Trachoma: an update on prevention, diagnosis, and treatment.

F. I Proctor Foundation and Department of Ophthalmology, University of California-San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, USA.
Current opinion in ophthalmology (Impact Factor: 2.64). 05/2012; 23(4):288-95. DOI: 10.1097/ICU.0b013e32835438fc
Source: PubMed

ABSTRACT To review recent clinical and epidemiological studies regarding the prevention, diagnosis, and treatment of trachoma.
Newer studies propose novel diagnostic tests that appear sensitive for the detection of ocular chlamydial infection. For example, recent studies with ribosomal RNA-based nucleic acid amplification tests (NAATs) have demonstrated improved sensitivities compared to DNA-based NAATs; and the progression of scarring has now been characterized with confocal microscopy. Immunologic studies have further explored the etiology of clinical sequelae, suggesting that chronic inflammation can lead to progressive scarring even in the absence of Chlamydia. Mass oral azithromycin distributions remain a mainstay of treatment; studies have assessed the appropriate frequency and duration of treatment programs. Current studies have also explored ancillary effects of azithromycin distribution on mortality and bacterial infections.
Trachoma programs have had remarkable success at reducing chlamydial infection and clinical signs of trachoma. Recent work suggests improved methods to monitor infection and scarring, and better ways to distribute treatment. Whereas studies continue to demonstrate reduction in infection in hyperendemic areas, more work is necessary to achieve elimination of this blinding disease.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Here, we report the draft genome sequence of high-temperature-adapted Protochlamydia sp. strain HS-T3, an environmental chlamydia. This bacterium is an amoebal endosymbiont, found in Acanthamoeba isolated from a hot spring in Japan. Strain HS-T3 readily grew in mammalian cells at 37°C, a characteristic not previously reported for environmental chlamydiae. FOOTNOTES Address correspondence to Hiroyuki Yamaguchi, hiroyuki{at} Citation Yamaguchi H, Matsuo J, Yamazaki T, Ishida K, Yagita K. 2015. Draft genome sequence of high-temperature-adapted Protochlamydia sp. HS-T3, an amoebal endosymbiotic bacterium found in Acanthamoeba isolated from a hot spring in Japan. Genome Announc 3(1):e01507-14. doi:10.1128/genomeA.01507-14. Received 12 December 2014. Accepted 29 December 2014. Published 5 February 2015. Copyright © 2015 Yamaguchi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 Unported license.
    Genome Announcements 02/2015; 3(1). DOI:10.1128/genomeA.01507-14
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Lymphogranuloma venereum is a sexually transmitted infection caused by the Chlamydia trachomatis serovars L1-3. It has been found to be endemic in tropical countries. In the last decades several cases have been reported in Western Europe, particularly in men who have sex with men population infected with human immunodeficiency virus. The authors present three cases of lymphogranuloma venereum infections, observed at their department in 2013 and 2014. The three human immunodeficiency virus infected patients who belonged to men who have sex with men population had casual sexual contacts in Western Europe. The symptoms included urethral discharge, discomfort and inguinal lymphadenomegaly in two patients, and rectal pain, discharge and perianal ulceration in one patient. The diagnosis was confirmed by nucleic acid amplification test performed in samples obtained from urethral discharge and exudate of perianal ulcer; lymphogranuloma venereum 2b serovars were demonstrated in two patients and serovar 2 in one patient. Doxycyclin (daily dose of two times 100 mg for 21 days) resolved the symptoms in all cases. The authors conclude that lymphogranuloma venereum is a diagnostic challenge in Hungary, too. It is important to be aware of the altered clinical features of this disease to prevent complications and spreading. Orv. Hetil., 2015, 156(1), 36-40.
    Orvosi Hetilap 01/2015; 156(1):36-40. DOI:10.1556/OH.2015.30083
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Given the established role of Chlamydia spp. as causative agents of both acute and chronic diseases, search for new antimicrobial agents against these intracellular bacteria is required to promote human health. Isoflavones are naturally occurring phytoestrogens, antioxidants and efflux pump inhibitors, but their therapeutic use is limited by poor water-solubility and intense first-pass metabolism. Here, we report on effects of isoflavones against C. pneumoniae and C. trachomatis and describe buccal permeability and initial formulation development for biochanin A. Biochanin A was the most potent Chlamydia growth inhibitor among the studied isoflavones, with an IC50 = 12 µM on C. pneumoniae inclusion counts and 6.5 µM on infectious progeny production, both determined by immunofluorescent staining of infected epithelial cell cultures. Encouraged by the permeation of biochanin A across porcine buccal mucosa without detectable metabolism, oromucosal film formulations were designed and prepared by a solvent casting method. The film formulations showed improved dissolution rate of biochanin A compared to powder or a physical mixture, presumably due to the solubilizing effect of hydrophilic additives and presence of biochanin A in amorphous state. In summary, biochanin A is a potent inhibitor of Chlamydia spp., and the in vitro dissolution results support the use of a buccal formulation to potentially improve its bioavailability in antichlamydial or other pharmaceutical applications.
    PLoS ONE 12/2014; 9(12):e115115. DOI:10.1371/journal.pone.0115115 · 3.53 Impact Factor