The Pathogenesis of Gonococcal Urethritis in Men: Confocal and Immunoelectron Microscopic Analysis of Urethral Exudates from Men Infected with Neisseria gonorrhoeae

• Published in: The Journal of infectious diseases Vol. 173; no. 3; pp. 636 - 646
• Main Authors: Apicella, Michael A., Ketterer, Margaret, Lee, Frank K. N., Zhou, Daoguo, Rice, Peter A., Blake, Milan S.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.03.1996; University of Chicago Press; Oxford University Press
• Subjects: 3T3 cells; Bacterial diseases; Biological and medical sciences; Cell lines; Cell membranes; Epithelial cells; Epithelium - microbiology; Epithelium - pathology; Exudates and Transudates - cytology; Exudates and Transudates - microbiology; Gonorrhea - etiology; Gonorrhea - microbiology; Gonorrhea - pathology; Hep G2 cells; Human bacterial diseases; Humans; Infections; Infectious diseases; Major Articles; Male; Medical sciences; Membrane Fusion; Microscopy; Microscopy, Confocal; Microscopy, Immunoelectron; Miscellaneous; Neisseria gonorrhoeae; Neisseria gonorrhoeae - isolation & purification; Phagocytes; Urethritis - etiology; Urethritis - microbiology; Urethritis - pathology; Vacuoles; Vacuoles - microbiology; Vacuoles - ultrastructure; Human; Urinary system disease; Urethral disease; Pathogenesis; Neisseriaceae; Cytology; Exploration; Urinary tract disease; Electron microscopy; Infection; Gonococcal infection; Neisseria gonorrhoeae; Bacteriosis; Bacteria; Micrococcales; Epithelial cell; Urethritis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/173.3.636

Confocal and immunoelectron microscopic analysis of urethral exudates from 12 men with gonococcal urethritis showed that Neisseria gonorrhoeae can invade urethral epithelial cells. Studies with acridine orange stain demonstrated that the majority of organisms within urethral epithelial cells were viable at the time of fixation. Three-dimensional modeling of an infected epithelial cell using image analysis of 21 digitized confocal sections stained with YOYO-1 and DiIC18(3) revealed that gonococcal invasion of these cells occurred in a polar fashion, most likely at the epithelial luminal surface. Serial immunoelectron micrographs showed evidence of membrane fusion with pedestal formation between the gonococcus and the epithelial cell, gonococci within vacuoles, and occasional gonococci free in the cytoplasm. Immunoelectron microscopy studies showed ruptured vacuoles at the cell surface releasing organisms. These studies demonstrate that urethral epithelial cells are invaded by gonococci during the course of infection in males.