Potential role of enterohepatic Helicobacter species as a facilitating factor in the development of Chlamydia trachomatis proctitis.

Gastrointestinal manifestations of chlamydial infection are frequent, yet not always recognised. One of the common entities is proctitis, especially prevalent amongst men who have sex with men (MSM). Likewise, some enterohepatic Helicobacter species have also been associated with proctitis, namely Helicobacter (H.) cinaedi and H. fennelliae. It is well established that Helicobacter species have general and specific mechanisms for innate immune evasion and suppression, and can affect intestinal homeostasis. Here it is proposed that their presence in the rectum might facilitate the development of Chlamydia trachomatis proctitis, where they could act as cofactors in initial infection and progression of the disease.