Urgent Need to Understand and Prevent Gonococcal Infection: From the Laboratory to Real-World Context.

Autor:	Ruiz García Y; GSK, Tres Cantos, Spain., Marrazzo J; University of Alabama at Birmingham, Birmingham, Alabama, USA., Martinón-Torres F; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.; Genetics, Vaccines and Infections Research Group, Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain., Workowski K; Emory University, Atlanta, Georgia., Giordano G; GSK, Siena, Italy., Pizza M; GSK, Siena, Italy., Sohn WY; GSK, Rockville, Maryland, USA.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2024 Oct 16; Vol. 230 (4), pp. e758-e767.
DOI:	10.1093/infdis/jiae289
Abstrakt:	Neisseria gonorrhoeae is widespread globally. Primary prevention is unsuccessful and antimicrobial resistance threatens optimal management. There is no specific vaccine and natural infection studies show that N gonorrhoeae can avoid and suppress immune responses. In addition to extensive variation in expression and specificity of many gonococcal surface antigens, it induces a robust inflammatory response through the Th17 pathway with a large influx of neutrophils and inflammatory cytokines but evades macrophages. The Th1- and Th2-mediated response is suppressed, resulting in low, short-lived antibody titers. Real-world evidence suggests that gonorrhea cases are reduced among recipients of Neisseria meningitidis group B vaccines containing outer membrane vesicles (OMVs). Although the first randomized trial of an OMV-containing MenB vaccine against N gonorrhoeae infection did not show statistically significant vaccine efficacy, ongoing trials might shed further light. Several candidate vaccine antigens for a gonococcal-specific vaccine are being evaluated preclinically but only one has reached clinical trials. Competing Interests: Potential conflicts of interest. Y. R. G., G. G., and W-Y. S. are employed by GSK and hold shares in GSK. M. P. was employed by GSK at the time of the study, holds shares in GSK, and is now Visiting Professor at Imperial College London. J. M. reported payment to her institution from the National Institutes of Health (NIH) for conduct of phase 2 trial of Bexsero (a trademark owned by or licensed to GSK) in prevention of gonorrhea. F. M-T. has received honoraria from GSK, Pfizer Inc, Sanofi Pasteur, MSD, Seqirus, Biofabri, and Janssen for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work. F. M-T. has also acted as principal investigator in randomized controlled trials of the above-mentioned companies as well as Ablynx, Gilead, Regeneron, Roche, Abbott, Novavax, and MedImmune, with honoraria paid to his institution. K. W. reported payment from NIH for the conduct of a Bexsero clinical trial. The authors declare no other financial and non-financial relationships and activities. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© GSK 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze:	MEDLINE
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