Anyone clapping for super gonorrhea?

Sexually transmitted disease is becoming resistant to treatment

Each year 800,000 new gonorrhea infections are reported in the U.S. Norfolk had the most in Hampton Roads in 2016 (Southside Daily photo/Courtesy of www.cdc.gov)
Each year 800,000 new gonorrhea infections are reported in the U.S. Norfolk had the most in Hampton Roads in 2016. (Southside Daily photo/Courtesy of www.cdc.gov)

In recent years there’s been a lot of talk about the diseases that are becoming resistant to the drugs we use to treat them – drugs like antibiotics.

So, how about a drug resistant sexually transmitted disease known as “super gonorrhea?”

Now that’s nothing to “clap” about.

Cases of super gonorrhea were identified recently in England and Australia, all traced back to origins in Southeast Asia.

If there is any good news to be had about the super gonorrhea, it’s coming out of Charlottesville and the University of Virginia School of Medicine, where researchers and their collaborators in the United Kingdom have discovered a new way the bacteria that cause gonorrhea resist the body’s immune defenses.

Researchers said scientists can use this knowledge to develop vaccines or empower our immune system to take down a sexually transmitted disease that has already conquered most antibiotics.

Each year about 78 million new cases of gonorrhea are reported worldwide and around 800,000 in the United States.

In Hampton Roads in 2016, Virginia Department of Health statistics show that Norfolk had the highest number of gonorrhea cases reported with 996, which equates to 403.1 infections per 100,000 people. Newport News was next with 719 reported cases of the sexually transmitted disease (392.4). For the rest of the cities it was Virginia Beach with 667 (147.0); Hampton 479 (348.4); Portsmouth 475 (493.9); and Chesapeake with 367 cases reported for a rate of 152.6 cases per 100,000 residents.

“Every time we think we understand how gonorrhea bacteria manage to survive and cause disease in people, we learn something new,” said lead researcher Alison K. Criss, PhD, of UVA’s Department of Microbiology, Immunology and Cancer Biology. “Our discovery is especially exciting because it opens up new ways to tackle the growing threat of untreatable gonorrhea.”

Gonorrhea infections have traditionally been treated with antibiotics, but the rise of drug-resistant gonorrhea has prompted the U.S. Centers for Disease Control and Prevention to label it an “urgent threat.”

The CDC estimates that 246,000 gonorrhea infections in the U.S. each year are resistant to at least one antibiotic.

Infections can lead to blindness, infertility and serious infections in the heart and nervous system, possibly even resulting in death.

Inhibitors

The UVA research highlights how the gonorrhea bacterium defeats the body’s antimicrobial defenses.

Gonorrhea, the researchers determined, takes a two-fisted approach to neutralizing lysozyme, an enzyme that degrades bacteria and is abundant in tears, saliva and other secretions at body sites where the gonorrhea bacteria grows. Gonorrhea produces two proteins, known as inhibitors, that bind directly to lysozyme, preventing it from doing its job.

Together, gonorrhea’s inhibitors “confer full resistance to this abundant antimicrobial defense,” the UVA researchers wrote in their new scientific paper.

“It’s fascinating that the gonorrhea bacteria use two independent proteins to inhibit lysozyme, one of the main enzyme defenses our bodies have against bacteria,” said first author Stephanie Ragland, graduate student in the UVA biomedical sciences graduate program. “Our finding suggests that lysozyme resistance is key to the survival of the gonorrhea bacterium.”

Going forward researchers want to understand exactly how these lysozyme inhibitors work, and when and how the bacteria release them.

That knowledge, Ragland said, can lead to the development new drugs or vaccines against gonorrhea, which are urgent priorities of the CDC and World Health Organization.

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