Abstracts: The relative contribution of causal factors in the transition from infection to clinical chlamydial disease

Chlamydia is a major bacterial pathogen in humans and animals globally. Yet 80 per cent of infections never progress to clinical disease. Decades of research have generated an interconnected network linking pathogen, host, and environmental factors to disease expression, but the relative importance of these and whether they account for disease progression remains unknown.

To address this, we used structural equation modeling to evaluate putative factors likely to contribute to urogenital and ocular chlamydial disease in the koala (Phascolarctos cinereus). These factors include Chlamydia detection, load, and ompA genotype; urogenital and ocular microbiomes; host sex, age, weight, body condition; breeding season, time of year; location; retrovirus co-infection; and major histocompatibility complex class II (MHCII) alleles.

We show different microbiological processes underpin disease progression at urogenital and ocular sites. From each category of factors, urogenital disease was most strongly predicted by chlamydial PCR detection and load, koala body condition and environmental location. In contrast, ocular disease was most strongly predicted by phylum-level Chlamydiae microbiome proportions, sampling during breeding season and co-infection with koala retrovirus subtype B. Host MHCII alleles also contributed predictive power to both disease models. Our results also show considerable uncertainty remains, suggesting major causal mechanisms are yet to be discovered.

The study is from the Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia; School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia; and Endeavour Veterinary Ecology, Toorbul, Queensland, Australia.

Quigley BL, Carver S, Hanger J, et al. Sci Rep 2018;8(1):8893. doi: 10.1038/s41598-018-27253-z.

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