bTrichomonas vaginalis is an extracellular protozoan parasite that binds to the epithelium of the human urogenital tract during infection. In this study, we examined the propensities of 26 T. vaginalis strains to bind to and lyse prostate (BPH-1) and ectocervical (Ect1) epithelium and to lyse red blood cells (RBCs). We found that only three of the strains had a statistically significant preference for either BPH-1 (MSA1103) or Ect1 (LA1 and MSA1123). Overall, we observed that levels of adherence are highly variable among strains, with a 12-fold range of adherence on Ect1 cells and a 45-fold range on BPH-1 cells. Cytolysis levels displayed even greater variability, from no detectable cytolysis to 80% or 90% cytolysis of Ect1 and BPH-1, respectively. Levels of adherence and cytolysis correlate for weakly adherent/cytolytic strains, and a threshold of attachment was found to be necessary to trigger cytolysis; however, this threshold can be reached without inducing cytolysis. Furthermore, cytolysis was completely blocked when we prevented attachment of the parasites to host cells while allowing soluble factors complete access. We demonstrate that hemolysis was a rare trait, with only 4 of the 26 strains capable of lysing >20% RBCs with a 1:30 parasite/RBC ratio. Hemolysis also did not correlate with adherence to or cytolysis of either male (BPH-1)-or female (Ect1)-derived epithelial cell lines. Our results reveal that despite a broad range of pathogenic properties among different T. vaginalis strains, all strains show strict contact-dependent cytolysis.
T he exclusively human-infective flagellated parasitic protistTrichomonas vaginalis is the cause of the most common nonviral sexually transmitted disease, trichomoniasis. In women, the parasite resides in the vagina and colonizes the cervix; in men, it can be found in the urogenital tract and the prostate. In 2008 alone there were an estimated 276.4 million new cases in adults between 19 and 49 years of age, with a 10-fold-higher prevalence in females than in males (1). T. vaginalis in males often goes undetected, and thus the incidence is difficult to determine. However, it has been reported that in men with infected female partners, the incidence can range from 15 to 73% (2, 3, 4, 5). Additionally, men can clear infections 3 to 12 times faster than women whether the infection is treated or not (6, 7). The percentage of men who reportedly remain asymptomatic upon T. vaginalis infection is highly variable depending on the population examined and the diagnostic technique utilized. Regardless, it is thought that a higher proportion of men than women have asymptomatic infections (4,8,9).T. vaginalis infection can cause symptoms ranging from irritation and swelling in the urogenital tract to severe complications such as cervical erosion and premature birth during pregnancy (10,11,12). Trichomoniasis is also associated with infertility in both men and women (13,14). Moreover, infections are linked to cervical cancer (15,16,17,18), benign prostate hyperplasia (19), advance...