Increased adhesiveness and internalization of Neisseria gonorrhoeae and changes in the expression of epithelial gonococcal receptors in the Fallopiantube of copper T and Norplant (R) users

Interaction of Neisseria gonorrhoeae with the oviductal epithelium in vitro was examined in 2 cm length segments obtained after surgical sterilization from users of copper T intrauterine device (IUD) or Norplant(R) and contro l women. Segments perfused with N.gonorrhoeae suspensions were incubated fr om 30 min up to 4 h, fixed, frozen and cut in 6-10 mum sections. Bacteria w ere detected immunohistochemically with rabbit anti-gonococcal serum follow ed by light and confocal microscopy, Adhesion and internalization of gonoco cci by epithelial cells were observed at all incubation times, and both wer e higher in explants from users of copper T IUD or Norplant implants than c ontrols, The epithelium of controls expressed CD66 and syndecan-1; but CD46 was found in only one out of six cases. The epithelium of copper T IUD use rs expressed CD66 but not syndecan-1 or CD46, Users of Norplant(R) exhibite d expression of CD46, CD66 and syndecan-1. Label was always found along the luminal border of the epithelium. There were more intraepithelial lymphocy tes in users of contraceptive methods than in controls. Results indicate th at (i) N,gonorrhoeae invade the oviductal epithelium from the first minutes of exposure, (ii) the epithelium is constitutively endowed with two known receptors for the gonococcus, CD66 and syndecan-1, (iii) copper T IUD and N orplant users exhibit higher rates of attachment and internalization of the gonococcus into the oviductal epithelium associated with changes in expres sion of gonococcal receptors.