{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:08:46Z","timestamp":1789434526709,"version":"build-2803163510"},"reference-count":63,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:00:00Z","timestamp":1722124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Trachoma is the most common infectious cause of blindness worldwide. This review investigates the pathogenesis of trachoma, focusing on its causative agent, transmission pathways, disease progression, and immune responses. Trachoma is caused by serovars A\u2013C of the bacterium Chlamydia trachomatis (Ct). Transmission occurs through direct or indirect exchanges of ocular and nasal secretions, especially in regions with poor hygiene and overcrowded living conditions. The disease is initiated in early childhood by repeated infection of the ocular surface by Ct. This triggers recurrent chronic inflammatory episodes, leading to the development of conjunctival scarring and potentially to trichiasis, corneal opacity, and visual impairment. Exploring the pathogenesis of trachoma not only unveils the intricate pathways and mechanisms underlying this devastating eye disease but also underscores the multifaceted dimensions that must be considered in its management.<\/jats:p>","DOI":"10.3390\/microorganisms12081544","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T07:54:03Z","timestamp":1722239643000},"page":"1544","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Insights into Pathogenesis of Trachoma"],"prefix":"10.3390","volume":"12","author":[{"given":"Panagiotis","family":"Toumasis","sequence":"first","affiliation":[{"name":"MSc in Ocular Surgery, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-8238","authenticated-orcid":false,"given":"Georgia","family":"Vrioni","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 115 25 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9189-805X","authenticated-orcid":false,"given":"Ioannis T.","family":"Tsinopoulos","sequence":"additional","affiliation":[{"name":"MSc in Ocular Surgery, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"},{"name":"Second Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 564 29 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4052-8550","authenticated-orcid":false,"given":"Maria","family":"Exindari","sequence":"additional","affiliation":[{"name":"MSc in Ocular Surgery, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"},{"name":"Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 715 00 Heraklion, Greece"},{"name":"Metropolitan Hospital, 185 47 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990\u20132020: A systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/s41572-022-00359-5","article-title":"Trachoma","volume":"8","author":"Solomon","year":"2022","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","unstructured":"World Health Organization (2024, April 01). Trachoma. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/trachoma."},{"key":"ref_4","unstructured":"World Health Organization (2024, April 02). Ending the Neglect to Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240052932."},{"key":"ref_5","first-page":"1458","article-title":"The History of Trachoma and Current Prevalence (Spotlight on Iran): A Review Article","volume":"47","author":"Yaghoobi","year":"2018","journal-title":"Iran. J. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Fan, H., and Scidmore, M.A. (2015). Chlamydia. Reference Module in Biomedical Sciences, Elsevier.","DOI":"10.1016\/B978-0-12-801238-3.02287-X"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Jury, B., Fleming, C., Huston, W.M., and Luu, L.D.W. (2023). Molecular pathogenesis of Chlamydia trachomatis. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1281823"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1002\/pro.3501","article-title":"Spectroscopic analysis of chlamydial major outer membrane protein in support of structure elucidation","volume":"27","author":"Hepler","year":"2018","journal-title":"Protein Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Grygiel-Gorniak, B., and Folga, B.A. (2023). Chlamydia trachomatis\u2014An Emerging Old Entity?. Microorganisms, 11.","DOI":"10.3390\/microorganisms11051283"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"18327","DOI":"10.1038\/s41598-019-54886-5","article-title":"Chlamydia trachomatis serovars in urogenital and ocular samples collected 2014\u20132017 from Austrian patients","volume":"9","author":"Schotta","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_11","unstructured":"Makker, K., Nassar, G.N., and Kaufman, E.J. (2024). Neonatal Conjunctivitis. StatPearls, Ineligible Companies."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e01367","DOI":"10.1016\/j.idcr.2021.e01367","article-title":"Adult inclusion conjunctivitis diagnosed by polymerase chain reaction and Giemsa stain","volume":"27","author":"Lee","year":"2022","journal-title":"IDCases"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.2217\/fmb.13.80","article-title":"Genetic variation in Chlamydia trachomatis and their hosts: Impact on disease severity and tissue tropism","volume":"8","author":"Abdelsamed","year":"2013","journal-title":"Future Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"26893","DOI":"10.1074\/jbc.M203937200","article-title":"Molecular basis defining human Chlamydia trachomatis tissue tropism. A possible role for tryptophan synthase","volume":"277","author":"Roshick","year":"2002","journal-title":"J. Biol. Chem."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1172\/JCI17993","article-title":"Polymorphisms in Chlamydia trachomatis tryptophan synthase genes differentiate between genital and ocular isolates","volume":"111","author":"Caldwell","year":"2003","journal-title":"J. Clin. Investig."},{"key":"ref_16","first-page":"385","article-title":"Chlamydia cell biology and pathogenesis. Nature reviews","volume":"14","author":"Elwell","year":"2016","journal-title":"Microbiology"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Versteeg, B., Vasileva, H., Houghton, J., Last, A., Shafi Abdurahman, O., Sarah, V., Macleod, D., Solomon, A.W., Holland, M.J., and Thomson, N. (2020). Viability PCR shows that non-ocular surfaces could contribute to transmission of Chlamydia trachomatis infection in trachoma. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008449"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Last, A., Versteeg, B., Shafi Abdurahman, O., Robinson, A., Dumessa, G., Abraham Aga, M., Shumi Bejiga, G., Negussu, N., Greenland, K., and Czerniewska, A. (2020). Detecting extra-ocular Chlamydia trachomatis in a trachoma-endemic community in Ethiopia: Identifying potential routes of transmission. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008120"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/S0140-6736(04)15891-1","article-title":"Role of flies and provision of latrines in trachoma control: Cluster-randomised controlled trial","volume":"363","author":"Emerson","year":"2004","journal-title":"Lancet"},{"key":"ref_20","first-page":"854","article-title":"Persistence and Significance of Chlamydia trachomatis in the Housefly, Musca domestica L.","volume":"21","author":"Brewer","year":"2021","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Robinson, A., Bristow, J., Holl, M.V., Makalo, P., Alemayehu, W., Bailey, R.L., Macleod, D., Birkett, M.A., Caulfield, J.C., and Sarah, V. (2020). Responses of the putative trachoma vector, Musca sorbens, to volatile semiochemicals from human faeces. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0007719"},{"key":"ref_22","first-page":"e52358","article-title":"Eliminating Trachoma in Africa: The Importance of Environmental Interventions","volume":"16","author":"Ageed","year":"2024","journal-title":"Cureus"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Chen, X., Munoz, B., Wolle, M.A., Woods, G., Odonkor, M., Naufal, F., Mkocha, H., and West, S.K. (2021). Environmental factors and hygiene behaviors associated with facial cleanliness and trachoma in Kongwa, Tanzania. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009902"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.2147\/OPTH.S321294","article-title":"Knowledge, Attitude, Practices and Associated Factors towards Trachoma among People Living in Arba Minch Zuria District, Gamo Zone, Southern Ethiopia","volume":"15","author":"Churko","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1093\/ije\/18.4.944","article-title":"Analysis of the household distribution of trachoma in a Gambian village using a Monte Carlo simulation procedure","volume":"18","author":"Bailey","year":"1989","journal-title":"Int. J. Epidemiol."},{"key":"ref_26","unstructured":"Ahmad, B., and Patel, B.C. (2024). Trachoma. StatPearls, StatPearls Publishing LLC\/Ineligible Companies. StatPearls Publishing Copyright \u00a9 2024."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S1473-3099(05)70116-X","article-title":"Clinical examination and laboratory tests for estimation of trachoma prevalence in a remote setting: What are they really telling us?","volume":"5","author":"Wright","year":"2005","journal-title":"Lancet Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Grassly, N.C., Ward, M.E., Ferris, S., Mabey, D.C., and Bailey, R.L. (2008). The natural history of trachoma infection and disease in a Gambian cohort with frequent follow-up. PLoS Negl. Trop. Dis., 2.","DOI":"10.1371\/journal.pntd.0000341"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gambhir, M., Bas\u00e1\u00f1ez, M.G., Burton, M.J., Solomon, A.W., Bailey, R.L., Holland, M.J., Blake, I.M., Donnelly, C.A., Jabr, I., and Mabey, D.C. (2009). The development of an age-structured model for trachoma transmission dynamics, pathogenesis and control. PLoS Negl. Trop. Dis., 3.","DOI":"10.1371\/journal.pntd.0000462"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hu, V.H., Holland, M.J., and Burton, M.J. (2013). Trachoma: Protective and pathogenic ocular immune responses to Chlamydia trachomatis. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002020"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1128\/IAI.05965-11","article-title":"Innate immune responses and modified extracellular matrix regulation characterize bacterial infection and cellular\/connective tissue changes in scarring trachoma","volume":"80","author":"Hu","year":"2012","journal-title":"Infect. Immun."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1128\/IAI.00888-10","article-title":"Conjunctival transcriptome in scarring trachoma","volume":"79","author":"Burton","year":"2011","journal-title":"Infect. Immun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1167\/iovs.17-23381","article-title":"Non-Chlamydial Bacterial Infection and Progression of Conjunctival Scarring in Trachoma","volume":"59","author":"Hu","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"7974","DOI":"10.1167\/iovs.11-7880","article-title":"The clinical phenotype of trachomatous trichiasis in Ethiopia: Not all trichiasis is due to entropion","volume":"52","author":"Rajak","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1136\/bjo.86.3.339","article-title":"Longitudinal study of trachomatous trichiasis in the Gambia","volume":"86","author":"Bowman","year":"2002","journal-title":"Br. J. Ophthalmol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1167\/iovs.05-0714","article-title":"The long-term natural history of trachomatous trichiasis in the Gambia","volume":"47","author":"Burton","year":"2006","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1136\/bjo.2004.062489","article-title":"A randomised controlled trial of azithromycin following surgery for trachomatous trichiasis in the Gambia","volume":"89","author":"Burton","year":"2005","journal-title":"Br. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"698","DOI":"10.2471\/BLT.19.248708","article-title":"The simplified trachoma grading system, amended","volume":"98","author":"Solomon","year":"2020","journal-title":"Bull. World Health Organ."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1093\/ije\/20.4.1088","article-title":"The epidemiology of trachoma in central Tanzania","volume":"20","author":"West","year":"1991","journal-title":"Int. J. Epidemiol."},{"key":"ref_40","first-page":"904","article-title":"The epidemiology of trachoma in Eastern Equatoria and Upper Nile States, southern Sudan","volume":"83","author":"Ngondi","year":"2005","journal-title":"Bull. World Health Organ."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.trstmh.2008.11.023","article-title":"Evaluation of three years of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement) for trachoma control in five districts of Ethiopia hyperendemic for trachoma","volume":"103","author":"Ngondi","year":"2009","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Gebrie, A., Alebel, A., Zegeye, A., Tesfaye, B., and Wagnew, F. (2019). Prevalence and associated factors of active trachoma among children in Ethiopia: A systematic review and meta-analysis. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4686-8"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/S0140-6736(03)13909-8","article-title":"Strategies for control of trachoma: Observational study with quantitative PCR","volume":"362","author":"Solomon","year":"2003","journal-title":"Lancet"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1128\/jcm.29.8.1593-1595.1991","article-title":"Longitudinal study of the microbiology of endemic trachoma","volume":"29","author":"Taylor","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1093\/oxfordjournals.aje.a116683","article-title":"Exposure to children and risk of active trachoma in Tanzanian women","volume":"137","author":"Congdon","year":"1993","journal-title":"Am. J. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1136\/bjo.82.8.930","article-title":"Trachoma in the Gambia","volume":"82","author":"Dolin","year":"1998","journal-title":"Br. J. Ophthalmol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1136\/bjo.73.7.536","article-title":"Trachoma and blindness in the Nile Delta: Current patterns and projections for the future in the rural Egyptian population","volume":"73","author":"Courtright","year":"1989","journal-title":"Br. J. Ophthalmol."},{"key":"ref_48","unstructured":"Shumway, C.L., Motlagh, M., and Wade, M. (2024). Anatomy, Head and Neck, Eye Conjunctiva. StatPearls, StatPearls Publishing."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1136\/bjo.73.4.276","article-title":"Immunopathology of trachomatous conjunctivitis","volume":"73","author":"Geboes","year":"1989","journal-title":"Br. J. Ophthalmol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1038\/eye.1998.179","article-title":"Collagen content and types in trachomatous conjunctivitis","volume":"12","author":"Geboes","year":"1998","journal-title":"Eye"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/S0161-6420(93)31485-5","article-title":"The histopathology and the mechanism of entropion in patients with trachoma","volume":"100","author":"Hidayat","year":"1993","journal-title":"Ophthalmology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1136\/bjophthalmol-2013-303126","article-title":"In vivo confocal microscopy and histopathology of the conjunctiva in trachomatous scarring and normal tissue: A systematic comparison","volume":"97","author":"Hu","year":"2013","journal-title":"Br. J. Ophthalmol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Hu, V.H., Luthert, P.J., Derrick, T., Pullin, J., Weiss, H.A., Massae, P., Mtuy, T., Makupa, W., Essex, D., and Mabey, D.C. (2016). Immunohistochemical Analysis of Scarring Trachoma Indicates Infiltration by Natural Killer and Undefined CD45 Negative Cells. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004734"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Derrick, T., Luthert, P.J., Jama, H., Hu, V.H., Massae, P., Essex, D., Holland, M.J., and Burton, M.J. (2016). Increased Epithelial Expression of CTGF and S100A7 with Elevated Subepithelial Expression of IL-1\u03b2 in Trachomatous Trichiasis. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004752"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S0966-842X(02)00011-2","article-title":"The cellular paradigm of chlamydial pathogenesis","volume":"11","author":"Stephens","year":"2003","journal-title":"Trends Microbiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1172\/JCI119136","article-title":"Secretion of proinflammatory cytokines by epithelial cells in response to Chlamydia infection suggests a central role for epithelial cells in chlamydial pathogenesis","volume":"99","author":"Rasmussen","year":"1997","journal-title":"J. Clin. Investig."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"7352","DOI":"10.1128\/IAI.72.12.7352-7356.2004","article-title":"Cytokine and fibrogenic gene expression in the conjunctivas of subjects from a Gambian community where trachoma is endemic","volume":"72","author":"Burton","year":"2004","journal-title":"Infect. Immun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4895","DOI":"10.1128\/IAI.00844-10","article-title":"Human conjunctival transcriptome analysis reveals the prominence of innate defense in Chlamydia trachomatis infection","volume":"78","author":"Natividad","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Ramadhani, A.M., Derrick, T., Macleod, D., Massae, P., Mtuy, T., Jeffries, D., Roberts, C.H., Bailey, R.L., Mabey, D.C.W., and Holland, M.J. (2017). Immunofibrogenic Gene Expression Patterns in Tanzanian Children with Ocular Chlamydia trachomatis Infection, Active Trachoma and Scarring: Baseline Results of a 4-Year Longitudinal Study. Front. Cell. Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00406"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"3023","DOI":"10.4049\/jimmunol.138.9.3023","article-title":"Pathogenesis of trachoma: The stimulus for inflammation","volume":"138","author":"Taylor","year":"1987","journal-title":"J. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Vicetti Miguel, R.D., Quispe Calla, N.E., Pavelko, S.D., and Cherpes, T.L. (2016). Intravaginal Chlamydia trachomatis Challenge Infection Elicits TH1 and TH17 Immune Responses in Mice That Promote Pathogen Clearance and Genital Tract Damage. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0162445"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Burton, M.J., Rajak, S.N., Hu, V.H., Ramadhani, A., Habtamu, E., Massae, P., Tadesse, Z., Callahan, K., Emerson, P.M., and Khaw, P.T. (2015). Pathogenesis of progressive scarring trachoma in Ethiopia and Tanzania and its implications for disease control: Two cohort studies. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003763"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Natividad, A., Cooke, G., Holland, M.J., Burton, M.J., Joof, H.M., Rockett, K., Kwiatkowski, D.P., Mabey, D.C., and Bailey, R.L. (2006). A coding polymorphism in matrix metalloproteinase 9 reduces risk of scarring sequelae of ocular Chlamydia trachomatis infection. BMC Med. Genet., 7.","DOI":"10.1186\/1471-2350-7-40"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/8\/1544\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:25:14Z","timestamp":1760109914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/8\/1544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,28]]},"references-count":63,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["microorganisms12081544"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms12081544","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,28]]}}}