Mycoplasma genitalium is a sexually transmitted pathogen associated with several acute and chronic reproductive tract disease syndromes in men and women. To evaluate the suitability of a pig-tailed macaque model of M. genitalium infection, we inoculated a pilot animal with M. genitalium strain G37 in the uterine cervix and in salpingeal pockets generated by transplanting autologous Fallopian tube tissue subcutaneously. Viable organisms were recovered throughout the 8-week experiment in cervicovaginal specimens and up to 2 weeks postinfection in salpingeal pockets. Humoral and cervicovaginal antibodies reacting to MgpB were induced postinoculation and persisted throughout the infection. The immunodominance of the MgpB adhesin and the accumulation of mgpB sequence diversity previously observed in persistent human infections prompted us to evaluate sequence variation in this animal model. We found that after 8 weeks of infection, sequences within mgpB variable region B were replaced by novel sequences generated by reciprocal recombination with an archived variant sequence located elsewhere on the chromosome. In contrast, mgpB region B of the same inoculum propagated for 8 weeks in vitro remained unchanged. Notably, serum IgG reacted strongly with a recombinant protein spanning MgpB region B of the inoculum, while reactivity to a recombinant protein representing the week 8 variant was reduced, suggesting that antibodies were involved in the clearance of bacteria expressing the original infecting sequence. Together these results suggest that the pig-tailed macaque is a suitable model to study M. genitalium pathogenesis, antibody-mediated selection of antigenic variants in vivo, and immune escape.
Mycoplasma genitalium is a recently recognized sexually transmitted pathogen associated with reproductive tract disease in men and women (reviewed in references 1 to 3). Infection with this organism has been associated with urethritis in men (4-6) and cervicitis (7-9), urethritis (10, 11), acute endometritis (12), chronic pelvic inflammatory disease (13), tubal factor infertility (14, 15), and preterm birth (16, 17) in women. When untreated or inappropriately treated, M. genitalium infection can persist for months to years (18-21), suggesting that this organism avoids elimination by the host immune response. Recent studies assessing M. genitalium treatment regimens have found that standard antibiotic therapy fails to cure a significant proportion of infections (reviewed in reference 1), highlighting the importance of a better understanding of M. genitalium pathogenesis so that effective treatment and prevention methods can be devised.The distinct flask-shaped morphology of M. genitalium cells can be attributed to its complex tip organelle involved in gliding motility (22-25) and adherence to host cells and inanimate surfaces (26-30). Included among the tip organelle-associated proteins are the major adhesin, MgpB (also known as MgPa or P140), and its accessory protein, MgpC (also known as P110), which is required for the sta...