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Background  Clinical signs of active (inflammatory) trachoma are found in many children in the Solomon Islands, but the majority of these individuals have no serological evidence of previous infection with  Chlamydia trachomatis . In Temotu and Rennell and Bellona provinces, ocular infections with  C. trachomatis  were seldom detected among children with active trachoma; a similar lack of association was seen between active trachoma and other common bacterial and viral causes of follicular conjunctivitis. Here, we set out to characterise patterns of gene expression at the conjunctivae of children in these provinces with and without clinical signs of trachomatous inflammation-follicular (TF) and  C. trachomatis  infection.    Methods  Purified RNA from children with and without active trachoma was run on Affymetrix GeneChip Human Transcriptome Array 2.0 microarrays. Profiles were compared between individuals with ocular  C. trachomatis  infection and TF (group DI;  n  = 6), individuals with TF but no  C. trachomatis  infection (group D;  n  = 7), and individuals without TF or  C. trachomatis  infection (group N;  n  = 7). Differential gene expression and gene set enrichment for pathway membership were assessed.    Results  Conjunctival gene expression profiles were more similar within-group than between-group. Principal components analysis indicated that the first and second principal components combined explained almost 50% of the variance in the dataset. When comparing the DI group to the N group, genes involved in T-cell proliferation, B-cell signalling and CD8+ T cell signalling pathways were differentially regulated. When comparing the DI group to the D group, CD8+ T-cell regulation, interferon-gamma and IL17 production pathways were enriched. Genes involved in RNA transcription and translation pathways were upregulated when comparing the D group to the N group.    Conclusions  Gene expression profiles in children in the Solomon Islands indicate immune responses consistent with bacterial infection when TF and  C. trachomatis  infection are concurrent. The transcriptomes of children with TF but without identified infection were not consistent with allergic or viral conjunctivitis.

Conjunctival transcriptome profiling of Solomon Islanders with active trachoma in the absence of Chlamydia trachomatis infection