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首页> 外文期刊>Infection and immunity >Hidden in Plain Sight: Chlamydial Gastrointestinal Infection and Its Relevance to Persistence in Human Genital Infection
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Hidden in Plain Sight: Chlamydial Gastrointestinal Infection and Its Relevance to Persistence in Human Genital Infection

机译：隐藏在纯净的视线中：衣原体胃肠道感染及其与人类生殖器感染持续存在的关系

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Although the concept of persistence in chlamydial infections has been recognized for about 80 years, there is still very little known about the mechanism by which this occurs. In this review, we revisit an old paradigm, long known to chlamydiologists and veterinarians, that in virtually all hosts of chlamydiae, including mammals and birds, chlamydiae reside in the gastrointestinal tract for long periods of time in the absence of clinical disease. Thus, if gastrointestinal infection occurs in most hosts, then it is very likely that gastrointestinal infection occurs in humans as well. We demonstrate that gastrointestinal infection does indeed occur in humans and propose that this anatomical site is the source of persistent infection in humans. The data in ruminants and animal models demonstrate that the immune system is unable to clear chlamydiae from the gut, so they can remain indefinitely, with continual shedding in feces. Clearly, many women become reinfected from an untreated partner; however, we propose that women, cured of genital infection, remain at risk for autoinoculation from the lower gastrointestinal tract. Moreover, there are substantial data demonstrating treatment failure of chlamydial infections, particularly with azithromycin. New data in the mouse model have shown that azithromycin is far less effective against chlamydial gastrointestinal infection than against genital infections. Therefore, it is possible that women cured of genital infection by antibiotics remain infected in the gastrointestinal tract and can become reinfected by autoinoculation from that site.
机译：尽管在衣原体感染中持续存在的概念已被认识了约80年，但对其发生机理的了解仍很少。在这篇综述中，我们回顾了衣原体学家和兽医长期以来所知的一个旧范例，即在几乎所有衣原体宿主中，包括哺乳动物和鸟类，在没有临床疾病的情况下，衣原体在胃肠道中长期居住。因此，如果在大多数宿主中发生胃肠道感染，那么很有可能在人类中也发生胃肠道感染。我们证明胃肠道感染确实确实发生在人类中，并提出该解剖部位是人类持续感染的来源。反刍动物和动物模型中的数据表明，免疫系统无法清除肠道中的衣原体，因此它们可以无限期保留，并在粪便中不断脱落。显然，许多妇女因未经治疗的伴侣而被重新感染。但是，我们建议治愈生殖器感染的妇女仍然面临下胃肠道自动接种的风险。此外，有大量数据表明衣原体感染，特别是阿奇霉素的治疗失败。小鼠模型中的新数据表明，阿奇霉素对衣原体胃肠道感染的疗效远不如对生殖器感染有效。因此，用抗生素治愈生殖器感染的妇女有可能在胃肠道中受到感染，并可能通过从该部位进行自动接种而再次感染。

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