Editing Chlamydia (section)

==Pathophysiology==
Chlamydia bacteria have the ability to establish long-term associations with host cells. When an infected host cell is starved for various nutrients such as [[amino acid]]s (for example, [[tryptophan]]),<ref name="pmid17724071">{{cite journal | vauthors = Leonhardt RM, Lee SJ, Kavathas PB, Cresswell P | title = Severe tryptophan starvation blocks onset of conventional persistence and reduces reactivation of Chlamydia trachomatis | journal = Infection and Immunity | volume = 75 | issue = 11 | pages = 5105–5117 | date = November 2007 | pmid = 17724071 | pmc = 2168275 | doi = 10.1128/IAI.00668-07 }}</ref> [[iron]], or [[vitamin]]s, this has a negative consequence for chlamydia bacteria since the organism is dependent on the host cell for these nutrients. Long-term cohort studies indicate that approximately 50% of those infected clear within a year, 80% within two years, and 90% within three years.<ref name="Fairley2007">{{cite journal | vauthors = Fairley CK, Gurrin L, Walker J, Hocking JS | title = "Doctor, how long has my Chlamydia been there?" Answer: ".... years" | journal = Sexually Transmitted Diseases | volume = 34 | issue = 9 | pages = 727–728 | date = September 2007 | pmid = 17717486 | doi = 10.1097/OLQ.0b013e31812dfb6e | doi-access = free }}</ref>

The starved chlamydia bacteria can enter a persistent growth state where they stop [[cell division]] and become morphologically aberrant by increasing in size.<ref name="pmid16338585">{{cite journal | vauthors = Mpiga P, Ravaoarinoro M | title = Chlamydia trachomatis persistence: an update | journal = Microbiological Research | volume = 161 | issue = 1 | pages = 9–19 | year = 2006 | pmid = 16338585 | doi = 10.1016/j.micres.2005.04.004 | doi-access =  }}</ref> Persistent organisms remain viable as they are capable of returning to a normal growth state once conditions in the host cell improve.<ref>{{cite book | vauthors = Kushwaha AK |url=https://books.google.com/books?id=r4vtDwAAQBAJ&dq=persistent+organisms+remain+viable+as+they+are+capable+of+returning+to+a+normal+growth+state+once+conditions+in+the+host+cell+improve&pg=PA202 |title=Textbook of Microbiology |date=2020-07-26 |publisher=Dr. A.K KUSHWAHA |language=en}}</ref>

There is debate as to whether persistence has relevance: some believe that persistent chlamydia bacteria are the cause of chronic chlamydial diseases. Some antibiotics such as [[β-lactam]]s have been found to induce a persistent-like growth state.<ref name="bayramova2018insight">{{cite journal | vauthors = Bayramova F, Jacquier N, Greub G | title = Insight in the biology of Chlamydia-related bacteria | journal = Microbes and Infection | volume = 20 | issue = 7–8 | pages = 432–440 | year = 2018 | pmid = 29269129 | doi = 10.1016/j.micinf.2017.11.008 | publisher = Elsevier | doi-access = free }}</ref><ref name="klockner2016deconstructing">{{cite book| vauthors = Klöckner A, Bühl H, Viollier P, Henrichfreise B | title=Biology of Chlamydia | volume=412 | editor=Häcker, Georg | chapter=Deconstructing the Chlamydial Cell Wall | year=2018 | publisher=Springer International Publishing | location=Cham | pages=1–33|doi=10.1007/82_2016_34| pmid=27726004 |isbn=978-3-319-71232-1| series=Current Topics in Microbiology and Immunology }}</ref>