![]() ![]() ![]() A model of gonococcal pathogenesis is presented in the context of the male and female human urogenital tracts. Gonococcal engagement of complement receptor 3 on the cervical epithelia results in membrane ruffling and does not promote inflammation. This is in part the result of the ability of the gonococcus to subvert the alternative pathway of complement present in the lower female genital tract. In contrast, gonococcal infection of the lower female genital tract is typically asymptomatic. Gonococci invade the nonciliated epithelia, and the ciliated cells are subjected to the cytotoxic effects of tumor necrosis factor alpha induced by gonococcal peptidoglycan and lipooligosaccharide. Similarly, gonococcal infection of the upper female genital tract also results in inflammation. Gonococcal interaction with the urethral epithelia cell triggers cytokine release, which promotes neutrophil influx and an inflammatory response. ![]() An intimate association occurs between the gonococcus and the urethral epithelium and is mediated by the asialoglycoprotein receptor. The clinical presentations of disease are also strikingly different upon comparison of gonococcal urethritis to gonococcal cervicitis. The molecular mechanisms used by the gonococcus to initiate infection exhibit gender specificity.
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