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The World Health Organization WHO estimates that 78 million people worldwide are infected with gonorrhea each yearly. Men with infections tend to have obvious symptoms while women experience mild symptoms. Antibiotic treatment can clears the infection in men and women.
However, there has been an emergence of strains of antimicrobial-resistant Neisseria gonorrhoeae, the bacterial pathogen responsible for gonorrhea, and in 2013, the Centers for Disease Control and Prevention listed drug-resistant N. gonorrhoeae as an urgent public health threat.
A team led by researchers from Tufts University School of Medicine conducted the first full comparison of gonococcal gene expression and regulation in both men and women infected with N. gonorrhoeae, identifying gender-specific signatures in infection and in antibiotic resistance genes.
Using gene expression during infection in females to include both genders in the present analysis, they discovered the expression profiles during active disease in males and their asymptomatic partners. When the bacteria are infecting the male, it’s a different gene expression profile compared to when they are infecting the female.
Studying active, natural infection in both men and women is critical to develop strategies to treat and prevent infection. To understand the disease in both genders, the team looked at disease manifestation in a cohort of subjects attending a clinic that treats sexually transmitted infections in a country where there are high rates of gonorrhea and antibiotic resistance. Specimens were collected from males who went to the clinic for treatment for gonorrhea and from the female partners who came in for treatment following confirmation of their partner’s diagnosis.
The researchers used RNA-sequencing to identify what host and bacterial genes are expressed during mucosal infection.
The analysis revealed that 9 percent of gonococcal genes showed increased expression exclusively in men and included genes involved in host immune cell interactions. Four percent of genes showed increased expression exclusively in women and included phage-associated genes.
In whole genome DNA sequencing, men and women displayed similar antibiotic-resistant genotypes, but researchers observed an expression of these antibiotic-resistant genes four times higher in men. Limitations include the small sample size and the potential variance in stages of infection in the male subjects compared to the female.
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