Predicted sequence of events in O. volvulus/Wolbachia-induced keratitis. Predicted sequence of events in O. volvulus/Wolbachia-induced keratitis. Wolbachia.

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Predicted sequence of events in O. volvulus/Wolbachia-induced keratitis. Predicted sequence of events in O. volvulus/Wolbachia-induced keratitis. Wolbachia released from dying microfilariae in the corneal stroma (1) activates resident cells, including fibroblasts, dendritic cells, and macrophages (2). These cells produce chemokines MIP-2 and predominantly KC (3). KC induces a CXCR2-dependent neutrophil migration to the corneal stroma, where neutrophils are also activated via TLR2/6 by Wolbachia (4). Neutrophils produce additional chemokines, predominantly MIP-2, inducing further neutrophil migration (5). Neutrophils degrade the corneal matrix, causing corneal haze and visual impairment (6). Abbreviations: TLR, Toll-like receptor; MyD88, myeloid differentiation primary response gene (88); Mal, MyD88 adaptor-like; KC, keratinocyte-derived chemokine; MIP, macrophage-inflammatory protein 2; TNF-α, tumor necrosis factor α DC, dendritic cell. Francesca Tamarozzi et al. Clin. Microbiol. Rev. 2011; doi:10.1128/CMR.00057-10