Indiana University-Purdue University Indianapolis (IUPUI) / Chlamydia trachomatis is the leading cause of bacterial sexually transmitted disease. Chlamydia spp. are all obligate intracellular organisms that undergo a biphasic developmental cycle within a vacuole termed the inclusion. Infectious, non metabolically active elementary bodies (EBs) are endocytosed and differentiate into non infectious, metabolically active reticulate bodies (RBs) before re-differentiating back into EBs. The chlamydial factors that mediate these differentiation events are mostly unknown. Comparative genomics revealed that Chlamydia spp. have small, highly conserved genomes, suggesting that many of their genes may be essential. Genetic manipulation strategies for Chlamydia spp. are in their infancy, and most of these cannot be used to inactivate essential genes. We generated a clonal ethyl methanesulfonate (EMS)-mutagenized C. trachomatis library and screened it for temperature sensitive (TS) mutants that produced fewer inclusions at either 32°C or 40°C compared to 37°C. Because EMS mutagenesis elicited multiple mutations in most of the library isolates, we also developed a novel lateral gene transfer strategy for mapping mutations linked to TS phenotypes. We identified TS alleles of genes that are essential in other bacteria and that are involved in diverse biological processes including DNA replication, protein synthesis, carbohydrate metabolism, fatty acid biosynthesis, and energy generation, as well as in highly conserved chlamydial hypothetical genes. TS DNA polymerase (dnaEts) and glutamyl-tRNA synthestase (gltXts) mutants were characterized further. Both the dnaEts and gltXts mutants failed to replicate their genomes at 40°C but exhibited unique signs of stress. Chlamydial DNA replication begins by 12 hpi and protein synthesis begins by 2 hpi. However, inclusion expansion and replication of both of the mutants could be rescued by shifting to them to 37°C prior to mid-late development. Since gltXts is likely unable to produce aminoacyl-tRNAs at 40°C, our observation suggests that de novo chlamydial translation uses a pre-existing pool of aminoacyl-tRNA in EBs. Genetic suppressor analysis indicated that the inability of the dnaEts mutant to replicate its genome at 40°C might be linked to an inability of mutant DnaE to bind the DNA template. The tools and mutants we have identified will be invaluable assets for investigating many essential aspects of chlamydial biology.

The population for this study consisted of 4013 sexually active women seen for family planning. Culture for Chlamydia trachomatis yielded an isolation rate of 6.1%. Women aged 16 to 25 accounted for 81.7% of the C. trachomatis infections, while those younger than 16 or older than 35 accounted for only 2.4% of the infections. Of the 246 patients whose cultures were positive for C. trachomatis, 159 (65%) were asymptomatic. The incidence of C. trachomatis was 11.2% among those with symptoms but only 6.4% among the asymptomatic group. Among 63 patients with Neisseria gonorrhoeae (who were excluded from the study), 26 (41.3%) also were infected by C. trachomatis. There were no microbiologic drug failures with erythromycin or clindamycin. Of 56 patients who enrolled in the clindamycin arm of the protocol, 48 (85.7%) completed therapy and experienced microbiologic and clinical cures. In contrast, erythromycin therapy was completed by only 25 of 57 women (43.9%) enrolled. The number of side effect failures for erythromycin was 22 of 57 (38.6%). This was more than five times the number of side effect failures for clindamycin (4 of 56, or 7.1%).

Chlamydia is the most prevalent sexually transmitted bacterial infection in many developed countries, including Canada. Untreated infections in women can lead to a number of complications including pelvic inflammatory disease, tubal factor infertility, and ectopic pregnancy. Public health programs, including screening for at-risk individuals, partner identification, and antibiotic treatment, have had limited success in controlling the rising incidence of chlamydial infections over the past two decades. A chlamydia vaccine that prevents infection and its pathological sequelae is the next essential step to control this persistent public health problem. Chlamydia spp. utilize the highly conserved type III secretion (T3S) system as an essential virulence factor for infection and intracellular replication. Here, we evaluated a novel chimeric antigen (BD584) consisting of three T3S proteins from C. trachomatis (CopB, CopD, and CT584) as a potential chlamydia vaccine candidate. Intranasal immunization with BD584 elicited strong humoral responses that neutralized infection in vitro. Following intravaginal challenge with C. muridarum, immunized mice had a 95% reduction in chlamydial shedding and a 87.5% reduction in incidence of upper genital tract pathology compared to control mice. BD584 immunization generated strong cell-mediated and mucosal antibody responses in mice with different genetic backgrounds, and conferred protection against an intravaginal C. trachomatis infection in two out of three strains of mice. BD584 formulated with NE01, a mucosal adjuvant known to be safe and effective in humans, was shown to be highly immunogenic and efficacious against C. trachomatis infection in mice. These results suggest that BD584 may represent a promising antigen for use in a chlamydia vaccine. / Thesis / Doctor of Philosophy (PhD) / Chlamydia is the most common sexually transmitted bacterial infection in the world. The goal of this thesis is to evaluate a novel chlamydia vaccine in a mouse model of genital chlamydia infection. We engineered a fusion protein, BD584, made up of three highly conserved type III secretion (T3S) proteins CopB, CopD, and CT584. We show that vaccination with BD584 generated strong immune responses and protected mice from chlamydia infection and the associated reproductive tract disease. Interestingly, the level of protection afforded by BD584 vaccination is dependent upon the genetic background of the animal. Furthermore, we have identified particular antibody subtypes directed against BD584 as markers of BD584-mediated protective immunity. Lastly, we show that vaccination with BD584 formulated with a clinically safe and effective mucosal adjuvant generates robust immune responses and confers protection against chlamydia in mice. Together, these results provide support for the use of T3S proteins in a chlamydia vaccine.

Infectious disease remains one of the leading causes of morbidity and mortality worldwide. Many bacteria that cause disease have the capacity to enter into eukaryotic cells such as epithelial cells and tissue macrophages. Gaining access into the intracellular environment is one of the most critical steps in their survival and/or in pathogenesis. The entry mechanisms employed by these organisms vary considerably, but most mechanisms involve sabotaging and manipulating host cell functions. Invasion of epithelial cells involves triggering host signal transduction mechanisms to induce cytoskeleton rearrangement, thereby facilitating bacterial uptake. My work focuses on understanding the molecular mechanisms employed by bacterial pathogen Listeria monocytogenes and Chlamydia trachomatis to gain access into the host cells in order to cause the disease. In first part of my thesis I investigated the mechanism of Listeria monocytogenes entry. Listeria, a facultative intracellular organism, is responsible for causing meningitis, septicemia, gastroenteritis and abortions. Critical for Listeria virulence is its ability to get internalized, replicates and spread into adjacent host cells. One of the pathways of Listeria internalization into mammalian cells is promoted by binding of its surface protein Internalin B (InlB) to host receptor MET. Studies done in the past demonstrated a critical role of host type IA Phosphoinositide (PI) 3-kinase in controlling cytoskeleton rearrangement and entry of Listeria downstream of MET. An important unresolved question was how activation of PI3K results in cytoskeleton rearrangements that promote Listeria entry. In this work, we identified 9 host signaling molecules, that iv includes Rab 5c, SWAP 70, GIT1, PDK1, mTor, ARAP2, ARNO, DAPP1 & PKC-δ, acting downstream of type IA Phosphoinositide (PI) 3-kinase to regulate changes in host cytoskeleton to cause Listeria entry. Second part of my thesis involved studying the functions of chlamydial effector protein Tarp in its invasion. Infection caused by Chlamydia Trachomatis is the most common sexually transmitted disease resulting in uro-genital diseases, LGV, ectopic pregnancy and infertility. It is also responsible for causing trachoma, the leading cause of preventable blindness in third world countries. Being an obligate intracellular pathogen, gaining access into intracellular environment is the most critical step in lifecycle and pathogenesis of Chlamydia. Previous studies demonstrate the role of both chlamydial and host actin nucleators, Tarp and Arp2/3 complex respectively, in mediating Chlamydial entry into non-phagocytic cells. But the molecular details of these processes were not well understood. In this study, we demonstrate novel function of Tarp protein to form actin bundles by its ability to bind filamentous actin through newly identified FAB domains. And we also provide bio-chemical evidence that Tarp and Arp2/3 complex works in conjunction to cause changes in host cytoskeleton that effectively culminate into bacterial uptake by host cells. Overall, this research was a significant step in enhancing our understanding, at a molecular level, to pathogenesis of infections caused by Listeria monocytogenes and Chlamydia trachomatis

A mouse in vitro co-culture model between endometrial epithelial cells (EEC) and peripheral blood lymphocytes and monocytes (PBLM) immune cells was established, and Ct lipopolysaccharide (LPS) was added to the cells to mimic Ct bacterial infection and to stimulate an immune response. This model enabled us to study the cross-talk between EEC and PBLM and the physiological changes that occur in the endometrium upon Ct LPS stimulation. Results showed that EEC-PBLM co-culture and Ct LPS stimulation caused changes in transepithelial resistance (TER) as well as the expression and function of the cystic fibrosis transmembrane conductance regulator (CFTR) ion channel of epithelial cells. CFTR gene transcription was up-regulated at early hours after Ct LPS stimulation, while its channel activity was down-regulated at later hours. These results suggested the possible involvement of CFTR acting as a receptor for the internalization of Ct, which may ultimately lead to the disappearance of CFTR on the apical membrane. The EEC-PBLM co-culture showed that cross-talk was important for host defense in the endometrium. Direct cross-talk by cell-cell contact between EEC and PBLM was vital for immune cell survival as well as strengthening epithelials' barrier function. (Abstract shortened by UMI.) / Chlamydia trachomatis (Ct) infection is one of the most prevalent causes for sexually transmitted disease (STD) in the female reproductive tract. Ct is unique in that it is a bacterium, but infects and replicates like a virus inside a host cell. Ct infection can lead to a variety of reproductive diseases, such as pelvic inflammatory diseases (PID), tubule scarring, salpingitis, endometriosis, ectopic pregnancy and infertility. Effective immune defense in the uterus is necessary to eliminate these bacteria and to ensure optimal uterine environment for sperm motility, fertilization, and embryo implantation to occur. The immune system of the endometrium responds to Ct infection by the recruitment of many types of leukocytes, such as T-lymphocytes, B-lymphocytes, monocytes, macrophages and neutrophils, to the site of infection. Cross-talk between endometrial epithelial cells and immune cells may alter the activities of epithelial cells causing changes in channels function and anion secretion. / Ho Alice. / "August 2005." / Adviser: Chan Hsiao Chang. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3532. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 155-167). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.

Genomic analysis is a new approach for the characterization and investigation of novel genes, gene clusters, the function of uncharacterized proteins, and genetic diversity in microorganisms. These approaches are important for the study of chlamydiae, a system in which several genomes have been sequenced but in which techniques for genetic manipulation are not available. The objective of this thesis is to combine computer-based analysis of chiamydial inclusion membrane proteins (Incs) with cellular and molecular biological analysis of the bacteria. Three different experimental lines of investigation were examined, focusing on Incs of C. trachomatis and C. pneumoniae. Chlamydiae are obligate intracellular bacteria that develop within a nonacidified membrane bound vacuole termed an inclusion. Putative Inc proteins of C. trachomatis and C. pneumoniae were identified from genomic analysis and a unique structural motif. Selected putative Inc proteins are shown to localize to the inclusion membrane. Chiamydia trachomatis variants with unusual multiple-lobed, nonfusogenic, inclusion were identified from a large scale serotyping study. Fluorescence microscopy showed that IncA, a chiamydial protein localized to the inclusion membrane, was undetectable on non-fusogenic inclusions of these variants. Sequence analysis of incA from non-fusogenic variant isolates revealed a defective incA in most of the variants. Some variants lack not only IncA on the inclusion membrane but also CT223p, an additional Inc protein. However, no correlation between the absence of CT223p and distinctive inclusion phenotype was identified. Nucleotide sequence analysis revealed sequence variations of C. trachomatis incA and CT223 in some variant and wild type isolates. Comparative analyses of the three recently published C. pneumoniae genomes have led to the identification of a novel gene cluster named the CPn1O54 gene family. Each member of this family encodes a polypeptide with a hydrophobic domain characteristic of proteins localized to the inclusion membrane. These studies provided evidence that gene variation might occur within this single collection of paralogous genes. Collectively, the variability within this gene family may modulate either phase or antigenic variation, and subsequent physiologic diversity, within a C. pneumoniae population. These studies demonstrate the genetic diversity of Inc proteins and candidate Inc proteins, within and among the different chiamydial species. This work sets the stage for further investigations of the structure and function of this set of proteins that are likely critical to chlamydial intracellular growth. / Graduation date: 2003

The Chlamydiaceae are widespread pathogens of both humans and animals. Chlamydia trachomatis infection causes blinding trachoma and reproductive complications in humans. Chlamydia pneumoniae causes human respiratory tract infections and atypical pneumonia. Chlamydia suis infection is associated with conjunctivitis, diarrhea, and failure to gain weight in domestic swine. Chlamydial infections in humans and domesticated animals are generally controlled by antibiotic treatment—particularly macrolides (usually azithromycin) and tetracyclines (tetracycline and doxycycline). Tetracycline-containing feed has also been used to limit infections and promote growth in livestock populations, although its use has decreased because of growing concerns about antimicrobial resistance development. Because Sandoz and Rockey published an elegant review of chlamydial anti-microbial resistance in 2010, we will review the following: (i) antibiotic resistance in C. suis, (ii) recent evidence for acquired resistance in human chlamydial infections, and (iii) recent non-genetic mechanisms of antibiotic resistance that may contribute to treatment failure.

Les amibes appartenant au genre Acanthamoeba sont ubiquitaires et responsables de diverses infections, en particulier de kératite amibienne. Par ailleurs elles sont résistantes à de nombreux traitements de désinfection, aussi bien sous leur forme libre (trophozoite) que sous leur forme enkystée. La plupart des données d’efficacité disponibles ont évalué des biocides utilisés pour la désinfection de l’eau potable et/ou des lentilles de contact, mais peu de données sont disponibles concernant le traitement des surfaces ou des matériels médicaux. Ces amibes sont également capables de servir de réservoir à des bactéries pathogènes, notamment des nouvelles espèces de Chlamydia regroupées sous le terme « Chlamydia-like ». Il s’agit de bactéries découvertes récemment et potentiellement responsables d’infections respiratoires et d’avortements spontanés. Malgré leur importance, peu de données sont disponibles concernant la survie et la résistance aux biocides de ces bactéries. L’objectif de ce travail a été dans un premier temps d’évaluer la résistance des amibes aux traitements de désinfections, aussi bien pour les trophozoites que pour les kystes. Dans un second temps, nous avons étudié la survie et la résistance des Chlamydia-like à la désinfection, ainsi que leurs interactions avec les amibes et avec différentes lignées cellulaires ; Chlamydia trachomatis a servi de contrôle dans cette deuxième série d’expérimentations. Les méthodes de culture et d’enkystement des trophozoites ainsi que le choix des souches testées se sont avérés critiques pour l’évaluation des biocides. Certains traitements de désinfection généralement réputés efficaces contre la plupart des micro-organismes ont montré une efficacité limitée vis-à-vis des kystes amibiens ainsi que des trophozoites (glutaraldehyde). Les Chlamydia-like se sont avérées capables de survivre dans l’environnement pendant de longues périodes mais sont globalement sensibles aux désinfectants. Certaines de ces bactéries sont également capables de survivre dans les kystes d’amibes, ce qui peut leur conférer une résistance accrue vis-à-vis des biocides. / Acanthamoebae are ubiquitous amoebae responsible for several infections, mostly amoebic keratitis. They are also resistant to numerous disinfection treatments, as well under their free shape (trophozoite ) as under their encysted shape. Most of the available data of efficiency estimated biocides used for the disinfection of the drinking water and\or the contact lenses, but few data are available concerning the treatment of surfaces or medical devices. These amoebae are also capable of serving as reservoir for pathogenic bacteria, in particular for new species of Chlamydia named " Chlamydia-like ". These new bacteria recently discovered are potentially responsible for respiratory infections and miscarriages. Despite their importance, only few data are available concerning the survival and the resistance to biocides. The objective of this work was at first time to evaluate the resistance of amoebae to disinfection treatments, as well for the trophozoites as for the cysts. Secondly, we studied the survival and the resistance of Chlamydia-like to disinfection, as well as their interactions with amoebae and with various cellular lineages; Chlamydia trachomatis served as control in this second series of experiments. The methods of culture and encystement of trophozoites as well as the choice of selected strains turned out critical for the evaluation of biocides. Some treatments generally considered as effective treatments of disinfection against most of the microorganisms showed an efficiency limited towards the amoebic cysts as well as the trophozoites ( glutaraldehyde ). Chlamydia-like turned out capable of surviving in the environment during long periods but are globally sensitive to disinfectants. Some of these bacteria are also capable to surve in amoebal cysts, what can confer them a resistance increased towards biocides.

A Chlamydia trachomatis é um patógeno causador de doenças sexualmente transmissíveis (DST). Esse agente afeta significativamente a saúde sexual e reprodutiva de mulheres, estando relacionado à esterilidade em número bastante significativo,sendo também responsável por desfechos em gestantes acometidaspor DSTs no Brasil e no mundo. Apesar da sua alta prevalência, muito pouco se sabe sobre a distribuição de genótipos de Chlamydiatrachomatis. Este estudo teve como objetivo estimar a prevalência e os fatores associados à infecção causada por esse patógeno em gestantes admitidas na Maternidade da Fundação Santa Casa de Misericórdia do Pará. O estudo constou de uma amostra mínima de 363 gestantes atendidas por demanda espontânea, sendo incluídas na amostra o excedente de 32 gestantes totalizando 395 gestantes,em um período da coleta de 3 meses. Foram aplicados testes Qui-quadrado para verificação de associações entre as variáveis selecionadas para ump<0,05 como estatisticamente significativo. A prevalência de infecção porChlamydiafoi de 9,11%. A infecção porChlamydianão se associou à idade(p = 0,826),à realização de consulta pré-natal (p = 0,451),à presença de HIV (p = 0,379)ao exame VDRL(p = 0,344) ou à prematuridade (p = 0,229). O estudo mostra alta prevalência de infecção por Chlamydiatrachomatis em gestantes. A infecção urogenital por Chlamydia trachomatis representa uma importante causa de morbidade perinatal, que pode ser adequadamente tratada por antibioticoterapia durante a gestação. A prevalência da infecção mostrou-se também superior às obtidas em outras populações de gestantes, sendo o Estado do Pará considerado de alta prevalência para a infecção. Fatores de risco para DSTs, como baixa idade, ausência de parceiro fixo e concomitância com outras DSTs apresentam-se importantes também dentro do quadro da infecção por Chlamydia trachomatis. / Chlamydia trachomatis is a pathogen that causes sexually transmitted infections (STIs). This agent significantly affects the sexual and reproductive health of women, and is related to sterility in a rather significant number of cases. It is also responsible for outcomes in pregnant women who have STIs in Brazil and worldwide. Despite its high prevalence, very little is known about the distribution of Chlamydia trachomatis genotypes. The objective of this study was to estimate the prevalence and factors associated with infection caused by this pathogen in pregnant women admitted to the Maternity Department at Fundação Santa Casa de Misericórdia do Pará, in the state of Pará. Sample of 363 pregnant women seen due to spontaneous demand, and the sample included the surplus of 32 pregnant women, to a total of 395 pregnant women in a 3-month collection period. Chi-Square tests were applied to verify the associations between the variables selected for a p < 0.05 as statistically significant. The prevalence of Chlamydia infection was 9.11%. The result of Chlamydiawas not associated with age (p = 0.826), antenatal visit (p = 0.451), presence of HIV (p = 0.379) VDRL test (p = 0.344) and with prematurity (p = 0.229). The study shows a high prevalence of infection due to Chlamydiatrachomatis in pregnant women. Urogenital infection due to Chlamydia trachomatis is a major cause of perinatal morbidity, which can be treated by antibiotics during pregnancy. The prevalence of infection also proved superior to those obtained in other populations of pregnant women, and the state of Pará is considered a place with a high prevalence of the infection. Risk factors for STIs, such as young age, absence of a fixed partner and concomitance with other STIs are also important in the picture of infection by Chlamydia trachomatis.

The obligate intracellular bacterium, Chlamydia trachomatis, and Herpes Simplex Virus Type-2 (HSV-2) are the leading sexually transmitted pathogens in the world. These infections are usually asymptomatic and clinically mild, but complications can be severe. Reports of dual detection of Chlamydia and HSV within the genital tracts of humans led our laboratory to develop an in vitro Chlamydia/HSV co-infection model. Little is known regarding the specific pathogenesis of Chlamydia and HSV co-infections, but HSV-super-infection of Chlamydia-infected cells caused the chlamydiae to deviate from their normal developmental cycle into a non-replicative state termed persistence, or the chlamydial stress response. Interactions between HSV envelope protein, gD with host cell junction protein, nectin-1, were enough to stimulate the departure from normal chlamydial development. Additional data also suggested that there might be differences between single infection and co-infection outcomes in vivo. Thus, two diverging hypotheses were investigated here: i) that host nectin-1 is required for normal chlamydial development; and ii) that pathogen shedding and/or disease progression in Chlamydia and HSV-2 co-infected animals will differ from that observed in singly-infected animals. Chlamydial infection of nectin-1 knockdown cell lines revealed no inhibition of chlamydial entry, but significant reductions in inclusion size and production of infectious chlamydiae. Additionally, nectin-1 knockout mice shed fewer Chlamydia compared to wild type mice. In other studies, we developed a novel in vivo Chlamydia and HSV-2 intravaginal super-infection model in BALB/c mice. Infection with Chlamydia muridarum, followed up to 9 days later by HSV-2 super-infection, both reduced HSV shedding and protected mice from HSV-induced fatal neurologic disease compared to HSV singly-infected animals. Protection is lost when: i) infected animals are no longer shedding C. muridarum; ii) when mice are inoculated with UV-inactivated C. muridarum; or iii) when viable chlamydiae are eliminated from the genital tract using antibiotics prior to HSV-2 super-infection. Altogether, we have determined that host nectin-1 is required for chlamydial development both in vitro and in vivo, and that chlamydial pre-infection protects mice from subsequent HSV infection. We predict that these observations may lead to novel approaches to prevent human infection by these two common sexually transmitted pathogens.