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Year : 1981  |  Volume : 29  |  Issue : 3  |  Page : 257-260

Persistence of chlamydial antigen in conjunctiva and lacrimal sac of monkeys

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Correspondence Address:
V M Mahajan
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
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Source of Support: None, Conflict of Interest: None

PMID: 7346440

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How to cite this article:
Mahajan V M, Niroola R, Agarwal LP. Persistence of chlamydial antigen in conjunctiva and lacrimal sac of monkeys. Indian J Ophthalmol 1981;29:257-60

How to cite this URL:
Mahajan V M, Niroola R, Agarwal LP. Persistence of chlamydial antigen in conjunctiva and lacrimal sac of monkeys. Indian J Ophthalmol [serial online] 1981 [cited 2023 Dec 1];29:257-60. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1981/29/3/257/30897

The problem of recurrences in trachoma in endemic countries is still menacing. The question of whether reinfection occurs with a fresh agent or by recrudescence of an old dying infection still remains unscrutinised. This study was undertaken to find out the time period for which chlamydia can persist in the ocular tissues (especially the conjunc­tiva and the lacrimal sacs) of monkeys after an experimental infection.

  Materials and methods Top

Sixteen Indian rhesus monkeys free from spontaneous folliculosis and follicular con­junctivitis were used for the study.

The inoculation was carried out by rubb­ing a cotton swab soaked in infected yolk sac suspension of Bour strain containing 10 3.6 ELD 50 /0.2 ml. Five eyes kept as con­trol were similarly inoculated with normal yolk sac suspension.

The clinical findings were scored by the system of W.H.O.[1]

The conjunctival scrapings collected regu­larly were studied after Giemsa and fluores­cent antibody (FA) staining. Reisolation attempts were made using ambryonated eggs and confirmation was done by staining the yolk sac membranes with Gimenez stain[3].

The lacrimal sac was also investigated similarly for reisolation, fluorescent staining of impression smears and histopathological examination by H & E as well as by Giemsa staining.

  Observations Top

Conjunctival congestion persisted in 57% of the eyes upto 90 days when the experi­ment was terminated. Follicles [Figure - 1] which appeared after 20 days were there in 71% eyes, while the papillary hyperplasia persisted in 43% of the test eyes till the end. Almost always, one third of tarsus was invol­ved. With Giemsa staining intracytoplasmic inclusions were seen in 25/57 slides (44%) examined over a period of 90 days. Five out of seven scrapings on the 90th day showed the presence of inclusions. Other cytologi­cal features were the presence of polymor­phonuclear cells, extra cellular elementary bodies, cytoplasmic vacuolation, nuclear ex­trusions and germinal centre cells [Figure - 2]. Out of 57 smears studied by FA technique, 40 (70%) showed intracytoplasmic inclusions. On the 90th day, 86% of the scrapings were positive [Figure - 3]. Successful reisolations could be made upto the 90th day.

The H & E stained sections showed chan­ges in the epithelium of 70% of the lacrimal sacs. Changes were mainly the squamous cell metaplasia, exfoliation of superficial epi­thelium or its hyperplasia [Figure - 4]. Giemsa stained sections of the sac removed on the 90th day showed numerous intracycloplasmic inclusions [Figure - 5]. However, the isolation attempts and the demonstration of inclusions by FA technique in the impression smears of the lacrimal sac were unsuccessful.

  Discussion Top

After a single inoculation of Bour strain of Chlamydia trachomatis all the monkeys developed a clinical picture akin to that des­cribed by several others[4],[5],[6]. The persistence of chlamydia in the infected conjunctiva and lacrimal sac studied by the various laboratory procedures clearly showed that the chlamydial activity was perceptible till the 90th post-ino­culation day. Our findings were further substantiated by the demonstration of inclu­sions in the conjunctival cells till the 90th day by Giemsa and FA procedures and the successful reisolation even on the 90th day specimen which showed that the organism was still viable. Had a more sensitive method like the irradiated or IUDR treated tissue culture been used, the efficiency of reisolation could have been definitely more. Gale et al[6] have reported reisolation ten years after the infection in Taiwan monkeys.

The histopathological changes in the lacri­mal sac tissue were suggestive of chronic irri­tation. These changes were progressive in nature and visible even on the 90th day which were in conformation with others[7],[8]. Though no reisolation could be possible, the numerous intracytoplasmic inclusions in Giemsa stained section of the lacrimal sac (90th day) alone implies an active pathology and deserves a special mention. if it is true, it would mean that the duration of antitrachoma treatment should be redetermined, the possibility of irrigating the sac with antitrachoma agent should be considered, the role of chlamydia in dacryocystitis and post-operative iridocylitis and keratitis especially in trachoma endemic countries should be evaluated.

  Summary Top

Single inoculation of Bour strain of Chlamydia trachomatis in the conjuctival sac of Indian Rhesus monkeys led to the develop­ment of chlamydial infection which remained active in a large number of animals upto 90 days. Inclusion positivity in conjunctival scrapings by Giemsa stain was 43.85% as com­pared to 70.17% by fluorescent antibody tech­nique (FAT) thus confirming the superiority of the latter over the former. FAT was able to detect chlamydia even when the clinical signs were not manifest. Over-all reisolation rate in embryonating eggs was 25% only. The agent was however, detectable by one or the other means upto the 90th day in conjunc­tiva as well as lacrimal sac tissue. Histo­pathological changes in the latter were sugges­tive of chronic infection and indicative of its being a possible reservoir for chlamydia[9].

  References Top

World Health Organisation Technical Report, 1966, Series No. 330:20,  Back to cited text no. 1
Mahajan, V.M., Niroola, R. and Agarwal, L.P., 1979, East. Arch, Ophthalmol, 7:1.  Back to cited text no. 2
Mahajan, V.M., Balaya S., Mohapatra L.N. and Agarwal, L.P., 1977, East. Arch. Ophthalmol., 5:52.   Back to cited text no. 3
Collier, L.H., 1962, Ann. A.Y. Acad. Sci., 98:188.  Back to cited text no. 4
Dawson, C., Jawetz, E., Thygeson, P. and Hanna L.: 1961, Pr oc. Soc. Exptl. Biol. Med., 106: 198.  Back to cited text no. 5
Gale, J.L., Wang S.P. and Grayston J.T.: 1971, In trachoma and related disorders caused by cblamydial agents, Ed. R.L. Nichols. Excerpta Medica, P. 1489.   Back to cited text no. 6
El - Gammal, Y., 1958, First Afro-Asian Cong. Ophthalmol. 89.  Back to cited text no. 7
Abdalla, M.I. and Bahnasawi, S.A., 1978, XXIII International Congress Ophthalmol. In Kyoto, Excerpta Medica No. 42 P. 136.  Back to cited text no. 8
Wang, S. and Grayston J. T., 1962, Ann, N.Y. Acad., Sci., 98 : 177.  Back to cited text no. 9


  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]


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