All about gonorrhea

Gonorrhea is a serious veneric disease that can cause infertility in women and it is a major risk factor for HIV infection. On average, a man is infected every 4th intercourse with an infected woman while a woman is infected every 2nd intercourse with an infected men.

Neisseria gonorrhoeae infection mechanism is different in men than in women.

Gonorrhea is an exclusively human pathogen. It developed remarkable mechanisms that avoid the host immune system attack (congenital and adapted). In particular, the surface has a coating of red cell antigens identical to human ones.

Through a unique mechanism, a number of important virulence factors are expressed, allowing them to be ubiquitous in some people, in different environmental conditions. Adhesion factors, called pili, are widely variable. This is due to a unique genetic mechanism, by which, large portions of the structure are encoded in some boxes that can be accidentally moved inside or outside the gene expressed. The result is that a single microorganism has the ability to produce over 1 million distinct antigenic pili, thereby allowing it to overcome the host's immune system attack.

A remarkable feature is the ability of gonorrhea to infect men and women by different pathogenetic mechanisms. Both mechanisms are highly efficient and use conditions of the receiving environment and the expression of cell surface receptors. These mechanisms have been studied for the first time in the departments of microbiology, urology and obstetrics / gynecology in USA.

In men

Studies have shown that epithelial cells lining the distal two-thirds of the male urethra are susceptible to infection with gonorrhea. Pili, surface structures that allow gonorrhea avoid immune attack of the host, set on the epithelial cell surface receptors on the urethra.

Infected cell's life is prolonged, because the cells are prevented from dying naturally, while gonococci multiply within them. Finally, when the number of gonococcal cells is very high, nutrients are depleted and the cells die.

Women

In women, gonococcal infection involves a different interaction, more complex, between host and bacterial factors. Initial targets of gonorrhea are ecto and endocervical tissues.

Alternative pathway complement components interact with gonorrhea, resulting in assembling ligands for CR3 surface gonorrhea. In addition, gonococcal pili, the main factor of bacteria attachment on host cells, and a channel of nutrients called porina can interact with cells as such, without the need for other mechanisms to facilitate attachment. Cooperative interaction with CR3 results in altered plasma membrane (composed of epithelial cells mentioned above), and the formation of inclusions.

Once the epithelial cells were infected the gonococ begins to secrete various proteins. One of these proteins is the enzyme called phospholipase D. A human enzyme with similar function is involved in processing of gonorrhea within cells. It seems that phospholipase D accelerates epithelial cell surface CR3 position, thus facilitating invasion of gonococcal cells.