Chlamydia trachomatis infection of the male genital tract: An update

MACKERN-OBERTI JP; MOTRICH RD; BRESER ML; SÁNCHEZ LR; CUFFINI C; RIVERO VE

JOURNAL OF REPRODUCTIVE IMMUNOLOGY.

ELSEVIER IRELAND LTD

Lugar: Amsterdam; Año: 2013 vol. 100 p. 37 - 53

0165-0378

Chlamydia trachomatis (CT) is the most prevalent cause of sexually transmitteddiseases. Although the prevalence of chlamydial infection is similar in men andwomen, current research and screening are still focused on women, who develop themost severe complications, leaving the study of male genital tract (MGT)infection underrated. Herein, we reviewed the literature on genital CT infection with special focus on the MGT. Data indicate that CT certainly infects different parts of the MGT such as the urethra, seminal vesicles, prostate, epididymis and testis. However, whether or not CT infection has detrimental effects on malefertility is still controversial. The most important features of CT infection areits chronic nature and the presence of a mild inflammation that remainssubclinical in most individuals. Chlamydia antigens and pathogen recognitionreceptors (PRR), expressed on epithelial cells and immune cells from the MGT,have been studied in the last years. Toll-like receptor (TLR) expression has beenobserved in the testis, epididymis, prostate and vas deferens. It has beendemonstrated that recognition of chlamydial antigens is associated with TLR2,TLR4, and possibly, other PRRs. CT recognition by PRRs induces a local productionof cytokines/chemokines, which, in turn, provoke chronic inflammation that might evolve in the onset of an autoimmune process in genetically susceptibleindividuals. Understanding local immune response along the MGT, as well as thecrosstalk between resident leukocytes, epithelial, and stromal cells, would becrucial in inducing a protective immunity, thus adding to the design of newtherapeutic approaches to a Chlamydia vaccine.