Abstract
The extracellular protozoan parasite Trichomonas vaginalis colonizes the lower urogenital tract of humans: the vagina, ectocervix, urethra, and prostate, where trophozoites divide asexually and the transmission depends on sexual contact. Trichomoniasis is the most common, nonviral sexually transmitted infection worldwide, accounting for ~270 million cases each year. Pathogenesis has been well characterized in the female genital tract, where reproductive outcomes are clinically relevant, resulting in vaginitis with discharge. T. vaginalis often carries endosymbionts (Mycoplasma and Trichomonasvirus spp.) and is accompanied with vaginal dysbiotic microbiota containing mostly anaerobic bacteria. Host cell adhesion, phagocytosis, and lysis are the major virulence traits of T. vaginalis, with levels varying among strains. Immunopathogenesis is modulated by endosymbionts and the associated microbiota. Despite drug resistance being documented for decades, 5-nitroimidazoles remain the only treatment option.
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