Pathophysiology
Chlamydiae have the ability to establish long-term
associations with host cells. When an infected host cell is starved for
various nutrients such as amino acids (for example, tryptophan), iron, or vitamins, this has a negative consequence for Chlamydiae
since the organism is dependent on the host cell for these nutrients.
Long-term cohort studies indicate that approximately 50% of those
infected clear within a year, 80% within two years, and 90% within three
years
The starved chlamydiae enter a persistent growth state wherein they
stop cell division and become morphologically aberrant by increasing in
size.
Persistent organisms remain viable as they are capable of returning to a
normal growth state once conditions in the host cell improve.
There is much debate as to whether persistence has in vivo
relevance. Many believe that persistent chlamydiae are the cause of
chronic chlamydial diseases. Some antibiotics such as β-lactams can also
induce a persistent-like growth state, which can contribute to the
chronicity of chlamydial diseases
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