Pathogenesis of Genital Chlamydia Infection and Implications for Chlamydia Control Programs

Understanding the relative importance of different immune responses to chlamydia is important for control programs. If disease primarily results from innate immune responses propagated by infected epithelial cells, then control programs should focus on preventing new infections and detecting existing infections soon after acquisition, as tissue-damaging responses could occur as soon as the oviduct is infected. If, however, adaptive chlamydial-specific cellular responses primarily cause disease, tissue damage would mainly occur late in the course of an initial infection, or with accelerated responses during repeat infections. Thus, efforts should focus on screening women with longstanding infection and especially preventing repeat infection.