Nongonococcal urethritis: New views through the prism of modern molecular microbiology

Martín, David H.

doi:10.1007/s11908-008-0023-x

Cited by 40 publications

(30 citation statements)

References 28 publications

(30 reference statements)

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“…3 It was shown that the disease spectrum of M. genitalium infections is similar to that of C. trachomatis and N. gonorrhoeae infections and that M. genitalium is associated with urethritis, cervicitis, acute endometritis, salpingitis, tubal factor infertility and pelvic inflammatory disease in women, [4][5][6][7][8] and NGU in men. 9 The prevalence of M. genitalium varies by country and by patient population, ranging from 1% in the general population to 42% in women with vaginal discharge and cervicitis as reviewed in Sethi et al 10 Trichomonas vaginalis is considered the most common non-viral sexually transmitted infection worldwide. 11 The clinical syndrome ranges from asymptomatic carriership to vaginitis, cervicitis and urethritis in women.…”

Section: Introductionmentioning

confidence: 99%

Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands

et al. 2016

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Mycoplasma genitalium and Trichomonas vaginalis are common sexually transmitted infections (STIs). In the Netherlands, testing for M. genitalium and T. vaginalis is not recommended for first-line STI screening. Recent reports about the increasing antimicrobial resistance in M. genitalium raise concern about the adequacy of current empirical treatment regimens. It is necessary to have insight in the prevalence of M. genitalium and T. vaginalis in order to evaluate current first-line STI screening and treatment protocols. During a five-month period, samples sent to two large medical microbiology diagnostic centres in the Netherlands for STI screening (Chlamydia trachomatis and Neisseria gonorrhoeae) were retrospectively tested for the prevalence of M. genitalium and T. vaginalis using the Diagenode S-DiaMGTV kit. A total of 1569 samples from 1188 unique patients (55.4% female) were tested. M. genitalium was the second most prevalent STI detected (4.5% of the patients), after C. trachomatis (8.3%). T. vaginalis was detected in 1.4% of the patients, comparable to the prevalence of N. gonorrhoeae (1.3%). Dual infections were only detected in a small number of patients (1.0%). Incorporation of M. genitalium into routine STI screening should be considered, because of its relatively high prevalence, the consequences of its detection for antibiotic treatment and because of the availability of easy-to-use molecular diagnostic tests. For T. vaginalis, routine screening may be considered, depending on local prevalence and (sub)population.

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Section: Introductionmentioning

confidence: 99%

Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands

et al. 2016

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“…Mycoplasma genitalium is a sexually transmitted pathogen (20,27) implicated as an important cause of nongonococcal urethritis in men (28). In women, inflammatory reproductive tract disease syndromes, including pelvic inflammatory disease (17) and cervicitis (11,24,26,34,44), also have been associated with M. genitalium infection.…”

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confidence: 99%

Mycoplasma genitalium -Encoded MG309 Activates NF-κB via Toll-Like Receptors 2 and 6 To Elicit Proinflammatory Cytokine Secretion from Human Genital Epithelial Cells

McGowin

Martín

et al. 2009

Infect Immun

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Mycoplasma genitalium has been implicated in several important reproductive tract syndromes in women, including pelvic inflammatory disease, cervicitis, and tubal factor infertility. The mechanisms of immune activation are unclear, and we sought to determine whether M. genitalium was capable of activating innate immune responses through ligation of highly expressed Toll-like receptors (TLR) of the genital tract. Using HEK293 cells expressing specific human TLR, viable M. genitalium and the recombinant C-terminal portion of the immunogenic protein MG309 (rMG309c) were shown to activate NF-B via TLR2/6. These data provided a putative mechanism for activation of the innate response in genital tissues. Genital epithelial cells (EC) are the first responders to sexually transmitted pathogens and express high levels of TLR2 and -6. Following exposure to purified rMG309c, vaginal and ecto-and endocervical EC secreted proinflammatory cytokines, including interleukin-6 (IL-6) and IL-8. Vaginal EC were less responsive than cervical EC. The capacity of rMG309c to bind TLR2/6 and elicit inflammation was sensitive to proteinase K digestion and independent of traditional N-terminal lipoylation. Furthermore, the immunostimulatory capacity of rMG309c was localized specifically to a 91-amino-acid subfragment of the recombinant protein, suggesting that TLR activation is likely amino acid based. Together, these data indicated that human vaginal and cervical EC are immunologically responsive to M. genitalium and to purified rMG309c via highly expressed TLR of the genital tract. These findings provide valuable insights into the mechanisms for activation of acute-phase inflammatory responses and suggest that M. genitalium colonization of reproductive tract tissues may result in inflammatory sequelae.Mycoplasma genitalium is a sexually transmitted pathogen (20, 27) implicated as an important cause of nongonococcal urethritis in men (28). In women, inflammatory reproductive tract disease syndromes, including pelvic inflammatory disease (17) and cervicitis (11,24,26,34,44), also have been associated with M. genitalium infection. However, the mechanisms for initiation of the innate immune response in these tissues have yet to be elucidated. Results presented herein establish that M. genitalium and the C-terminal portion of the antigenic protein encoded by MG309 activate NF-B via Toll-like receptors 2 and 6 (TLR2/6), resulting in cytokine secretion from relevant epithelial cells (EC) of the reproductive tract. These findings elucidate a putative mechanism for induction of proinflammatory responses and provide a rationale for continued investigation into the mechanisms of M. genitalium-induced urogenital disease in women.The female reproductive tract includes the normally sterile upper genital tract, composed of the uterus, fallopian tubes, and ovaries. The lower genital tract includes the polymicrobial environment of the vagina and the translational ectocervical and endocervical tissues. EC of the reproductive tract provide a physical barr...

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“…Recent data supporting U. urealyticum as a commensal or pathogenic bacterium are inconsistent. 2,3,5 Further studies are required to improve our understanding of the role of U. urealyticum in NGU.…”

Section: Mycoplasmamentioning

confidence: 99%

“…1,2 However, nonchlamydial NGU is still a problematic disease for clinics. Various infectious pathogens, including Mycoplasma, viruses, and protozoan parasites, are possible causes of NGU 3 and exhibit similar symptoms. However, pathogens still cannot be detected in most cases of nonchlamydial NGU.…”

Section: Introductionmentioning

confidence: 99%

Nonchlamydial nongonococcal urethritis in men

Tsai

2013

Urological Science

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a b s t r a c tBy definition, nongonococcal urethritis (NGU) is an infectious condition involving urethra inflammation without Neisseria gonorrhoeae infection. According to recent studies, NGU accounts for 10e30% of initial visits to sexually transmitted infection (STI) clinics, and is one of the most common forms of STI in men. Chlamydia trachomatis is the most prevalent and well-established pathogen in NGU. However, nonchlamydial NGU is still a problematic disease in clinics because of its minimally symptomatic or asymptomatic manifestation. Various infection causes, including Mycoplasma, Trichomonas vaginalis, and herpes simplex virus, are possible pathogens in nonchlamydial NGU. In this brief review, we focus on the evaluation and management of nonchlamydial NGU.

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Nongonococcal urethritis: New views through the prism of modern molecular microbiology

Cited by 40 publications

References 28 publications

Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands

Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands

Mycoplasma genitalium -Encoded MG309 Activates NF-κB via Toll-Like Receptors 2 and 6 To Elicit Proinflammatory Cytokine Secretion from Human Genital Epithelial Cells

Nonchlamydial nongonococcal urethritis in men

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