The immunology of Chlamydia trachomatis.
Chlamydia trachomatis (C. trachomatis) is one of the most common sexually transmitted bacterial agents. What distinguishes it from other organisms is its intracellular reproductive cycle. Up to now, four antigens have been identified in the Chlamydia genus: genus-specific antigen as well as species-specific, type-specific and subspecies-specific. C. trachomatis is a powerful immunogen which stimulates the host's immunological processes. The intracellular parasitism of the bacteria is the basis for both symptomatic or asymptomatic infection as well as for chronic ones. The primary infection leads to a local inflammatory reaction due to penetration and reproduction of the bacteria in the epithelial cells and to IgA secretory antibody production. In most cases the host's reaction to the primary infection is transient and does not cause tissue damage. In the course of chronic infection or reinfection, the most important processes are those of delayed hypersensitivity, which lead to a fast and intense immunological reaction of specifically sensitized Th1 lymphocytes. This reaction leads to progressive damage of the epithelial cells and to cicatrization and fibrosis, which means irreversible complications. Interferon gamma is of special importance in the process of C. trachomatis infection. High concentrations of it inhibit the bacteria's reproductive cycle, while lower concentrations promote the development of atypical, non-contagious forms of Chlamydia of diminished metabolic activity and altered antigenicity. The chlamydial heat shock proteins are considered to be of great importance lately. Their molecular weights of 60 and 10 kDa are a powerful stimulant of immunological reactions and show significant homology (40-90%) to human and other bacterial heat shock proteins.