gonorreia/patologia , Ativação Linfocitária , Doenças Retais/patologia , ADP-Ribosil Ciclase 1/análise , Adulto , Doenças Assintomáticas , Antígenos CD8/análise , Linfócitos T CD8-Positivos/química , Chlamydia trachomatis/isolamento & purificação , Estudos Transversais , Citometria de Fluxo , Antígenos HLA-DR/análise , Humanos , Masculino , Glicoproteínas de Membrana/análise , Neisseria gonorrhoeae/isolamento & purificação , Adulto JovemRESUMO
Chlamydia trachomatis is the most prevalent sexually transmitted bacterial infection. However, whether Chlamydia trachomatis has a negative impact on sperm quality and male fertility is still controversial. Herein, we report the effects on sperm quality of the in vitro exposure of spermatozoa to Chlamydia trachomatis, and also the effects of male genital infection on male fertility using an animal model. Human and mouse sperm were obtained from healthy donors and cauda epididimys from C57BL/6 mice, respectively. Highly motile human or mouse spermatozoa were in vitro exposed to C. trachomatis (serovar E or LGV) or C. muridarum, respectively. Then, sperm quality parameters were analyzed. Moreover, male fertility of Chlamydia muridarum infected male C57BL/6 mice was assessed. Human or murine sperm in vitro exposed to increasing bacterial concentrations or soluble factors from C. trachomatis or C. muridarum, respectively, did not show differences in sperm motility and viability, apoptosis, mitochondrial membrane potential, DNA fragmentation, ROS production and lipid peroxidation levels, when compared with control sperm (p > 0.05). Moreover, no differences in fertility parameters (potency, fecundity, fertility index, pre- and post-implantation loss) were observed between control and infected males. In conclusion, our results indicate that Chlamydia spp. neither directly exerts deleterious effects on spermatozoa nor impairs male fertility.
Assuntos
Infecções por Chlamydia/complicações , Infecções por Chlamydia/patologia , Chlamydia trachomatis/patogenicidade , Fertilidade , Infecções do Sistema Genital/complicações , Infecções do Sistema Genital/patologia , Espermatozoides/fisiologia , Animais , Movimento Celular , Sobrevivência Celular , Chlamydia muridarum/patogenicidade , Modelos Animais de Doenças , Humanos , Peroxidação de Lipídeos , Masculino , Camundongos Endogâmicos C57BL , Espécies Reativas de Oxigênio/metabolismoRESUMO
Sexually transmitted infections are an important cause of morbidity among sexually active women worldwide, and have been implicated as cofactors in the pathogenesis of cervical cancer. We investigated the prevalence of human papillomavirus (HPV), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV), and accessed the diversity of HPV in women with normal and abnormal cytology in Manaus, Brazil. We used polymerase chain reaction and HPV genotyping by direct sequencing. The chi-square test was used to calculate the absolute and relative frequencies of the categorical variables, and Fisher's test was used when P < 0.05. The level of significance was set at 5%. All statistical analyses were performed using R 2.9.0. There were statistically significant differences in age (P = 0.0395), education level (P = 0.0131), sexual partners (P = 0.0211), condom use (P = 0.0039), marital status (P < 0.0001), and pregnancy (P = 0.0003) between the normal and abnormal groups. HPV DNA was found in 36.56 and 93.88% of subjects in the normal and abnormal groups, respectively. A total of 19 genotypes were detected; HPV16 was the most common, followed by HPV58. The percentages of TV and CT DNA were 18.04 and 9.02% in the normal group, respectively. The percentages of HPV/TV and HPV/CT coinfection were 12.5% each in women with normal cytology. These findings improve our understanding of HPV, CT, and TV, and the distribution of HPV types, which may be relevant to vaccination strategies for protecting women from the north of Brazil from cervical cancers and precancerous lesions.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/genética , Genótipo , Papillomaviridae/genética , Infecções por Papillomavirus/epidemiologia , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/genética , Adolescente , Adulto , Brasil , Infecções por Chlamydia/microbiologia , Infecções por Chlamydia/patologia , Chlamydia trachomatis/isolamento & purificação , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Prevalência , Vaginite por Trichomonas/parasitologia , Vaginite por Trichomonas/patologia , Trichomonas vaginalis/isolamento & purificaçãoRESUMO
OBJECTIVE: This study included women attending primary health care units in Botucatu, São Paulo, Brazil, to assess the cervicovaginal levels of human ß-defensin (hBD) 1, 2, 3, and 4 during Chlamydia trachomatis infection. PATIENTS AND METHODS: Cervicovaginal samples were collected for Pap testing and assessing the presence of infection by C. trachomatis, human papillomavirus, Neisseria gonorrhoeae, and Trichomonas vaginalis. Vaginal smears were taken to evaluate local microbiota. Human ß-defensin levels were determined using enzyme-linked immunosorbent assay in cervicovaginal fluid samples. Seventy-four women with normal vaginal microbiota and no evidence of infection were included in hBD quantification assays; 37 tested positive for C. trachomatis and 37 were negative. Statistical analysis was performed using Mann-Whitney U test. RESULTS: Women positive for C. trachomatis had significantly lower cervicovaginal hBD-1, hBD-2, and hBD-3 compared with those who tested negative (hBD-1: 0 pg/mL [0-2.1] vs 1.6 pg/mL [0-2.4], p < .0001; hBD-2: 0 pg/mL [0-3.9] vs 0.61 pg/mL [0-8.9], p = .0097; and hBD-3: 0 pg/mL [0-4.3] vs 0.28 pg/mL [0-8.4], p = .0076). Human ß-defensin 4 was not detected. CONCLUSIONS: Lower levels of hBD-1, hBD-2, and hBD-3 in cervicovaginal fluid were detected in the presence of C. trachomatis infection.
Assuntos
Colo do Útero/patologia , Infecções por Chlamydia/patologia , Chlamydia trachomatis/isolamento & purificação , Vagina/patologia , beta-Defensinas/análise , Adolescente , Adulto , Brasil , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
Objetivo: Detectar la prevalencia de Chlamydia t. en mujeres embarazadas del Hospital Prof. A. Posadas. Materiales y método. Diseño: Se realizó un estudio observacional descriptivo y prospectivo, en el servicio de Obstetricia del Hospital Nacional Prof. Dr. A. Posadas en Argentina, en el área de Patología Tracto Genital Inferior durante el período comprendido entre Octubre 2015 a Enero del año 2016. A todas las mujeres embarazadas que concurrieron a realizarse el Papanicolaou y colposcopía, se les extrajo muestras del contenido vaginal y endocervical. Las muestras endocervicales fueron analizadas por Técnica Real Time por PCR. Criterios de Inclusión: Todas las mujeres embarazadas que llegan al consultorio de Área Patología Tracto Genital Inferior por 1ra vez a realizarse un Papanicolaou. Resultados: El total de mujeres embarazadas estudiadas en ese periodo fue de 270, de las cuales el 12,22 % (33) fueron positivas para la banda de amplificación compatible con ADN de Chlamydia t. De las positivas el 73 % de las embarazadas (24) eran menores de 25 años. De las 270 mujeres embarazadas estudiadas el 57,40 % fueron menores de 25 años (155). Esto coincide con la casuística internacional que sugiere la búsqueda de Chlamydia t. en todas las mujeres menores de 25 años. Además, de las 33 (12%) que fueron positivas para Chlamydia t., 22 (67%) de ellas fueron asintomáticas. Conclusiones: Se sugiere el screening rutinario de Chlamydia t. por PCR a todas las mujeres embarazadas menores de 25 años, para evitar las graves complicaciones neonatales como así también las complicaciones puerperales frecuentes por esta infección.
The order Chlamydiales contains only a single genus, Chlamydia, and three species C. psittaci, C trachomatis, and C pneumonia. All three are obligate, intracellular parasites with a relatively complex life cycle. C trachomatis is capable of infecting transitional and columnar epithelial cells of the conjunctiva, respiratory tract, and urogenital tract. Untreated infection may resolve spontaneously or progress to a low-grade persistent infection. In either case, it usually can produce serious sequelae moreover if it is reactivated or a reinfection occurs. Objective: the aim of the present report was to detect the prevalence of Chlamydia trachomatis in pregnant women in the "A. Posadas" Hospital. Design: an observational descriptive and prospective survey was performed, at the Obstetric Service of the National tal "A. Posadas" from Argentina, in the Area of Lower Genital Tract Pathology, during the period between October 2015 through January 2016. To all the pregnant women assisted to perform a Papanicolaou test and colposcopy, samples of the vaginal and endocervical content were obtained, . The endocervical samples were analyzed by Real Time Technique. Results: The total of the pregnant women studied in that period were 270, of whom 12,22% (33) were positive with the AND of Chlamydia t. From the positive patients 73 % of the pregnants (24) were younger than 25 years. Out of the 270 pregnant women studied, 57,40% were younger than 25 years (155). These data coincide with the international casuistics that suggests a searching for Chlamydia t. in all women younger than 25 years. Besides, of the 33 (12%) that were positives for Chlamydia t. , 22 (67%) were asymptomatic. Conclusions: It is suggested the rutinary screening for Chlamysia t. in all the pregnant women younger than 25 years, to avoid the severe neonatal complications and also the puerperal complications frecquent in this infection.
Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Gravidez , Infecções por Chlamydia/patologia , Chlamydia trachomatis , Programas de Rastreamento , Epidemiologia Descritiva , Estudos Prospectivos , Colposcopia , Teste de PapanicolaouRESUMO
BACKGROUND: Chlamydia trachomatis urogenital infections are the leading cause of sexually transmitted bacterial infections. Although the prevalence of chlamydial infection is similar in men and women, current research is mainly focused on women, neglecting the study of male genital tract infections. We, therefore, investigated Chlamydia infection in the rodent male genital tract. MATERIALS AND METHODS: Male NOD and C57BL/6 mice were inoculated in the meatus urethra with C. muridarum. Bacterial DNA, leukocyte infiltration of male genital tract tissues, pelvic pain, and Chlamydia-specific immune responses were analyzed at different time points. RESULTS AND CONCLUSIONS: The inoculation of C. muridarum in the meatus urethra of male mice resulted in an ascending and widely disseminated infection of the male genital tract. C. muridarum remained longer and with the highest bacterial burdens in the prostate, thus showing a special tropism for this organ. Infection caused leukocyte infiltration, mainly composed by neutrophils, and also induced early pelvic pain development that rapidly dropped and resolved as the infection became chronic. Bacterial load and leukocyte infiltration was observed in all prostate lobes, although dorsolateral prostate was the most affected lobe. Interestingly, immune responses induced by both mice strains were characterized by the production of high levels of IL-10 during early stages of the infection, with highest and sustained levels observed in NOD mice, which showed to be less efficient in clearing the infection. Chronic infection of the prostate accompanied by local inflammation and pelvic pain development described herein have important implications for the improvement of the diagnosis and for the design of new efficient therapies. Prostate 77:517-529, 2017. © 2017 Wiley Periodicals, Inc.
Assuntos
Infecções por Chlamydia/patologia , Chlamydia muridarum , Dor Pélvica/microbiologia , Dor Pélvica/patologia , Próstata/microbiologia , Próstata/patologia , Animais , Infecções por Chlamydia/imunologia , Doença Crônica , Inflamação/imunologia , Inflamação/microbiologia , Inflamação/patologia , Leucócitos/imunologia , Leucócitos/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos NOD , Dor Pélvica/imunologia , Próstata/imunologia , Especificidade da Espécie , Uretra/imunologia , Uretra/microbiologia , Uretra/patologiaRESUMO
Chlamydia felis is an obligate intracellular bacterial pathogen that infects cats, causing severe conjunctivitis associated with upper respiratory tract disease (URTD). In the present study, 186 cats from three non-commercial catteries in São Paulo, SP, Brazil were evaluated. The detection of Chlamydia felis was performed by PCR. The clinical severity was scored from 1 to 4, with a score of 4 as the most severe manifestation. The total occurrence of C. felis was of 18.82% (35/186) of cats overall, but notably, 58.06% (18/31) of infected cats originated from a single cattery. All animals harboring C. felis had URTD clinical signs and higher scores (3 and 4). In addition, C. felis occurrence was associated with the presence of cryptic plasmid. However, the virulence and clinical severity were not correlated.
Assuntos
Doenças do Gato/microbiologia , Doenças do Gato/patologia , Infecções por Chlamydia/veterinária , Chlamydia/genética , Chlamydia/patogenicidade , Plasmídeos/análise , Animais , Brasil/epidemiologia , Doenças do Gato/epidemiologia , Gatos , Chlamydia/isolamento & purificação , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/microbiologia , Infecções por Chlamydia/patologia , Conjuntivite/epidemiologia , Conjuntivite/microbiologia , Conjuntivite/patologia , Conjuntivite/veterinária , DNA Bacteriano/genética , Reação em Cadeia da Polimerase , Prevalência , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/patologia , Infecções Respiratórias/veterinária , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Matrix metalloproteinases (MMP) are important enzymes in the tumor microenvironment associated with progression of cervical intraepithelial neoplasia (CIN) toward squamous cell carcinoma (SCC) of the cervix. However, the role of MMPs in the inflammatory process associated with Chlamydia trachomatis infection concomitant with the carcinogenic process driven by HPV has not yet been addressed. In the present study, we analyzed the state of the MMP-9-RECK axis in cervical carcinogenesis. METHODS: The levels of MMP-9 and RECK expression were analyzed by immunocytochemistry in liquid-based cytology samples from 136 women with high-grade cervical lesions (CIN2/CIN3) and cervical SCC diagnosed by LLETZ, and in 196 women without cervical neoplasia or CIN1. Real-time qPCR was performed to analyze expression of MMP-9 and RECK in 15 cervical samples. The presence of HPV-DNA and other genital pathogens was evaluated by PCR. RESULTS: We found a higher expression of MMP-9 [OR, 4.2; 95% confidence interval (CI), 2.2-7.8] and lower expression of RECK (OR, 0.4; 95% CI, 0.2-0.7) in women with CIN2/CIN3/SCC when compared with women from the control group (no neoplasia/CIN1). A statistically significant association was also found between MMP-9/RECK imbalance and infection by alpha-9 HPV and C. trachomatis. The prevalence of C. trachomatis infection was significantly higher in women with high-grade cervical disease (OR, 3.7; 95% CI, 1.3-11.3). CONCLUSIONS: MMP-9/RECK imbalance in cervical smears is significantly associated with high-grade cervical diseases and infection by alpha-9 HPV and C. trachomatis. IMPACT: MMP-9/RECK imbalance during cervical inflammation induced by C. trachomatis might play a role in HPV-mediated cervical carcinogenesis.
Assuntos
Infecções por Chlamydia/genética , Proteínas Ligadas por GPI/genética , Regulação Neoplásica da Expressão Gênica , Metaloproteinase 9 da Matriz/genética , Infecções por Papillomavirus/genética , Neoplasias do Colo do Útero/genética , Cervicite Uterina/genética , Adulto , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/virologia , Colo do Útero/metabolismo , Colo do Útero/patologia , Infecções por Chlamydia/metabolismo , Infecções por Chlamydia/patologia , Chlamydia trachomatis/genética , Estudos Transversais , DNA Bacteriano/genética , DNA de Neoplasias/genética , DNA Viral/genética , Feminino , Proteínas Ligadas por GPI/biossíntese , Regulação Bacteriana da Expressão Gênica , Genótipo , Papillomavirus Humano 16/genética , Humanos , Imuno-Histoquímica , Metaloproteinase 9 da Matriz/biossíntese , Teste de Papanicolaou , Infecções por Papillomavirus/metabolismo , Infecções por Papillomavirus/virologia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/virologia , Cervicite Uterina/metabolismo , Cervicite Uterina/microbiologia , Esfregaço VaginalRESUMO
Although new chemotherapeutic drugs have been applied constantly, their efficacy for non-small cell lung cancer (NSCLC) is still not satisfactory. In recent years, epidemiological investigations have shown that lung cancer may be induced by chronic Chlamydia pneumoniae (Cpn) infection, since stable high titers of Cpn antibodies, especially IgA, are a hallmark of chronic infections. Azithromycin is commonly used for the treatment of Cpn infections; however, there are only few reports regarding the application of azithromycin (A) combined with paclitaxel and cisplatin (TP) for advanced NSCLC. Considering that patients with NSCLC have a higher rate of Cpn infection, we proposed to employ azithromycin for Cpn infection in chemotherapy for advanced NSCLC. The aim of this study was to explore the effects of azithromycin on chemotherapy for NSCLC. A total of 86 patients with stage III-IV NSCLC were randomly divided into TP and ATP groups; the characteristics of patients in the two groups showed no significant differences. The TP group was treated with paclitaxel and cisplatin, and the ATP group was treated with azithromycin combined with TP for at least 4 weeks, followed by evaluation and comparison of efficacy, side effects and patients' quality of life before and after chemotherapy between the two groups. Testing for Cpn infection revealed a significant difference in the case number before and after therapy in the ATP group (P < 0.01) compared with the TP group (P > 0.05), and a statistical difference was observed (P < 0.01) between the ATP and TP groups after treatment. The changes in quality of life of patients after two different chemotherapy regimens were statistically significant (P < 0.05), but there was a significant difference in only cognitive function after treatment. The changes in symptom scores of patients after the two different chemotherapy regimens were statistically significant (P < 0.05), but there was a significant difference in only shortness of breath and cough after treatment. Kaplan-Meier estimate was utilized to describe the survival function of patients in the two groups. The median survival time was 12.0 months for the TP group and 13.0 months for the ATP group. One-year survival rates of the TP and ATP groups were 45.0 and 75.0%, respectively, which were significantly different (P < 0.05). Our study of azithromycin+paclitaxe l+cisplatin on stage III-IV NSCLC patients achieved favorable results in terms of side effects and overall survival.
Assuntos
Azitromicina/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Infecções por Chlamydia/tratamento farmacológico , Cisplatino/administração & dosagem , Paclitaxel/administração & dosagem , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/patologia , Infecções por Chlamydia/complicações , Infecções por Chlamydia/patologia , Chlamydophila pneumoniae/efeitos dos fármacos , Chlamydophila pneumoniae/patogenicidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Qualidade de VidaRESUMO
OBJECTIVE: The purpose of this study was to assess the cervicovaginal levels of proinflammatory cytokines in women with Chlamydia trachomatis (CT) infection in the presence of bacterial vaginosis (BV) and normal flora and to compare with those negative for CT. MATERIALS AND METHODS: In this cross-sectional study, nonpregnant women were enrolled at 2 outpatient clinics and at 1 primary medical care unit in São Paulo State, Brazil. Cervicovaginal samples from 256 women with BV, of which 68 (26.6%) had concomitant CT infection and 188 (73.4%) were CT-negative, were measured for interleukin-1ß (IL-1ß), IL-6, and IL-8 by enzyme-linked immunosorbent assay. A matching number of samples from women with normal flora, CT-positive (n = 68) and negative (n = 188), were evaluated as control. Cytokine levels were compared by Mann-Whitney test and differences were considered significant at p < .05. RESULTS: In CT-negative women, IL-1ß was increased in BV (p < .001) when compared to normal flora, while the levels of IL-6 and IL8 were unchanged. The presence of CT infection was not associated with differences on cytokine levels in women with normal flora. However, women with BV had higher levels of IL-1ß (p = .02), IL-6 (p = .02), and IL-8 (p = .03) in the presence of CT when compared to those who tested negative for CT. CONCLUSIONS: Detection of endocervical CT is associated with increased cervicovaginal IL-1ß, IL-6, and IL-8 levels in women with concomitant BV but not in those with normal flora.