Pan European Networks - Horizon 2020 - page 40

Recent
in vitro
and
in vivo
studies indicate that
a break in the normal chlamydial developmental
cycle can result in chlamydial ‘persistence’ and
long term infection that is refractory to antibiotic
treatment. Such ‘persistent’ infections can
cause a cascade of on-going inflammatory-
induced sequelae, resulting in scarring of the
conjunctiva and trichiasis (Fig. 1) which cannot
be reversed by antibiotic treatment and can
only be corrected by ocular surgery. Thus, novel
but non-pharmacologic therapeutic strategies
for trachoma are of high interest.
New therapeutic strategies
Water-filtered infrared A (wIRA) is short
wavelength infrared radiation with a spectrum
ranging from 780 to 1440nm. Light from a
halogen bulb, passing through a water
containing cuvette, emits wIRA and visible light
(VIS) (Fig. 2). wIRA alone, or in combination with
VIS (wIRA/VIS), has been used in various clinical
settings, and its efficacy has been proven in
acute and chronic wound-healing processes.
Due to its high tissue penetration and low
thermal load on the skin surface, wIRA does not
cause the skin irritation and overheating
associated with unfiltered IRA irradiation. This
makes wIRA an effective means to increase
tissue temperature, oxygenation and perfusion,
all important factors positively influencing
wound healing. Consequently, wIRA has been
shown to reduce the frequency of secondary
wound infections.
T
rachoma is the leading cause of infectious blindness in the world.
This devastating disease is caused by the ocular serovars (A, B,
Ba, and C) of the Gram-negative, obligate, intracellular bacterium
Chlamydia trachomatis,
which is hyperendemic in sub-Saharan Africa,
the Middle East, as well as parts of Asia and central and South America.
Globally, 84 million people, the majority of whom are children, suffer from
active ocular
C. trachomatis
infection, and nearly eight million people are
visually impaired as a result (Fig. 1).
Trachoma, a disease of poverty and poor hygiene, is categorised as a
‘neglected tropical disease’, and a number of global health organisations
are working together to eliminate blinding trachoma by 2020; this
includes the GET 2020 Alliance and the SAFE strategy of the World
Health Organization.
The primary frontline antibiotics used to treat ocular chlamydial infection
and prevent trachoma are oral azithromycin and topical tetracycline.
However, there are drawbacks to antibiotic treatment of chlamydial
infections, including unwanted and sometimes dangerous side effects,
expenses (which may be prohibitive in poorer countries where trachoma
is endemic), and the on-going and problematic emergence of antibiotic-
resistant bacteria. Furthermore, incomplete or failed elimination of
chlamydiae by antibiotic treatment may lead to deregulation of
chlamydial development.
I S S U E S I X
H O R I Z O N 2 0 2 0 P R O J E C T S : P O R TA L
40
O P T O M E T R Y
More than meets the eye
Professor Dr Nicole Borel
and her research group at the Center for Applied
Biotechnology and Molecular Medicine illustrate new therapeutic strategies for
treatment of chlamydial infections in humans and animals
Fig. 1 Trachoma
grading, adapted from
the World Health
Organization
trachoma simplified
grading card
Fig. 2 wIRA setting for
in vitro
experiments
1...,30,31,32,33,34,35,36,37,38,39 41,42,43,44,45,46,47,48,49,50,...244
Powered by FlippingBook