Neisseria gonorrhoeae and Lactobacillus from initial adherence to effects on human cells

Sammanfattning: The causative agent of gonorrhoea Neisseria gonorrhoeae (gonococcus) colonises the urogenital tract epithelia. The vaginal tract microbiota of healthy females is dominated by Lactobacillus species. In paper I, the ability of lactobacilli to protect cervical cells against gonococcal adherence was investigated. The number of adhered lactobacilli did not correlate to the level of protection against gonococci. Instead, the protection was dependent on specific Lactobacillus isolates. Gonococci able to outmanoeuvre the normal microbiota colonise and may elicit an influx of neutrophils. In paper II the initial interaction between pathogens and neutrophils was investigated. N. gonorrhoeae was found to bind to the non-phagocytic rear (uropod) of the neutrophils. Results suggest that uropod binding is a trait specific of Neisseria species. By binding to the uropod bacteria could avoid the phagocytic front part of the neutrophils whilst being transported across the epithelial cell layer to new sites. Since gonorrhoea has been associated with cancer in several studies, effects of gonococcal colonisation on eukaryote genome integrity was investigated in paper III.  N. gonorrhoeae caused DNA stand breaks in vaginal epithelial cells and decreased the level of tumor protein p53. Infected cells showed increase of cyclin-dependent kinase inhibitors p21 and p27 along with reduced proliferation. The impact of lactobacilli colonisation on cervical cell proliferation was investigated in paper IV. Three out of four Lactobacillus isolates tested reduced cell proliferation. Decreased pH due to lactic acid production was found to be a contributing factor. However, vaginal isolated L. gasseri required a direct bacteria-cell interaction to affect cell cycle progression. Additional unknown factors also contributed as in the case of saliva isolated L. reuteri. In summary, this thesis investigates N. gonorrhoeae pathogenesis and the impact of Lactobacillus species in protection and colonisation.