Aim: to discuss recent epidemiology of gonorrhoea and updates regarding its pathogenesis with a focus on biochemical aspects of contact and adhesion that preceded its epithelial invasion.
 Discussion: Neisseria gonorrhoeae, a Gram-negative obligate human pathogenic bacterium, infects human epithelial cells and causes sexually transmitted diseases in both males and females Gonorrhea rates are rising in many countries. It could lead to long-term health problems and even infertility. Vulnerable groups including men who have sex with men and sex workers appear to bear disproportionate burdens of gonorrhea. As N. gonorrhoeae advances through the steps of disease formation and pathogenesis (transmission, adherence, colonization and invasion, and also immune evasion), the bacterium expresses some virulence factors to facilitate its survival and replication; while at the same time keeping its existence barely invasive and almost undiscoverable by active immune cells. Adherence to epithelial cells becomes the first event that precedes invasion.
 Conclusion: Adhesion of gonococci to mucosal epithelial cells appears to be a critical step in the pathogenesis of gonococcal infection. Gonococci can adhere to a variety of human cells. Gonorrhea has multiple surface proteins that facilitate adhesion. N. gonorrhoeae utilize type IV pili and Opa, opacity-associated proteins, surface proteins involved in cellular attachment that preceded its invasion, Lipooligosaccharides (LOS) and also the outer membrane protein porin (POrB).
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