e Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted infection characterized by inflammation of the cervix or urethra. However, a significant subset of patients with N. gonorrhoeae remain asymptomatic, without evidence of localized inflammation. Inflammatory responses to N. gonorrhoeae are generated by host innate immune recognition of N. gonorrhoeae by several innate immune signaling pathways, including lipooligosaccharide (LOS) and other pathogen-derived molecules through activation of innate immune signaling systems, including toll-like receptor 4 (TLR4) and the interleukin-1 (IL-1) processing complex known as the inflammasome. The lipooligosaccharide of N. gonorrhoeae has a hexa-acylated lipid A. N. gonorrhoeae strains that carry an inactivated msbB (also known as lpxL1) gene produce a penta-acylated lipid A and exhibit reduced biofilm formation, survival in epithelial cells, and induction of epithelial cell inflammatory signaling. We now show that msbB-deficient N. gonorrhoeae induces less inflammatory signaling in human monocytic cell lines and murine macrophages than the parent organism. The penta-acylated LOS exhibits reduced toll-like receptor 4 signaling but does not affect N. gonorrhoeae-mediated activation of the inflammasome. We demonstrate that N. gonorrhoeae msbB is dispensable for initiating and maintaining infection in a murine model of gonorrhea. Interestingly, infection with msbB-deficient N. gonorrhoeae is associated with less localized inflammation. Combined, these data suggest that TLR4-mediated recognition of N. gonorrhoeae LOS plays an important role in the pathogenesis of symptomatic gonorrhea infection and that alterations in lipid A biosynthesis may play a role in determining symptomatic and asymptomatic infections. L ipopolysaccharide (LPS) is an importance virulence factor in Gram-negative bacteria. LPS consists of a complex polysaccharide attached to a core saccharide consisting of 3-deoxy-Dmannooctulosonic acid (keto-deoxyoctulosonate [KDO]) and an acylated diglucosamine moiety known as lipid A. Neisseria species (as well as some other commensal and pathogenic bacteria) make LPS with a truncated polysaccharide structure, which is termed lipooligosaccharide (LOS). LOS is a potent mediator of inflammatory signaling and is known to activate several host innate immune signaling systems, including toll-like receptor 4 (TLR4) through the lipid A molecule, C-lectin receptors (particularly MGL and DC-SIGN) through the oligosaccharide structure, and the caspase-1 activating complex known as the NLRP3-inflammasome through mechanisms yet to be determined (1-4).Lipid A synthesis is largely carried out by a highly conserved set of enzymatic steps that include the acylation of glucosaminebased precursors followed by condensation of these acylated glucosamine structures into the tetra-acylated disaccharide backbone that is the core structure of lipid A. This core is further decorated by the addition of two KDOs (2) and a variety of other additional modifications of the lipidated dis...