Ultrastructural analysis of the pathogenesis ofNeisseria gonorrhoeaeendometrial infection.

We have studied gonococcal infection in human endometrium organ culture and in human primary endometrial epithelial cells using various microscopic techniques including scanning electron microscopy, transmission electron microscopy, bright field light microscopy and laser scanning confocal microscopy. Here we describe the interactions betweenNeisseria gonorrhoeaeand human endometrial luminal epithelial cells at the ultrastructural levels.N. gonorrhoeaeattached to cilia but were not observed associated with the plasma membrane of ciliated epithelial cells or internalized into ciliated epithelial cells.N. gonorrhoeaecould be found in intracellular vacuoles in secretory epithelial cells.N. gonorrhoeaehave diverse interactions with endometrial epithelium. These include intimate association and colocalization with asialoglycoprotein receptor (ASGP-R) and CEACAM, lamellipodia and ruffle formation and colocalization with CR3, and microvillus engagement. These studies indicate thatN. gonorrhoeaeutilize multiple mechanisms to associate with endometrial epithelial cells and can associate with both ciliated and secretory cells. This diversity is consistent with a role of the endometrium as a transition zone between frequently asymptomatic cervical gonorrhoea and symptomatic pelvic inflammatory disease. [ABSTRACT FROM AUTHOR]