Why is Gonorrhea So Hard To Fight?

While it might not be sexy to talk about STIs, it’s worth taking a look at how these persistent infections well, persist in their hosts. The pathogens that cause STIs have adapted their own unique set of tools used to evade detection and deletion by the immune system. And Gonorrhea is a top contender for the most manipulative. It turns out, the G in “Gonorrhea” stands for “Gaslight”
Works Used
General STI History and background
Scurtu LG, Jinga V, Simionescu O. Fascinating Molecular and Immune Escape Mechanisms in the Treatment of STIs (Syphilis, Gonorrhea, Chlamydia, and Herpes Simplex). International Journal of Molecular Sciences. 2022; 23(7):3550. https://doi.org/10.3390/ijms23073550

Background Reviews
Quillin, S., Seifert, H. Neisseria gonorrhoeae host adaptation and pathogenesis. Nat Rev Microbiol 16, 226–240 (2018). https://doi.org/10.1038/nrmicro.2017.169

Hill SA, Masters TL, Wachter J. Gonorrhea - an evolving disease of the new millennium. Microb Cell. 2016 Sep 5;3(9):371-389. doi: 10.15698/mic2016.09.524. PMID: 28357376; PMCID: PMC5354566.

Johnson M. Brittany , Criss Alison K.Resistance of Neisseria Gonorrhoeae to Neutrophils Frontiers in Microbiology VOLUME 2 YEAR 2011
DOI=10.3389/fmicb.2011.00077 ISSN=1664-302X

Invasion Mechanisms
Edwards JL, Apicella MA. The molecular mechanisms used by Neisseria gonorrhoeae to initiate infection differ between men and women. Clin Microbiol Rev. 2004 Oct;17(4):965-81, table of contents. doi: 10.1128/CMR.17.4.965-981.2004. PMID: 15489357; PMCID: PMC523569.

Th1/2 Suppression
Liu Y, Islam EA, Jarvis GA, Gray-Owen SD, Russell MW. Neisseria gonorrhoeae selectively suppresses the development of Th1 and Th2 cells, and enhances Th17 cell responses, through TGF-β-dependent mechanisms. Mucosal Immunol. 2012 May;5(3):320-31. doi: 10.1038/mi.2012.12. Epub 2012 Feb 22. PMID: 22354319; PMCID: PMC3328619.
Gonorrhea destroys commensal bacteria
Gunderson CW, Seifert HS.2015.Neisseria gonorrhoeae Elicits Extracellular Traps in Primary Neutrophil Culture While Suppressing the Oxidative Burst. mBio6:10.1128/mbio.02452-14.https://doi.org/10.1128/mbio.02452-14

SEM of Pili
Yingxia He, Song Zhang, Yingmiao Zhang, Bicong Wu, Ying Xue, Chenglin Ye, Qiao Li, Adhiambo Njiri Olivia, John Mambwe Tembo, Hongxiang Chen, Huahua Cai, Tie Chen, "Distinct Patterns of Host Adherence by Neisseria gonorrhoeae Isolated from Experimental Gonorrhea", Canadian Journal of Infectious Diseases and Medical Microbiology, vol. 2021, Article ID 7865405, 9 pages, 2021. https://doi.org/10.1155/2021/7865405

Video of Neutrophil
Behnsen J, Narang P, Hasenberg M, Gunzer F, Bilitewski U, Klippel N, Rohde M, Brock M, Brakhage AA, Gunzer M. Environmental dimensionality controls the interaction of phagocytes with the pathogenic fungi Aspergillus fumigatus and Candida albicans. PLoS Pathog. 2007 Feb;3(2):e13. doi: 10.1371/journal.ppat.0030013. PMID: 17274685; PMCID: PMC1790725.

Picture of NETs
Urban CF, Ermert D, Schmid M, Abu-Abed U, Goosmann C, et al. 2009 Neutrophil Extracellular Traps Contain Calprotectin, a Cytosolic Protein Complex Involved in Host Defense against Candida albicans. PLoS Pathog 5(10): e1000639. doi:10.1371/journal.ppat.1000639

NETosis video
Maueröder C, Mahajan A, Paulus S, Gößwein S, Hahn J, Kienhöfer D, Biermann M, Tripal P, Friedrich R, Munoz L, Neurath M, Becker C, Schett G, Herrmann M, Leppkes M (2016). "Ménage-à-Trois: The Ratio of Bicarbonate to CO2 and the pH Regulate the Capacity of Neutrophils to Form NETs". Frontiers in Immunology. DOI:10.3389/fimmu.2016.00583. PMID 28018350. PMC: 5145884.

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Outro: Chopsticks - Text Me Records