Association of <i>Chlamydia</i> species with ocular adnexal mucosa-associated lymphoid tissue lymphoma in Taiwan.

Abstract

Chronic antigenic stimulation, including autoimmune disorders and infection, may contribute to lymphoproliferation in specific tissues. <i>Chlamydia</i> species have been linked to ocular adnexal mucosa-associated lymphoid tissue lymphoma (OAML), with geographic variation in prevalence. This study explores the association between <i>Chlamydia</i> infection and OAML and correlates the presence of <i>Chlamydia</i> DNA with clinical features and treatment outcomes in Taiwan. Pathology specimens from 71 patients diagnosed with primary OAML were analysed for the presence of <i>Chlamydia</i> species, including <i>C. psittaci</i>, <i>C. pneumoniae</i> and <i>C. trachomatis</i> DNA, using touchdown enzyme time-release PCR. Demographic and clinical data, including age, sex, lymphoma location, staging and treatment modalities, were compared between <i>Chlamydia</i> DNA-positive and negative groups. Treatment outcomes such as relapse rates, survival time and treatment response were also analysed. Among the 71 OAML specimens, 27 (38%) tested positive for <i>C. trachomatis</i> DNA, with two cases also positive for <i>C. pneumoniae</i> DNA. <i>Chlamydia</i> positivity was significantly associated with orbital involvement (p=0.020). No differences were found between the two groups in terms of disease staging, treatment methods, relapse rates, survival time and treatment response at last follow-up. The study is the first regional report elucidating the association between <i>Chlamydia</i> and OAML in Taiwan. The findings suggest a possible link between <i>C. trachomatis</i> and orbital involvement in OAML. Further large-scale and prospective studies are needed to clarify the role of <i>Chlamydia</i> in OAML pathogenesis and to evaluate the potential benefits of antibiotic therapy in the patient population.