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Chlamydia: a global health question?

A leading researcher in the field of immunogenetics, Servaas Morré has investigated women’s genetic susceptibilities to Chlamydia trachomatis, recently co-authoring “NOD1 in contrast to NOD2 functional polymorphism influence Chlamydia trachomatis infection and the risk of tubal factor infertility” in a thematic issue of Pathogens and Disease. We sat down with Morré to discuss his findings about the most common sexually transmitted bacterial infection and the impact his research will have on treatment in the years to come.

What first interested you in specializing in Chlamydia research?

Chlamydia trachomatis is the most prevalent bacterial STD, with over 100 million new infections each year. The disease causes Pelvic Inflammatory Disease (PID), ectopic pregnancy, and tubal infertility, which is the reason for the many treatment and screening studies that combat this devastating infection.

In addition, the unique development cycle of Chlamydia trachomatis and its immunological interaction with its host create challenges in finding new treatment and vaccine approaches for its elimination.

Can you explain how Chlamydia can increase the probability of transmitting HIV?

This is the double edged sword. When Chlamydia exists before an HIV infection, it predisposes the subjects to HIV; and when HIV exists before a Chlamydia infection, it increases the risk of Chlamydia infection.

When a Chlamydia trachomatis infection goes untreated (which is the case in high-prevalence HIV regions), viral shedding will increase, as will the probability of HIV transmission during intercourse with an uninfected partner. With this in mind, HIV and STD detection and treatment should always be advocated for as a combined effort to manage these infections, especially in developing countries.

How does treatment of Chlamydia in Europe differ from the rest of the world?

In Europe—especially Eastern Europe—the treatment and screening of Chlamydia trachomatis is often suboptimal, which means partner treatment, monitoring during pregnancy, and risk group analyses could be improved. In the rest of the world, however, the problem is far more serious.

In a presentation on Chlamydia trachomatis at the 10th Annual Amsterdam Chlamydia Meeting in Africa, Dr. Remco Peters reported that countries with a Chlamydia trachomatis prevalence of over 20% displayed major problems in combating the infection. These problems include challenges in Chlamydia trachomatis management and control, lack of awareness among those infected, and struggles to incorporate the issue on the international public health agenda.

Can you describe how your research into Chlamydia and female infertility may affect medical approaches to infertility?

In Western society, 15% of couples are infertile, meaning they do not conceive within one year and will attend a fertility clinic or gynecologist. Chlamydia trachomatis is the major pathogen involved in infertility due to its ability to cause tubal pathology. This is only believed to occur in a subgroup of women who cannot combat Chlamydia trachomatis infection due to adverse genetic variation in genes involved in pathogen recognition and inflammatory responses. The genetic background of host pathogen interaction is expected to provide new personalized medical diagnostic approaches in the field of female infertility to decrease current misdiagnosis.

Image Credit: “McFarland standards, number 0.5, 1 and 2 from left to right” by Akaniji. CC by 3.0 via Wikimedia Commons.

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