Characteristics of the infectious process during urogenital chlamydiosis
by TLR gene expression evaluation

Karaulov A.V., Afanasiev S.S., Alyoshkin V.A., Evsegneeva I.V., Voropaeva E.A., Bairakova A.L., Afanasiev M.S., Nesvizhsky Y.V., Egorova E.A., Metelskaya V.A., Alyoshkin A.V., Grechishnikova O.G., Rubalskii E.O., Urban Y.N., Voropaev A.D., Tolstova E.S., Stepanov A.V.

1 Moscow Scientific Research Institute of Epidemiology and Microbiology n. a. G.N. Gabrichevsky, Moscow,
2 I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation Moscow

TLR are providing a launch of an infectious process when a macroorganism contacts with pathogenic OM and their communities. During the chlamydial infection different levels of TLR-2 and TLR-4 activation depend on qualitative composition of microbial communities present on the mucosa of UGT. Activation of TLR-2 and TLR-4 gene expression is occurring more pronounced in response to pathogens of STI, OM and less pronounced during contact with normoflora. The highest levels of TLR gene expression correspond to the higher OM contamination degree of cervical canal, urethra and vagina. TLR-2 and TLR-4 gene expression is taking place in response to OM in vagina and to OM and STI in cervical canal and urethra. Increase of TLR-2 and TLR-4 expression into urethra, cervical canal, and vagina correlates with severity of clinical manifestations of UGC depending on a pathogen, as well as on pathogenicity of associates (pathogens of STI and OM). Diagnostic and prognostic significance of the TLR-2 and TLR-4 gene expression levels assessment during urogenital chlamydiosis in women is determined. The assessment of levels of TLR-2 and TLR-4 gene expressions in scraping material of the cervix and urethra of patients with urogenital chlamydial infection allows to distinguish chronic and acute forms of chlamydiosis (chronic urogenital chlamydiosis is diagnosed with levels of expression of TL-receptor-2 not more than 5 units and TL-receptor-4 not more than 5 units in scraping material from the urethra), as well as to reveal the beginning of chronization of an infectious process. During acute urogenital chlamydiosis reduction of the TLR-2 and TLR-4 gene expression levels along with direct methods of detecting the pathogen can indirectly indicate an eradication of chlamydia.