Previous Article | Next Article 
Infection and Immunity, July 2005, p. 4281-4287, Vol. 73, No. 7
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.7.4281-4287.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
The Gonococcal Fur-Regulated tbpA and tbpB Genes Are Expressed during Natural Mucosal Gonococcal Infection
Sarika Agarwal,1
Carol A. King,1
Ellen K. Klein,1
David E. Soper,2
Peter A. Rice,1,3
Lee M. Wetzler,1,3 and
Caroline A. Genco1,3*
Department of Medicine, Section of Infectious Diseases,1
Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts 02118,3
Medical University of South Carolina, Charleston, South Carolina 294252
Received 29 October 2004/
Returned for modification 4 January 2005/
Accepted 2 March 2005

ABSTRACT
Iron is limiting in the human host, and bacterial pathogens
respond to this environment by regulating gene expression through
the ferric uptake regulator protein (Fur). In vitro studies
have demonstrated that
Neisseria gonorrhoeae controls the expression
of several critical genes through an iron- and Fur-mediated
mechanism. While most in vitro experiments are designed to determine
the response of
N. gonorrhoeae to an exogenous iron concentration
of zero, these organisms are unlikely to be exposed to such
severe limitations of iron in vivo. To determine if
N. gonorrhoeae expresses iron- and Fur-regulated genes in vivo during uncomplicated
gonococcal infection, we examined gene expression profiles of
specimens obtained from male subjects with urethral infections.
RNA was isolated from urethral swab specimens and used as a
template to amplify, by reverse transcriptase PCR (RT-PCR),
gonococcal genes known to be regulated by iron and Fur (
tbpA,
tbpB, and
fur). The constitutively expressed gonococcal
rmp gene was used as a positive control. RT-PCR analysis indicated
that gonorrhea-positive specimens where
rmp expression was seen
were also 93% (51/55)
fbpA positive, 87% (48/55)
tbpA positive,
and 86% (14 of 16 tested)
tbpB positive. In addition, we detected
a
fur transcript in 79% (37 of 47 tested) of positive specimens.
We also measured increases in levels of immunoglobulin G antibody
against TbpA (91%) and TbpB (73%) antigens in sera from infected
male subjects compared to those in uninfected controls. A positive
trend between
tbpA gene expression and TbpA antibody levels
in sera indicated a relationship between levels of gene expression
and immune response in male subjects infected with gonorrhea
for the first time. These results indicate that gonococcal iron-
and Fur-regulated
tbpA and
tbpB genes are expressed in gonococcal
infection and that male subjects with mucosal gonococcal infections
exhibit antibodies to these proteins.

INTRODUCTION
Neisseria gonorrhoeae, the causative agent of gonorrhea, is
one of the most common causes of sexually transmitted infections
in the world, with over 62 million new cases estimated by the
World Health Organization in 1999 alone (see
http://whqlibdoc.who.int/hq/2001/WHO_HIV_AIDS_2001.02.pdf).
Control of gonorrhea has been complicated by the development
of resistance to antimicrobial agents. Manifestations of gonococcal
disease include urethritis and epididymitis in men and urethritis,
cervicitis, salpingitis, and endometritis in women. If left
untreated, gonococcal infection in women may lead to the development
of pelvic inflammatory disease, which can result in infertility
or ectopic pregnancy. Recent data also suggest that gonorrhea
upregulates production of human immunodeficiency virus (HIV)
in seminal plasma of men coinfected with both agents and is
accompanied by increased transmission of HIV to female sex partners
(
9).
Bacteria are limited in their capacity to multiply in vivo by their hosts' "iron-withholding" defense mechanism (32, 41). Bacteria require iron (0.3 to 1.8 µM) for optimal growth (6), but as bacteria colonize and then proliferate in the host, they utilize elaborate mechanisms to acquire iron from the host. The best-characterized mechanism is to scavenge iron; this involves the synthesis of siderophores, which bind iron with high affinity. Pathogenic Neisseria, however, does not produce siderophores, but instead has evolved outer membrane receptors that bind directly to host iron sources, such as transferrin, lactoferrin, and hemoglobin. All gonococcal isolates can utilize iron from transferrin and hemoglobin (29), but only 50 to 70% of strains can internalize iron bound to lactoferrin (28). The transferrin receptor consists of a highly conserved integral outer membrane receptor, TbpA (10), and a variable surface-exposed lipoprotein, TbpB (2, 11). Together, these proteins bind human transferrin, specifically facilitating the removal of iron by Neisseria in an energy-dependent manner (12). Once iron is removed from transferrin, it is bound by periplasmic ferric binding protein (FbpA), which ferries it to a cytoplasmic membrane acceptor (FbpB), where it is internalized by an energy-dependent process (8). In the human male urethral challenge model of gonococcal infection, expression of a functional transferrin uptake system (but not necessarily the lactoferrin system) is essential for gonococcal colonization after urethral installation of the challenge inoculum, thereby emphasizing the importance of this system in human infection (13).
The expression of genes that encode gonococcal transferrin-binding proteins is controlled at the transcriptional level by the iron-dependent regulatory protein Fur (ferric uptake regulatory protein) (31). Fur functions as a general global regulator and controls the expression of genes required for iron transport and also controls genes that are required for virulence (20, 39). Fur forms a dimer with ferrous iron and binds to a consensus sequence (Fur-box) that overlaps the promoters of iron-regulated genes and results in inhibition of transcription. Although Fur may also act as a positive regulator in controlling gene expression (15-17, 25), the interactions between the operator regions of the iron-activated genes have not been studied in detail. We have determined previously that the gonococcal Fur protein binds to the promoter regions of several well-defined iron transport genes in Neisseria and to additional genes involved in catabolic, secretory, and recombination pathways. These include tonB, fur, recN, secY, sodB, hemO, hmbR, fumC, and the opa family of genes (39). Furthermore, we recently demonstrated with DNA microarray technology, using Neisseria meningitidis strain MC58, that
10% of the entire bacterial genome is regulated in response to growth with iron (20). While these recent observations demonstrate that pathogenic Neisseria may regulate the expression of specific genes globally in response to in vitro iron, little is known about gene expression in response to iron in vivo.
In this study, we have directly assessed the expression of the iron- and Fur-regulated genes fbpA, tbpA, tbpB, and fur in urethral samples obtained from male subjects with uncomplicated gonococcal infections. Levels of antibody directed to a subset of the proteins encoded by these genes were also measured to assess the immunogenic capacities of these iron- and Fur-regulated gene products when they are expressed in vivo.

MATERIALS AND METHODS
Study population.
Male subjects 18 years of age and older with uncomplicated gonorrhea
were enrolled from the Public Health Clinics at Boston Medical
Center (BMC), Boston, Mass., and the Medical University of South
Carolina (MUSC), Charleston, S.C. Men were excluded if they
had been treated with antibiotics in the past month or were
HIV infected. Informed consent was obtained and a current and
past sexual history recorded. Routine laboratory examination
of urethral swab specimens, including enumeration of polymorphonuclear
leukocytes and nucleic acid amplification testing for
Chlamydia trachomatis, was performed. Separate urethral swabs were obtained
for this study from men who were diagnosed with gonococcal infections
as evidenced by Gram's stains of urethral exudate that showed
gram-negative intracellular diplococci or who exhibited positive
tests for neisserial H8 antigen by use of immunochromatographic
detection assays (
27). The diagnoses were confirmed by the growth
of
N. gonorrhoeae on Thayer-Martin media or by positive hybridization
tests (Gen-Probe, San Diego, CA) or transcription-mediated amplification
assays (Gen-Probe, San Diego, CA) performed on the urethral
specimens. The separate urethral swabs to be used for this study
were placed in 1 ml TRIZOL reagent (Invitrogen, Carlsbad, CA)
for subsequent RNA isolation and stored at 80°C.
Specimens from MUSC were shipped on dry ice by overnight delivery
to Boston Medical Center, and specimens from both sites were
processed within 2 days. All 55 samples were analyzed for
fbpA and
tbpA mRNA transcripts. Forty-seven samples were tested for
fur transcripts and 16 for
tbpB transcripts. At MUSC, sera were
also collected to measure levels of immunoglobulin G (IgG) antibody
against gonococcal TbpA and TbpB antigens and gonococcal porin
isoforms IA (PIA) and IB (PIB), with the latter two used as
control antigens. Control sera were also obtained from five
uninfected volunteers with no history of gonococcal infection
or contact with gonococcal antigens.
In vitro growth of N. gonorrhoeae strain F62 and RNA isolation.
To determine the minimal concentration of RNA required to detect specific gonococcal mRNA transcripts by reverse transcriptase (RT)-PCR, in vitro, we grew N. gonorrhoeae strain F62 and isolated RNA from organisms grown under iron-depleted and iron-sufficient conditions. Strain F62 was grown in chemically defined medium (CDM) supplemented with 4.2% NaHCO3 and in CDM plus an iron chelator, 25 µM Desferal (CDM/25 µM Desferal) (Ciba-Geigy), for 3 h aerobically at 37°C. Organisms grown under iron-restricted conditions were then washed, resuspended, divided, and inoculated into fresh CDM/12.5 µM Desferal (iron-depleted liquid cultures) or CDM/100 µM ferric nitrate (iron-sufficient liquid cultures), each beginning with an absorbance at 660 nm (A660) of 0.06. Growth was monitored and samples collected hourly for a total of 5 h (30).
RT-PCR of N. gonorrhoeae strain F62 RNA.
Total RNA was isolated from N. gonorrhoeae strain F62 using the RNeasy kit (QIAGEN, Valencia, CA). Samples were treated with DNase I (Invitrogen) before performing an RT-PCR using the SuperScript one-step RT-PCR with the Platinum Taq kit (Invitrogen, Carlsbad, CA). To the DNA-free RNA samples (200 ng), we added 25 µl of 2x reaction mix, 100 ng of each primer (Table 1), 1 µl RT/Taq mix, and diethyl pyrocarbonate (DEPC)-treated water to final volumes of 50 µl. Samples were heated to 50°C for 30 min and subsequently predenaturated at 94°C for 2 min. PCR amplifications were then carried out using the following parameters: denaturation at 94°C for 30 s, annealing at 56°C for 45 s, and elongation at 72°C for 45 s, for 25 cycles. For each sample, a control was also included to ensure the absence of DNA contamination by performing a PCR lacking reverse transcriptase enzyme with the isolated RNA sample using the rmp gene-specific primers for amplification.
RNA isolation and RT-PCR of clinical samples.
Total RNA was isolated from TRIZOL-preserved urethral swab specimens
according to the manufacturer's instructions. Briefly, the sample
in TRIZOL was repeatedly pipetted to disrupt cells. The samples
were incubated for 5 min at room temperature to permit complete
dissociation of nucleoprotein complexes, 0.25-ml portions of
chloroform were added, and the samples were centrifuged at 12,000
x g for 15 min at 4°C. Five milligrams of RNase-free glycogen
and 0.5 ml of isopropyl alcohol were introduced to precipitate
nucleic acids for 15 min at room temperature, and the pellets
were washed with 75% ethanol (in DEPC-treated water). Pellets
were resuspended in DEPC-treated water, and DNase I (Invitrogen)
treatment was performed according to the manufacturer's instructions.
The total volume of isolated RNA was divided equally for each
amplification reaction, and all RT-PCRs for a single specimen
were performed simultaneously using parameters the same as those
described above for RNA from gonococcal strain F-62, except
that the number of amplification cycles was increased to 35.
Amplification was performed using gene-specific primers of gonococcal
genes known to be regulated by iron and Fur (
fbpA,
tbpA,
tbpB,
and
fur) and by the constitutively expressed
rmp gene (Table
1). For each sample, a control sample was also included to ensure
the absence of DNA contamination of RNA prepared from specimen
samples by performing a PCR, lacking reverse transcriptase enzyme,
with the isolated RNA sample using
rmp gene-specific primers
for amplification.
Semiquantitative densitometry analysis of amplified cDNA bands.
Amplified cDNA fragments isolated by the RT-PCR methods indicated above were run on a 1% agarose gel in 1x TAE (Tris-acetate-EDTA) buffer with 0.5 µg/ml ethidium bromide and then visualized under UV light (38). The density of each DNA band on the 1% agarose gel was measured using Bio-Rad QUANTITY ONE 4.1.1 quantitation software. Background measurements were subtracted, and a relative number was assigned to each band intensity (20).
Antigen production.
TbpA protein was purified from F62 that was grown in iron-deficient media using an affinity isolation procedure described earlier (5). Gonococcal porins were purified by previously published purification procedures using detergent extraction and column chromatography (4). Recombinant gonococcal outer membrane protein TbpB (36) was purified from Escherichia coli (DH5
) expressing the maltose-binding fusion protein that contained TbpB by affinity purification using an amylose resin column (36).
ELISA and antibody quantification.
Levels of anti-TbpA- and anti-TbpB-specific IgG antibody were measured in the sera of subjects infected with N. gonorrhoeae and in the sera of uninfected volunteers by use of quantitative enzyme-linked immunosorbent assay (ELISA) (40, 42). Antibodies directed against PIA and PIB were measured as positive controls, because previous studies have shown the presence of PIA- and PIB-specific antibodies in all sera from subjects with local (7, 23, 26, 33, 34) or disseminated (21, 37) gonococcal disease. The Mann-Whitney U test was used to compare IgG antibody levels in sera from subjects with control levels. We also compared levels of IgG antibody against TbpA and TbpB in subject sera with those in control sera by determining the number of subject sera that displayed antibody levels greater than 2 standard errors of the mean (SEMs) (geometric mean) above the geometric mean(s) of control sera. Fisher's exact test was used to assess the difference between levels of IgG antibody levels against TbpA and TbpB in subjects and those of control sera. A possible correlation between tbpA gene expression and TbpA isoantibody levels was assessed with Pearson's linear correlation (InStat; GraphPad, San Diego, CA).

RESULTS
Sensitivity of RNA isolation and detection of gonococcal transcripts.
Total RNA isolated from cultures of
N. gonorrhoeae strain F62
in iron-depleted and -sufficient conditions was analyzed for
differential gene expression of the iron- and Fur-regulated
fbpA,
tbpA,
tbpB, and
fur genes. The
rmp gene was also amplified
at different time points in iron-depleted and -sufficient conditions,
and no variability of expression was observed between the growth
conditions, indicating that the
rmp gene was constitutively
expressed in each of the growth conditions. We confirmed that
in iron-depleted conditions, the expression of the iron-regulated
genes was increased compared to the expression of the constitutively
expressed
rmp gene (Fig.
1). Total RNA isolated from
N. gonorrhoeae strain F62 grown in iron-sufficient conditions was also utilized
to determine the sensitivity of RT-PCR under the experimental
conditions used in this study. We amplified an
rmp PCR product
with as little as 1 ng of total RNA obtained from cultures grown
in iron-sufficient conditions (data not shown).
Detection of gonococcal transcripts in urethral specimens from male subjects.
Using the methodology described above, we next analyzed gonococcal
gene expression in specimens from male subjects with uncomplicated
gonococcal infections. The total amount of RNA isolated from
urethral specimens (host plus organism) typically ranged from
50 ng to 600 ng. Differential net gene expression of specific
iron- and Fur-regulated genes from urethral specimens was assessed
following RT-PCR and semiquantitative densitometry analysis
of each amplified product. Each gene examined in this manner
was assigned a relative densitometry value with Bio-Rad QUANTITY
ONE 4.1.1 quantitation software, and a ratio of the relative
densitometry values of the
fbpA,
tbpA,
tbpB, and
fur gene transcripts
was calculated against the
rmp value for each specimen. A ratio
(deemed the expression ratio) of <1.0 was arbitrarily taken
to represent a decrease in gene expression versus that of
rmp mRNA, and an expression ratio of >1.0 was taken to represent
increased gene expression compared to
rmp gene expression. Over
90% of gonorrhea-positive specimens expressed the
rmp gene by
RT-PCR. Of the 55
rmp-positive specimens, 51 (93%) expressed
the
fbpA gene (Table
2). The genes encoding the transferrin-binding
proteins TbpA and TbpB were expressed, respectively, in 48 (87%)
specimens positive for
rmp transcripts and in 14 out of 16 (86%)
rmp-positive specimens that were also tested for the
tbpB transcript.
We also detected a
fur transcript in 37 of 47 (79%) specimens
positive for
rmp transcripts that were also tested for the
fur transcript (Table
2). None of the RNA specimens prepared from
urethral swab specimens were contaminated with DNA, as determined
by PCRs lacking reverse transcriptase enzyme with
rmp-specific
primers (data not shown).
View this table:
[in this window]
[in a new window]
|
TABLE 2. Expression found by RT-PCR of iron- and Fur-regulated genes: fbpA, tbpA, fur, and tbpB transcripts and rmp transcripts amplified from total RNA isolated from urethral specimens from gonorrhea-infected males
|
Levels of the amplified transcripts for the iron-regulated genes,
relative to that of the
rmp gene (the expression ratio), varied
greatly from subject to subject (Fig.
2 and
3). Expression ratios
ranged from 0.03 to 17.4 for
fbpA transcripts; from 0.01 to
20.4 and from 0.01 to 20.1 for
tbpA and
fur transcripts, respectively;
and from 0.01 to 1.09 for the
tbpB transcript (Fig.
2). Overall,
73% of the specimens exhibited expression ratios for
fbpA,
tbpA,
and
fur transcripts of <1.0, and 27% had expression ratios
of >1.0. Two specimens demonstrated no differences in
fbpA or
tbpA gene expression compared to
rmp gene expression (expression
ratio, 1.0). Although expression ratios for
fbpA,
tbpA, and
fur genes fell above (28%, 28%, and 24%) and below (72%, 72%,
and 76%) 1.0, among the 14 specimens positive for
tbpB transcripts,
expression ratios were <1.0 in 13.
Antibody responses to iron-regulated proteins in male subjects.
We measured IgG antibody responses to gonococcal transferrin-binding
proteins TbpA and TbpB in sera from male subjects with gonorrhea
by use of quantitative ELISA to assess whether IgG antibody
responses correlated with upregulation of the genes encoding
these proteins. IgG antibodies against TbpA and TbpB were measured
because they exhibit complement-dependent bactericidal activity
in
Neisseria-infected mice, which may be protective in neisserial
infection (
24). Levels of IgG antibody against TbpA ranged widely,
from 10 to 6,970 ng/ml (median, 630 ng/ml; geometric mean ±
SEM, 379 ± 1.4 ng/ml). Levels of IgG against TbpB also
ranged widely (20 to 6,700 ng/ml) (median, 134 ng/ml; geometric
mean ± SEM, 164 ± 1.5 ng/ml) (Fig.
4). Measured
levels of IgG antibody against TbpA and TbpB from gonorrhea-infected
subjects were significantly higher than the corresponding levels
(49 ± 1 and 36 ± 1.3 ng/ml) measured in control
sera (
P = 0.003 and
P = 0.02, respectively). Ninety-one percent
of subjects had TbpA IgG antibody levels that exceeded the geometric
mean (± 2 SEM) level of the control sera (
P = 0.004),
compared to 73% for TbpB (
P = 0.04). As expected, levels of
IgG against PIA and PIB antigens were also higher than levels
in control sera (Table
3). These results indicate that subjects
exhibit above-normal levels of IgG antibody to these iron-regulated
protein antigens during natural gonococcal infection. A correlation
of
tbpA gene expression to antibody levels against TbpA in sera
from infected male specimens was determined by calculating the
correlation coefficient using the InStat program (version 3.06;
GraphPad Software, San Diego, CA). The expression ratios of
tbpA to
rmp versus IgG antibody levels in 10/22 subjects infected
with
N. gonorrhoeae were plotted (Fig.
5). These 10 subjects
reported first-time gonococcal infections; the remaining 12
had had gonorrhea before, and some exhibited elevated antibody
levels in the absence of
tbpA gene expression. The correlation
coefficient (
r) in the 10 subjects was 0.65 (
P = 0.04) (Fig.
5).
View this table:
[in this window]
[in a new window]
|
TABLE 3. Percentages of samples displaying levels of IgG antibody against the indicated antigens from male subjects with uncomplicated gonococcal infection greater than 2 SEM above the geometric means of levels measured in control sera
|

DISCUSSION
We have confirmed that a subset of gonococcal iron- and Fur-regulated
genes are expressed in men with uncomplicated gonococcal infections.
Furthermore, we have demonstrated that these subjects exhibit
antibodies to TbpA and TbpB proteins. In the majority of subjects
with gonococcal infections, we detected
fbpA,
tbpA,
tbpB, and
fur transcripts. The
Neisseria Fur appears to act as a global
regulator with the ability to act both as a repressor and as
an activator of gene transcription. While several studies have
recently demonstrated
fur expression during in vitro growth
(
14,
39), our study is the first to describe the expression
of the
fur transcript during natural gonococcal infection (in
79% of infected samples).
Our studies also demonstrated that a high proportion of male subjects with uncomplicated gonococcal infections exhibited levels of IgG antibody against TbpA and TbpB antigens that were significantly higher than levels measured in uninfected controls. The majority of sera from infected subjects in our study also contained anti-PIA and anti-PIB IgG antibody levels that were elevated relative to the levels in control sera (Table 3). Previous studies have shown measurable levels of IgG antibody to gonococcal porins in infected subjects (7, 23, 26, 40). Despite elevated levels of TbpA antibodies measured in gonorrhea-infected men, bactericidal function against TbpA is highly dependent on activity directed against native or conformational epitopes (1). Several studies have also suggested that TbpB should be considered as a candidate for a possible vaccine against N. meningitidis infection (1-3, 19). TbpB antibodies can be measured in convalescent-phase sera from patients with meningococcal disease (18, 19, 22); they are protective in a mouse model of infection, and they are also bactericidal in laboratory animals (24). However, TbpB is highly variable in different strains of N. gonorrhoeae and, taken together with lower tbpB transcript amounts produced in subject samples, may explain why we observed lower titers of IgG antibody against TbpB antigen than against TbpA. The gene-specific primers that we used for RT-PCR may have lacked the homology necessary to recognize all the separate tbpB genes. Interestingly, we have found that tbpB, when examined by microarray analysis (unpublished data), is expressed at levels higher than those found with RT-PCR, such as we have reported here. In the microarray analysis, we used a 50-bp oligonucleotide conserved across all the known tbpB genes to represent the tbpB gene, compared to a 350-bp internal tbpB fragment that was used here in RT-PCR analysis, containing both conserved and unique (variable) tbpB sequences.
Recently, Price et al. (35) reported IgG anti-TbpA and -TbpB antibody levels similar to those we report here for gonorrhea-infected male subjects but indicated that these were not different from the levels in uninfected controls (35). This may be explained by differences in the sources of control sera used to measure antibody specificity. In our study, control sera were obtained from normal volunteers with no previous history of neisserial disease and no contact with gonococcal antigens. In comparison, control sera used by Price et al. (35) were heavily weighted to include subjects from a sexually transmitted disease clinic who were culture negative for N. gonorrhoeae at the time blood was drawn for antibody determinations and who had no known prior history of gonococcal infection, reflecting antibody levels
10 times higher than those seen in our controls and those found by others (19).
In our study, a trend between tbpA gene expression and antibody levels in sera was observed only in subjects with initial gonococcal infections, suggesting that the increases in antibody levels over a low baseline (e.g., control sera) may come about from single gonococcal infections. Those with previous gonococcal infection(s) exhibited antibody levels, but this bore no relationship to tbpA gene expression at the time of the current infection and suggests the possibility of carryover of IgG antibodies from previous infection.
Cross-reactivity between gonococcal and meningococcal Tbp's cannot be ruled out. However, the following three observations reported here indicate that much of the IgG antibody against TbpA/TbpB was the result of past and present gonococcal infection. (i) Antibody levels in serum taken from male subjects with gonorrhea are displayed at significantly higher levels (7.7-fold higher for anti-TbpA and 4.6-fold higher for anti-TbpB) than those from normal sera obtained from individuals with no history of gonorrhea and no contact with gonococcal antigens. (ii) In N. gonorrhoeae-infected male subjects who also had prior histories of gonococcal infection, anti-TbpA and anti-TbpB levels were 8.3-fold higher than in the normal controls. These subjects did not show correlations of their antibody levels with normalized expressions of tbpA (expression ratios), indicating possible carryover of antibody from previous gonococcal infection. (iii) In first-time gonococcal infection, a correlation was found between anti-TbpA levels and normalized expression of tbpA (expression ratio) (Fig. 5).
In conclusion, we have shown that iron-regulated and Fur-regulated fbpA, tbpA, tbpB, and fur genes are expressed in vivo and that men with gonorrhea express measurable antibodies in their sera directed against certain of these gene products (TbpA and TbpB). We have also demonstrated that the iron- and Fur-regulated genes are differentially expressed in mucosal samples. Levels of antibody to TbpAB are present in male subjects with uncomplicated gonorrhea; in the case of TbpA, antibody levels correlate with the expression of the tbpA gene.

ACKNOWLEDGMENTS
This study was supported by grants AI48611 (C.A.G.), AI40944
(L.M.W.), and U19AI38515 (P.A.R.).
We thank Andrea Dandridge, Cresene Sanglap, Stephanie Crane, Rosalyn Liu, Faye Huang, and Linda Richard from Boston Medical Center Public Health Clinic and Faye LeBoeuf, Beth Collins-Sharp, Lisa Steed, Emily Betsille, and Sandy Hirschmann from the Medical University of South Carolina, Charleston, for their invaluable help in collecting subject samples.

FOOTNOTES
* Corresponding author. Mailing address: Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, 650 Albany Street, Room 637, Boston, MA 02118. Phone: (617) 414-5305. Fax: (617) 414-5280. E-mail:
caroline.genco{at}bmc.org.

Editor: V. J. DiRita

REFERENCES
1 - Ala'Aldeen, D. A., P. Stevenson, E. Griffiths, A. R. Gorringe, L. I. Irons, A. Robinson, S. Hyde, and S. P. Borriello. 1994. Immune responses in humans and animals to meningococcal transferrin-binding proteins: implications for vaccine design. Infect. Immun. 62:2984-2990.[Abstract/Free Full Text]
2 - Anderson, J. E., P. F. Sparling, and C. N. Cornelissen. 1994. Gonococcal transferrin-binding protein 2 facilitates but is not essential for transferrin utilization. J. Bacteriol. 176:3162-3170.[Abstract/Free Full Text]
3 - Archibald, F. S., and I. W. DeVoe. 1980. Iron acquisition by Neisseria meningitidis in vitro. Infect. Immun. 27:322-334.[Abstract/Free Full Text]
4 - Blake, M. S., and E. C. Gotschlich. 1982. Purification and partial characterization of the major outer membrane protein of Neisseria gonorrhoeae. Infect. Immun. 36:277-283.[Abstract/Free Full Text]
5 - Bonnah, R. A., R. Yu, and A. B. Schryvers. 1995. Biochemical analysis of lactoferrin receptors in the Neisseriaceae: identification of a second bacterial lactoferrin receptor protein. Microb. Pathog. 19:285-297.[Medline]
6 - Braun, V., and H. Killman. 1999. Bacterial solutions to the iron-supply problem. Trends Biochem. Sci. 24:104-109.[CrossRef][Medline]
7 - Brooks, G. F., and C. J. Lammel. 1989. Humoral immune response to gonococcal infections. Clin. Microbiol. Rev. 2(Suppl):S5-S10.
8 - Chen, C. Y., S. A. Berish, S. A. Morse, and T. A. Mietzner. 1993. The ferric iron-binding protein of pathogenic Neisseria spp. functions as a periplasmic transport protein in iron acquisition from human transferrin. Mol. Microbiol. 10:311-318.[Medline]
9 - Cohen, M. S., I. F. Hoffman, R. A. Royce, P. Kazembe, J. R. Dyer, C. C. Daly, D. Zimba, P. L. Vernazza, M. Maida, S. A. Fiscus, J. J. Eron, Jr., et al. 1997. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. Lancet 349:1868-1873.[CrossRef][Medline]
10 - Cornelissen, C. N., J. E. Anderson, I. C. Boulton, and P. F. Sparling. 2000. Antigenic and sequence diversity in gonococcal transferrin-binding protein A. Infect. Immun. 68:4725-4735.[Abstract/Free Full Text]
11 - Cornelissen, C. N., J. E. Anderson, and P. F. Sparling. 1997. Characterization of the diversity and the transferrin-binding domain of gonococcal transferrin-binding protein 2. Infect. Immun. 65:822-828.[Abstract]
12 - Cornelissen, C. N., J. E. Anderson, and P. F. Sparling. 1997. Energy-dependent changes in the gonococcal transferrin receptor. Mol. Microbiol. 26:25-35.[CrossRef][Medline]
13 - Cornelissen, C. N., M. Kelley, M. M. Hobbs, J. E. Anderson, J. G. Cannon, M. S. Cohen, and P. F. Sparling. 1998. The transferrin receptor expressed by gonococcal strain FA1090 is required for the experimental infection of human male volunteers. Mol. Microbiol. 27:611-616.[CrossRef][Medline]
14 - Delany, I., R. Rappuoli, and V. Scarlato. 2004. Fur functions as an activator and as a repressor of putative virulence genes in Neisseria meningitidis. Mol. Microbiol. 52:1081-1090.[CrossRef][Medline]
15 - Delany, I., G. Spohn, R. Rappuoli, and V. Scarlato. 2001. The Fur repressor controls transcription of iron-activated and -repressed genes in Helicobacter pylori. Mol. Microbiol. 42:1297-1309.[CrossRef][Medline]
16 - Dubrac, S., and D. Touati. 2000. Fur positive regulation of iron superoxide dismutase in Escherichia coli: functional analysis of the sodB promoter. J. Bacteriol. 182:3802-3808.[Abstract/Free Full Text]
17 - Dubrac, S., and D. Touati. 2002. Fur-mediated transcriptional and post-transcriptional regulation of FeSOD expression in Escherichia coli. Microbiology 148:147-156.[Abstract/Free Full Text]
18 - Ferreiros, C. M., L. Ferron, and M. T. Criado. 1994. In vivo human immune response to transferrin-binding protein 2 and other iron-regulated proteins of Neisseria meningitidis. FEMS Immunol. Med. Microbiol. 8:63-68.[Medline]
19 - Gorringe, A. R., R. Borrow, A. J. Fox, and A. Robinson. 1995. Human antibody response to meningococcal transferrin binding proteins: evidence for vaccine potential. Vaccine 13:1207-1212.[CrossRef][Medline]
20 - Grifantini, R., S. Sebastian, E. Frigimelica, M. Draghi, E. Bartolini, A. Muzzi, R. Rappuoli, G. Grandi, and C. A. Genco. 2003. Identification of iron-activated and -repressed Fur-dependent genes by transcriptome analysis of Neisseria meningitidis group B. Proc. Natl. Acad. Sci. USA 100:9542-9547.[Abstract/Free Full Text]
21 - Hadfield, S. G., and A. A. Glynn. 1982. Analysis of antibodies in local and disseminated Neisseria gonorrhoeae infections by means of gel electrophoresis-derived ELISA. Immunology 47:283-288.[Medline]
22 - Johnson, A. S., A. R. Gorringe, A. J. Fox, R. Borrow, and A. Robinson. 1997. Analysis of the human Ig isotype response to individual transferrin binding proteins A and B from Neisseria meningitidis. FEMS Immunol. Med. Microbiol. 19:159-167.[CrossRef][Medline]
23 - Lammel, C. J., R. L. Sweet, P. A. Rice, J. S. Knapp, G. K. Schoolnik, D. C. Heilbron, and G. F. Brooks. 1985. Antibody-antigen specificity in the immune response to infection with Neisseria gonorrhoeae. J. Infect. Dis. 152:990-1001.[Medline]
24 - Lissolo, L., G. Maitre-Wilmotte, P. Dumas, M. Mignon, B. Danve, and M. J. Quentin-Millet. 1995. Evaluation of transferrin-binding protein 2 within the transferrin-binding protein complex as a potential antigen for future meningococcal vaccines. Infect. Immun. 63:884-890.[Abstract]
25 - Masse, E., and S. Gottesman. 2002. A small RNA regulates the expression of genes involved in iron metabolism in Escherichia coli. Proc. Natl. Acad. Sci. USA 99:4620-4625.[Abstract/Free Full Text]
26 - McMillan, A., G. McNeillage, and H. Young. 1979. Antibodies to Neisseria gonorrhoeae: a study of the urethral exudates of 232 men. J. Infect. Dis. 140:89-95.[Medline]
27 - McQuillen, D. P., S. Gulati, S. Ram, A. K. Turner, D. B. Jani, T. C. Heeren, and P. A. Rice. 1999. Complement processing and immunoglobulin binding to Neisseria gonorrhoeae determined in vitro simulates in vivo effects. J. Infect. Dis. 179:124-135.[CrossRef][Medline]
28 - Mickelsen, P. A., E. Blackman, and P. F. Sparling. 1982. Ability of Neisseria gonorrhoeae, Neisseria meningitidis, and commensal Neisseria species to obtain iron from lactoferrin. Infect. Immun. 35:915-920.[Abstract/Free Full Text]
29 - Mickelsen, P. A., and P. F. Sparling. 1981. Ability of Neisseria gonorrhoeae, Neisseria meningitidis, and commensal Neisseria species to obtain iron from transferrin and iron compounds. Infect. Immun. 33:555-564.[Abstract/Free Full Text]
30 - Morse, S. A., and L. Bartenstein. 1980. Purine metabolism in Neisseria gonorrhoeae: the requirement for hypoxanthine. Can. J. Microbiol. 26:13-20.[Medline]
31 - Morton, D. J., J. M. Musser, and T. L. Stull. 1993. Expression of the Haemophilus influenzae transferrin receptor is repressible by hemin but not elemental iron alone. Infect. Immun. 61:4033-4037.[Abstract/Free Full Text]
32 - Payne, S. M. 1993. Iron acquisition in microbial pathogenesis. Trends Microbiol. 1:66-69.[CrossRef][Medline]
33 - Plummer, F. A., H. Chubb, J. N. Simonsen, M. Bosire, L. Slaney, I. Maclean, J. O. Ndinya-Achola, P. Waiyaki, and R. C. Brunham. 1993. Antibody to Rmp (outer membrane protein 3) increases susceptibility to gonococcal infection. J. Clin. Investig. 91:339-343.
34 - Plummer, F. A., H. Chubb, J. N. Simonsen, M. Bosire, L. Slaney, N. J. Nagelkerke, I. Maclean, J. O. Ndinya-Achola, P. Waiyaki, and R. C. Brunham. 1994. Antibodies to opacity proteins (Opa) correlate with a reduced risk of gonococcal salpingitis. J. Clin. Investig. 93:1748-1755.
35 - Price, G. A., M. M. Hobbs, and C. N. Cornelissen. 2004. Immunogenicity of gonococcal transferrin binding proteins during natural infections. Infect. Immun. 72:277-283.[Abstract/Free Full Text]
36 - Retzer, M. D., R. H. Yu, and A. B. Schryvers. 1999. Identification of sequences in human transferrin that bind to the bacterial receptor protein, transferrin-binding protein B. Mol. Microbiol. 32:111-121.[CrossRef][Medline]
37 - Rice, P. A., H. E. Vayo, M. R. Tam, and M. S. Blake. 1986. Immunoglobulin G antibodies directed against protein III block killing of serum-resistant Neisseria gonorrhoeae by immune serum. J. Exp. Med. 164:1735-1748.[Abstract/Free Full Text]
38 - Sambrook, J., and D. Russel (ed.). 2001. Molecular cloning: a laboratory manual, 3rd ed., vol. 1, p. 5.14-5.17. Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y.
39 - Sebastian, S., S. Agarwal, J. R. Murphy, and C. A. Genco. 2002. The gonococcal Fur regulon: identification of additional genes involved in major catabolic, recombination, and secretory pathways. J. Bacteriol. 184:3965-3974.[Abstract/Free Full Text]
40 - Simpson S. D., Y. Ho, P. A. Rice, and L. M. Wetzler. 1999. T lymphocyte response to Neisseria gonorrhoeae porin in individuals with mucosal gonococcal infections. J. Infect. Dis. 180:762-773.[CrossRef][Medline]
41 - Weinberg, E. D. 1993. The development of awareness of iron-withholding defense. Perspect. Biol. Med. 36:215-221.[Medline]
42 - Wetzler, L. M., M. S. Blake, K. Barry, and E. C. Gotschlich. 1992. Gonococcal porin vaccine evaluation: comparison of Por proteosomes, liposomes, and blebs isolated from rmp deletion mutants. J. Infect. Dis. 166:551-555.[Medline]
Infection and Immunity, July 2005, p. 4281-4287, Vol. 73, No. 7
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.7.4281-4287.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
This article has been cited by other articles:
-
Carpenter, B. M., Whitmire, J. M., Merrell, D. S.
(2009). This Is Not Your Mother's Repressor: the Complex Role of Fur in Pathogenesis. Infect. Immun.
77: 2590-2601
[Full Text]
-
Agarwal, S., Sebastian, S., Szmigielski, B., Rice, P. A., Genco, C. A.
(2008). Expression of the Gonococcal Global Regulatory Protein Fur and Genes Encompassing the Fur and Iron Regulon during In Vitro and In Vivo Infection in Women. J. Bacteriol.
190: 3129-3139
[Abstract]
[Full Text]