Search

In the presented study, clinical samples were obtained in order to investigate host responses (such as cytokine production) and pathogen factors (strain genotype, infectious load) that may determine the clinical manifestations of gonococcal infection. However, the prevalence of N. gonorrhoeae - as determined by polymerase chain reaction (PCR) assays - was 0% in two Thai study populations [480 asymptomatic male students and 90 mucopurulent crevices (MPC) patients], and 5.5% (all porin genotype porB1b) in 348 Sir Lankan female sexually transmitted disease (STD) clinic attendees. This precluded a patient based study of the immunopathology of gonorrhoea. In contrast, Chlamydia trachomatis infection was present in 4.2% of the Thai students, 25.6% of the Sri Lankan women, and 26.7% of the Thai MPC patients. Neither gonococcal nor chlamydial infection was significantly associated with cervical abnormalities in the Sri Lankan population, nor was the presence or infectious load of chlamydiae linked to the severity of MPC in Thai women. However, quantitative TaqMan® PCR assays revealed that in the latter group, women who shed large numbers of chlamydiae from the endocervix were more likely to have chlamydial urethritis or endometritis than were women who shed few or no organisms. Endocervical cytokine levels (measured by time-resolved fluorescence immunoassays) were not associated with the presence or load of chlamydiae; but secretion of interleukin (IL)-1β, IL-6 and IL-8 was increased in patients with overt cervical mucopus. The inflammatory cytokine response to an STD pathogen was further explored in vitro, using N. gonorrhoeae strain P9 and human mononuclear phagocytes resembling 'tissue-resident' macrophages.