Inflammatory Events in Trachoma

Purpose "Trachoma is not a disease of poverty, it is an immune disease – it is like chronic poison ivy” said H Taylor in 2005. Studies done on this topic suggest that inflammation rather than infection is responsible for blindness. This presentation will highlight the ocular surface inflammation induced by Chlamydia in infection and the effectiveness of azithromycin in reducing this inflammation. Methods Review of the literature on the topic. Medline research with ocular AND inflammation AND azithromycin key words. Results Trachoma infection usually evolves in two major phases: active or inflammatory trachoma and cicatricial or late trachoma. Active trachoma is characterized by an inflammatory response associated with the variable presence of demonstrable infection (PCR test). Trachoma is considered as a chronic, delayed‐type hypersensitivity reaction with subsequent fibrosis. Topical or systemic administration of azithromycin reduces the effects of acute inflammation such as mucus secretion and macrophage infiltration. Azithromycin inhibits inflammatory cytokines gene and protein expressions such as IL‐6, MMP‐2 activity and NFƘ B. In chronic or cicatricial trachoma a new concept is emmerging: a neglected ocular surface disease. Conclusion The role of induced chronic inflammation in trachoma is more and more important to be taken in count. These results suggest that azithromycin is not only effective on Chlamydia trachomatis infection but also appears as a promising agent for preventing and treating ocular trachoma surface inflammation in this immuno‐inflammatory disease.Commercial interest