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Infection and Immunity, June 2007, p. 3202-3204, Vol. 75, No. 6
0019-9567/07/$08.00+0 doi:10.1128/IAI.01501-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
The Phase-Variable Allele of the Pilus Glycosylation Gene pglA Is Not Strongly Associated with Strains of Neisseria gonorrhoeae Isolated from Patients with Disseminated Gonococcal Infection
,
P. M. Power,1
S. C. Ku,1
K. Rutter,1
M. J. Warren,1
E. A. Limnios,2
J. W. Tapsall,2 and
M. P. Jennings1*
School of Molecular and Microbial Sciences, The University of Queensland, St. Lucia, Queensland 4072, Australia,1
Neisseria Reference Laboratory, Microbiology Department, The Prince of Wales Hospital, Barker St., Randwick, New South Wales 2031, Australia2
Received 19 September 2006/
Returned for modification 2 November 2006/
Accepted 30 January 2007

ABSTRACT
The
Neisseria gonorrhoeae pglA gene has two alleles, one of
which is phase variable. A previous study reported that all
disseminated gonococcal infection (DGI) isolates contained the
phase-variable allele and proposed a causal link. In the present
study of 81 strains no absolute correlation between DGI and
the phase-variable
pglA allele was observed.

TEXT
Neisseria gonorrhoeae infections result in a spectrum of disease
from asymptomatic carriage and mucosal gonococcal infection
(MI) to disseminated gonococcal infection (DGI). Pili are a
major virulence factor of
N. gonorrhoeae, facilitating adhesion
to the epithelial surface. Pili are posttranslationally modified
by glycosylation, and a number of genes involved in the glycosylation
of pili have been identified (
5,
8,
9,
16,
17).
pglA was the
first of these genes to be identified (
8) and is responsible
for the transfer of the first galactose to the trideoxyhexose
sugar in the pilin-linked Gal(β1-4) Gal(

1-3) 2,4-diacetamido-2,4,6-trideoxyhexose
in
N. meningitidis (see Fig.
1B). Subsequent work by Banerjee
et al. (
5) reported on the equivalent gene in
N. gonorrhoeae (
pgtA [96% identical at the nucleotide level]) (
8). Hence,
pgtA is referred to as
pglA.
Jennings et al. (
8) and Banerjee et al. (
5) have reported that
the expression of
pglA is phase variable. Phase variation is
the reversible high-frequency on-off switching of the expression
of a gene and is commonly associated with virulence factors
in a number of host-adapted human pathogens (reviewed in reference
11). The
N. gonorrhoeae pglA gene has two distinct alleles:
one containing a homopolymeric tract that mediates phase variation
(random on/off switching of expression) and another lacking
the tract. The phase variation of
pglA is mediated by a tract
of G residues within the
pglA coding sequence (see Fig.
1A).
Variation in the number of G residues can result in a frameshift
mutation and a nonfunctional
pglA gene product. An analysis
of the
pglA gene in a number of strains conducted by Jennings
et al. (
8) revealed a wide variation in the number of G residues
in the homopolymeric tract in pathogenic
Neisseria.
Banerjee et al. (5) analyzed 52 strains of N. gonorrhoeae for the presence of this homopolymeric tract. All of the 24 strains from patients with DGI contained the pglA allele with the repeat tract. In contrast, only 8 of the 28 MI strains contained the pglA allele with the homopolymeric tract. This was an exciting observation since it identified the first example of a virulence factor where the potential for phase-variable expression was invariably associated with progression to a distinct pathology, and this has been subsequently cited in the literature (4, 7, 18). The reasons why some cases of gonorrhea progress from uncomplicated mucosal disease to DGI is not well characterized. Several prior studies (6, 12, 13) of the differences between MI and DGI strains have found no single factor that was predictive of whether an N. gonorrhoeae strain was a potential DGI strain (such as arginine, hypoxanthine, and uracil auxotrophy and the gonococcal pathogenicity island). Banerjee et al. (5) suggested that the phase variation of pglA is likely to be involved in the conversion of MI to DGI because of its absolute correlation of the phase-variable pglA allele with DGI.
In the present study, the observations made by Banerjee et al. (5) were tested in a larger, more diverse strain collection and are extended to examine the relationship between other phase-variable genes involved in the posttranslational modification of pili and the distinct pathologies of MI and DGI. The strain collection was derived from isolates referred from public and private sectors in two geographically distinct Australian jurisdictions, New South Wales and the Northern Territory, between 1988 and 2002. The sampling methods used were those of the Australian Gonococcal Surveillance Programme as detailed in annual reports (2, 3). Some cases were identified as having presented in Australia after being contracted overseas (i.e., in the Middle East, United Kingdom, Thailand, and Fiji). Strains were classified as being from DGI if they were isolated from blood or joint cultures or as MI if they were isolated from anogenital sites or the eye. The details of the strains are recorded in Table S1 in the supplemental material and include data on the isolation site and antibiotic resistances. In addition, an effort was made to exclude strains that were presumptively "clonal." The criteria for exclusion included geographic, temporal, and antibiotic resistance clustering. The repeat region of the pglA gene in each strain was sequenced as previously described (as described in reference 8). Phase-variable and non-phase-variable alleles of pglA were defined as shown in Fig. 1A. Similar to the study of Banerjee et al., non-phase-variable alleles were defined as having the sequence 5'-GGGAGCGGG-3' in place of the homopolymeric tract.
We observed no absolute correlation between the phase-variable pglA allele and DGI; only 37% of DGI strains examined in the present study had the PV tract in pglA (Table 1). Among the MI strains, 18% had a phase-variable allele. We conclude that there is no absolute correlation between the presence of the phase-variable allele and either pathology.
Two characterized
pglA-linked polymorphisms were described by
Power and Jennings (
15) (see Fig.
1A). There are up to two additional
genes inserted between
pglA and
fabF (
8), referred to by their
N. meningitidis Z2491 annotation: NMA0047, a member of the PFAM
sugar transporter family (
10) (PFAM PF00083), and NMA0046, a
member of a family of bile acid/Na
+ symporter family (PFAM PF01758).
The primers Fab-for (5'-ATGAGTCAGAGAAGAGTAG-3') and Fab-rev
(5'-TCAGCCTTTGAAGCGTTT-3') were used to PCR amplify the region
in which the polymorphisms had been identified. The size of
the products was used to determine which allele was present.
The results revealed that NMA0046 was present in all
N. gonorrhoeae strains studied. The alternative genetic arrangements found
in
N. meningitidis MC58 (
19) (no genes) and in
N. meningitidis Z2491 (
14) (two genes) were not found in any
N. gonorrhoeae strains.
Two other phase-variable genes associated with pilin-linked posttranslational modifications were also examined to look for a correlation with MI or DGI. pglE is responsible for the addition of the terminal galactose in the N. meningitidis pilin-linked trisaccharide (17). pptA, is involved in the addition of ChoP to pilin in N. meningitidis and a similar role has been suggested for pptA of N. gonorrhoeae (1, 20). The potential for phase variation, as defined by the presence or absence or polymorphism in the size of the repeat tracts of pglA or pptA, did not correlate with either pathology (see Table S1 in the supplemental material).
In the present study we demonstrate that there is no absolute correlation between the potential of the pilin glycosylation gene pglA to phase vary and DGI. We assume that the correlation reported by Banerjee et al. (5) was due to the use of a clonal strain collection and indicates the importance of accessing a large, diverse, and well-characterized bacterial strain collection in undertaking such studies.

ACKNOWLEDGMENTS
This study was supported by program grant 284214 from the National
Health and Medical Research Council of Australia.
We acknowledge the Australian National Neisseria Network, who provided access to the strain collection used in this study.

FOOTNOTES
* Corresponding author. Mailing address: School of Molecular and Microbial Sciences, The University of Queensland, Brisbane, QLD 4072, Australia. Phone: 61 7 3365 4879. Fax: 61 7 3365 4620. E-mail:
jennings{at}uq.edu.au 
Published ahead of print on 12 February 2007. 
Supplemental material for this article may be found at http://iai.asm.org./. 
Editor: J. N. Weiser

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Infection and Immunity, June 2007, p. 3202-3204, Vol. 75, No. 6
0019-9567/07/$08.00+0 doi:10.1128/IAI.01501-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
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