Every year, millions worldwide are infected with gonorrhea. Men typically experience noticeable symptoms, while women often have none or only mild ones. Antibiotics effectively clear the infection in both sexes. In a pioneering study, researchers conducted the first full comparison of gonococcal gene expression and regulation in men and women infected with N. gonorrhoeae, uncovering distinct gender-specific patterns in infection dynamics and antibiotic resistance genes. The bacteria display different gene expression profiles depending on the host's gender.
To investigate disease presentation across sexes, the team analyzed samples from patients at a sexually transmitted infection clinic in a region with high gonorrhea prevalence and antibiotic resistance. Specimens came from men seeking treatment and their female partners, who attended after positive partner diagnoses.
Using RNA sequencing, researchers pinpointed host and bacterial genes active during mucosal infection. Findings showed 9% of gonococcal genes upregulated exclusively in males, particularly those involved in immune cell interactions. In females, 4% of genes showed heightened expression, mainly phage-associated ones.
Whole-genome DNA sequencing indicated similar antibiotic resistance genotypes in both genders, but resistance gene expression was four times higher in males.
Limitations include the modest sample size and possible differences in infection stages between groups. A larger study with advanced genetic profiling is underway.
