Menschliche Mitochondrien enthalten etwa 1500 bis 2000 Proteine. Die meisten dieser Proteine werden im Zellkern kodiert und im Zytoplasma synthetisiert, und müssen daher über eine spezielle Maschinerie in die Mitochondrien transportiert werden. Obwohl mittlerweile viele Details über die Wirkungsweise dieser Proteinschleusen bekannt sind, wurden einige wichtige Aspekte des Proteinimports noch nicht ausreichend untersucht. Zum einen ist nicht bekannt, ob die einzelnen Importkomplexe einen Einfluss auf die mitochondrienvermittelte Apoptose haben. Weiterhin ist offen, welche genaue Rolle der Mitochondrienimport in der Pathogenese von Neisseria gonorrhoeae spielt. Außerdem ist unklar, ob Faktoren des Importapparates für die Aufrechterhaltung der mitochondrialen Morphologie notwendig sind. Um diese Fragestellungen zu untersuchen, wurden im Rahmen der vorliegenden Arbeit permanente Zelllinien hergestellt, in denen die Expression einzelner am Mitochondrienimport beteiligter Proteine mittels RNA-Interferenz (RNAi) inhibiert werden kann. Mithilfe dieser Zelllinien wurde getestet, ob die proapoptotischen Proteine Bax und Bak die Importmaschinerie benötigen, um in die äußere Mitochondrienmembran zu gelangen. Die Präsenz der beiden proapoptotischen Proteine in Mitochondrien während der Apoptose ist sehr entscheidend, da Bax und Bak in den Mitochondrien oligomerisieren und damit weitere Schritte der Apoptose einleiten. Im Widerspruch zu früheren Publikationen konnte hier gezeigt werden, dass die Translokation von Bax und Bak in die äußere Mitochondrienmembran unabhängig von Proteinimportfaktoren erfolgt. Der zweite Teil dieser Arbeit beschäftigt sich mit dem Einfluss mitochondrialer Importproteine auf die Pathogenese von Neisseria gonorrhoeae. Das Neisserienprotein PorB transloziert während der Infektion in die Mitochondrien der Wirtszelle und induziert Apoptose. Aufgrund der strukturellen Ähnlichkeit von PorB zu bestimmten Proteinen der äußeren Mitochondrienmembran wurde bisher angenommen, dass PorB diesen endogenen Proteinen auf ihrem Importweg in die äußere Mitochondrienmembran folgt. Überraschenderweise wurde im Rahmen dieser Arbeit entdeckt, dass PorB nicht von allen Komplexen der Importmaschinerie in den Mitochondrien erkannt wird. Infolgedessen transloziert es in die innere Mitochondrienmembran und wirkt dadurch toxisch auf die Wirtszelle. In einem weiteren Projekt wurde untersucht, welche Rolle die Proteinimportkomplexe der äußeren mitochondrialen Membran in der Aufrechterhaltung der Mitochondrienmorphologie spielen. Unter Verwendung der beschriebenen Zelllinien wurde entdeckt, dass in Abwesenheit des SAM (sorting and assembly) Importkomplexes die Struktur der inneren Mitochondrienmembran derangiert ist. Es wurden zudem Hinweise darauf gefunden, dass die Ursache für diesen Befund in einer Unterbrechung von Kontaktstellen zwischen den beiden Mitochondrienmembranen liegen könnte, für deren Aufrechterhaltung möglicherweise der SAM-Komplex verantwortlich ist. Die in dieser Arbeit vorgestellten Ergebnisse erlauben neue Einblicke in verschiedene Aspekte des Proteinimports in Mitochondrien. Zudem wurde mit der Entwicklung der stabilen Zelllinien ein neues Model geschaffen, anhand dessen in Zukunft weitere Detail des mitochondrialen Proteinimports erforscht werden können. / Human mitochondria comprise about 1500 to 2000 proteins. While only 13 proteins are encoded by the mitochondrial DNA the vast majority of mitochondrial proteins is encoded in the nucleus, synthesized in the cytosol, and translocated into mitochondria by a special protein import machinery. Although many details are now known about its function several important aspects of protein import in mitochondria were not unraveled yet. To begin with, the influence of the different mitochondrial import complexes on apoptosis is not known. Further, the exact role of the protein import machineries in mitochondria in the pathogenesis of Neisseria gonorrhoeae has not been clarified yet. Moreover, the question whether factors involved in protein import are required for the maintenance of the mitochondrial morphology is still unsolved. In order to address these open issues, permanent cell lines were generated within the frame of the present thesis in which the expression of single proteins implicated in mitochondrial import can be inhibited via RNA interference (RNAi). Using these cell lines, it was investigated whether the proapoptotic proteins Bax and Bak require the import machinery in order to gain access to the outer mitochondrial membrane. The presence of both proapoptotic proteins in mitochondria is essential during apoptosis as Bax and Bak oligomerize in the outer mitochondrial membrane leading to the execution of apoptosis. In contrast to earlier publications, results presented here prove that the translocation of Bax and Bak into the outer mitochondrial membrane occurs independent of its import machineries. The second part of this thesis explores the influence of mitochondrial import proteins on the pathogenesis of Neisseria gonorrhoeae. The neisserial protein PorB translocates into the mitochondria of host cells during infection and induces apoptosis. Because of structural similarities of PorB to a certain class of proteins in the outer mitochondrial membrane, it was assumed that PorB would follow the import pathway of these endogenous proteins into the outer mitochondrial membrane. Surprisingly, it was found within the present study that PorB is not recognized by all complexes implicated in this import pathway. As a consequence, it translocates into the inner mitochondrial membrane to exert its toxic effect on the host cell. In a further project, the role of import complexes of the outer mitochondrial membrane in the maintenance of the mitochondrial morphology was investigated. Using the described cell lines, it was found that in the absence of the SAM (sorting and assembly) import device, the structure of the inner mitochondrial membrane was disrupted. Further, evidence was found that the reason for this phenotype could be an interruption of contact sites between the two mitochondrial membranes, whose preservation possibly requires the SAM complex. The results presented here allow new insights into different aspects of mitochondrial protein import. Further, with the development of the stable cell lines a new model was generated that will allow future investigations on details about mitochondrial protein import.

As vacinas antimeningocócicas têm se demonstrado efetivas contra os sorogrupos A e C, no entanto ainda não existe vacina contra o sorogrupo B devido à similaridade entre a estrutura capsular do polissacáride B e o ácido polisiálico que faz parte do tecido cerebral humano, podendo levar à autoimunidade. O objetivo deste estudo foi investigar as propriedades adjuvantes dos toxóides Stx1 e Stx2 (STEC) de Escherichia coli, administrados em preparações antigênicas com vesículas de membrana externa nativa (NOMV) de Neisseria meningitidis B, comparando duas vias de imunização prime-boost ou intramuscular, em camundongos BALB/c com idade entre 6-8 semanas. A determinação dos níveis de anticorpos empregando a técnica de ELISA, mostrou elevadas concentrações de anticorpos IgG em soros de animais imunizados pela via intramuscular com Stx1+NOMV, mas não com NOMV, o que sugere que por esta via (intramuscular apenas) Stx1 possa ter atuado como adjuvante. No ensaio de Immunoblotting, soros de animais imunizados com Stx1+NOMV reconheceram maior número de antígenos de NOMV quando comparado ao grupo que recebeu Stx2+NOMV. O sistema prime-boost mostrou-se efetivo quando comparamos os níveis de anticorpos presentes no soro após a dose intramuscular (reforço), entretanto, não melhor do que quando utilizamos duas doses apenas pela via intramuscular. Este estudo poderá contribuir no desenvolvimento de tecnologias associadas a novas preparações antigênicas utilizando antígenos de membrana externa de N. meningitidis B , empregando toxóides como adjuvantes. / The meningococcal vaccines have been shown to be effective against serogroups A and C, however there is still no vaccine against serogroup B. The capsular polysaccharide from serogroup B meningococci polysialic acid moiety mimetic of many human glycoproteins including the neural cell adhesion molecules and may lead to autoimmunity. This study aimed to investigate the adjuvant properties of toxoids Stx1 and Stx2 (STEC) from Escherichia coli and native outer membrane vesicles (NOMV) of Neisseria meningitidis B, comparing two ways of immunization prime-boost or only intramuscular in BALB/c mice. The results showed high concentrations of IgG antibodies in sera of animals immunized intramuscularly with Stx1+NOMV, suggesting that in this way may have Stx1 acted as an adjuvant. In the Immunoblotting assay, sera from animals immunized with Stx1+NOMV recognized more antigens of NOMV when compared to the group that received Stx2+NOMV. The prime-boost was effective however, no better than only two doses intramuscularly. This study may contribute to the development of new technologies and strategies against N. meningitidis B employing toxoids as adjuvants.

Neisseria gonorrhoeae is an obligate human pathogen that causes the common STI gonorrhea, which presents a growing threat to global health. The WHO estimated 78 million new cases of gonorrhea worldwide in 2017, with estimates of 820,000 new cases in the United States alone according to the CDC. High-frequency phase and antigenic variation inherent in N. gonorrhoeae, coupled with its natural ability to rapidly acquire and stably integrate antimicrobial resistance factors into its genome, have culminated in an infection against which there is no effective vaccine, and for which the list of viable therapeutic options is quickly shrinking. Moreover, no protective immunity against subsequent infections is elicited upon exposure to N. gonorrhoeae, which highlights the need for research of novel antimicrobial and vaccination strategies. Within the human host, N. gonorrhoeae utilizes a unique strategy to overcome host sequestration of essential nutrients – termed nutritional immunity (NI) – such as ions of trace metals. The pathogen produces a family of outer membrane proteins called TonB-dependent transporters (TdTs) capable of binding to host NI factors and stripping them of their nutritional cargo for use by the pathogen. Importantly, these TdTs are very highly conserved and expressed among Neisseria species. TbpA is a well-characterized TdT that allows N. gonorrhoeae to acquire iron from human transferrin, and recent studies from our lab have shown that TdfH is capable of binding to a zinc-sequestering S100 protein called calprotectin and stripping it of its zinc ion. The S100 proteins are EF-hand calcium-binding proteins that naturally play an integral role in Ca2+ homeostasis, but due to their ability to bind transition metals, they have also demonstrated an innate immunity role by participating in nutrient sequestration. The S100 proteins are expressed in all human cells, and all are capable of binding transition metals including zinc, manganese, and cobalt. Calprotectin, S100A7, and S100A12 have demonstrated an ability to hinder the infection potential of pathogenic E. coli, S. aureus, C. albicans, and various other pathogens via zinc sequestration. Herein, we demonstrate that N. gonorrhoeae is able to overcome this phenomenon and actually utilize these proteins as a zinc source in vitro. Furthermore, we identify S100A7 as the specific ligand for TdfJ, which utilizes this ligand to internalize zinc during infection. S100A7 growth support in vitro is dependent upon a functional TonB, TdfJ, and the cognate ABC transport system ZnuABC, and isogenic mutants incapable of producing znuA or tdfJ recover S100A7 utilization by complementation. Whole-cell binding assays and affinity pulldowns show that S100A7 binds specifically to both gonococcal and recombinant TdfJ, and growth and binding experiments show that these described phenomena are specific to human and not mouse S100A7. Finally, we show that a His-Asn double mutant S100A7 that is incapable of binding zinc cannot be utilized for growth by gonococci. These data illustrate the unique nature of the gonococcus’ ability to co-opt host defense strategies for its own purposes, and further identify the TdTs as promising targets for strategies to combat and prevent gonococcal infection.

Neisseria meningitidis, Auslöser der Meningokokken-Meningitis und Sepsis, trägt auch heute noch zur hohen Kindersterblichkeit in Entwicklungsländern bei und sorgt, vor allem im afrikanischen Meningitis-Gürtel, immer wieder für Epidemien mit gravierenden Folgen für die Betroffenen. Im Rahmen dieser Arbeit wurden zwei an der Pathogenität von N. meningitidis beteiligte Proteine, der Transkriptionsregulator FarR und der Transportkanal HrpB, näher charakterisiert, um weitere Einblicke in die immer noch nicht vollständig entschlüsselte Pathogenese der Meningokokken-Meningitis zu erhalten. Das Neisseria adhesin A NadA ist Bestandteil der sich aktuell in der Entwicklung befindenden Impfung gegen Meningokokken der Serogruppe B. Im dem bekapselten B-Stamm MC58 wurde gezeigt, dass nadA unter der negativen Kontrolle des Transkriptionsregulators FarR steht (Schielke et al., 2009). In den ebenfalls zur Gattung Neisseria gehörenden Neisseria gonorrhoeae (Ng) wurde bereits 2001 ein FarR-Homolog beschrieben (Shafer et al., 2001). NgFarR ist an der Resistenz gegenüber antimikrobiellen, langkettigen Fettsäuren beteiligt, indem es die Expression des FarABEffluxpumpen-Systems reguliert, welches eingedrungene Fettsäuren wieder nach extrazellulär befördert. Dagegen zeigten Palmitinsäure-Resistenztests, dass FarR nicht an der intrinsischen Fettsäure-Resistenz der Meningokokken beteiligt ist. Die Deletion und die Komplementierung von farR hatten weder in bekapselten noch in unbekapselten Meningokokken Einfluss auf das normale Wachstumsverhalten. Ein Western Blot- Nachweis des FarR-Proteins in der frühen, mittleren und späten exponentiellen Wachstumsphase von Wildtyp, Kapsel-Deletionsmutante und farR-Komplementante zeigte, dass die Menge an FarR im zeitlichen Verlauf kontinuierlich zunimmt und FarR damit Wachstumsphasen-abhängig exprimiert wird. Dabei scheint es einer posttranskriptionalen oder posttranslationalen Regulation zu unterliegen, da auch in dem farRkomplementierten Stamm unabhängig vom farR-Promotor eine entsprechende Hochregulation stattfindet. In Infektionsversuchen wurde die Interaktion zwischen Meningokokken und humanen polymorphkernigen Granulozyten untersucht. In den Infektionsassays wurde die farRDeletionsmutante innerhalb des dreistündigen Versuchsrahmens deutlich stärker durch die Granulozyten abgetötet als der Serogruppe B-Wildtyp. Als Mitglied der in Bakterien und Archaeen weit verbreiteten Familie der MarR-Transkriptionsregulatoren (Multiple antibiotic resistance Regulator, MarR) bindet FarR mit hoher Wahrscheinlichkeit auch als Homodimer an seine Bindesequenz auf der DNA. FarR erkennt eine 16 bp lange, palindromische Sequenz in der Promotorregion von nadA (NMB1994), wodurch die nadA-Expression verhindert wird. Außerdem erkennt FarR eine ähnliche Bindesequenz im Promotorbereich von farAB (NMB0318/0319), wobei es aber keinen regulatorischen Einfluss ausübt. Mit einer aus diesen beiden Bindestellen berechneten minimalen Bindesequenz wurde im Genom von MC58 weitere mögliche Bindepartner detektiert. Eine Auswahl dieser möglichen Bindestellen wurde in Electrophoretic Mobility Shift Assays auf eine direkte Interaktion mit dem FarR-Protein hin untersucht, wobei sich allerdings keine direkte Bindung nachweisen ließ. Diese Ergebnisse darauf hin, dass der Transkriptionsregulator FarR hoch spezifisch bestimmte DNA-Bindesequenzen erkennt und die entsprechenden Gene reguliert. In der Promotorregion des TpsB-Proteins HrpB wurde in den sequenzierten Referenzstämmen Z2491, MC58, FAM18 und α14 eine mit der minimalen FarR-Bindesequenz kompatible Sequenz gefunden. In Electrophoretic Mobility Shift Assays konnte allerdings gezeigt werden, dass FarR nicht direkt daran bindet. Um das Transport-Protein HrpB näher zu charakterisieren, wurde das entsprechende Gen in 22 N. meningitidis-Isolaten sequenziert. Dabei zeigte sich, dass das Transportprotein hrpB in allen untersuchten invasiven und nicht-invasiven Stämmen vorhanden ist. Dieses äußerst konservierte Protein weist nur im seinem C-terminalen Bereich eine relativ variable Region auf, was vermutlich auf Rekombinationsereignisse zurückzuführen ist. Ein Alignment der Aminosäure-Sequenz des Serogruppe C-Stamms FAM18 mit der des homologen Bordetella pertussis TpsB-Proteins FhaC zeigte, dass die dreidimensionale Struktur des HrpB ebenfalls eine α-Helix, eine transmembranöse Domäne und variable extrazelluläre Loops enthält. Zusammengenommen erfüllt HrpB somit wichtige Bedingungen, um als Vakzine-Bestandteil in Betracht gezogen zu werden. / Function of the transcriptional regulator FarR in Neisseria meningitidis

<p><i>Francisella tularensis</i> is a Gram-negative intracellular pathogen causing the zoonotic disease tularemia. <i>F. tularensis</i> can be found almost all over the world and has been recovered from several animal species, even though the natural reservoir of the bacterium and parts of its life cycle are still unknown. Humans usually get infected after handling infected animals or from bites of blood-feeding arthropod vectors. There are four subspecies of <i>F. tularensis</i>: the highly virulent <i>tularensis</i> (Type A) that causes a very aggressive form of the disease, with mortality as high as 60% if untreated, the moderately virulent <i>holarctica</i> (Type B) and <i>mediasiatica</i>, and the essentially avirulent subspecies <i>F. novicida</i>. So far, our knowledge of the molecular mechanisms that would explain these differences in virulence among the subspecies is poor. However, recent developments of genetic tools and access to genomic sequences have laid the ground for progress in this research field. Analysis of genome sequences have identified several regions that differ between <i>F. tularensis</i> subspecies. One of these regions, RD19, encodes proteins postulated to be involved in assembly of type IV pili (Tfp), organelles that have been implicated in processes like twitching motility, biofilm formation and cell-to-cell communication in pathogenic bacteria. While there have been reports of pili-like structures on the surface of <i>F. tularensis</i>, these have not been linked to the Tfp encoding gene clusters until now. Herein, I present evidence that the <i>Francisella</i> pilin, PilA, can complement pilin-like characteristics and promote assembly of fibers in a heterologous system in <i>Neisseria gonorrhoeae. pilA</i> was demonstrated to be required for full virulence of both type A and type B strains in mice when infected via peripheral routes. A second region, RD18, encoding a protein unique to <i>F. tularensis</i> and without any known function, was verified to be essential for virulence in a type A strain. Interestingly, the non-licensed live vaccine strain, LVS (Type B), lacks both RD18 and RD19 (<i>pilA</i>) due to deletion events mediated by flanking direct repeats. The loss of RD18 and RD19 is responsible for the attenuation of LVS, since re-introducing them <i>in cis</i> could restore the virulence to a level similar to a virulent type B strain. Significantly, these deletion events are irreversible, preventing LVS to revert to a more virulent form. Therefore, this important finding could facilitate the licensing of LVS as a vaccine against tularemia.</p>

<p>Extensive use of the sulphonamide drugs against the bacterium <i>Neisseria meningitidis</i> has resulted in drug resistance development. Sulphonamide resistance in <i>N. meningitidis</i> is caused by alterations in the chromosomal <i>folP</i> gene, coding for DHPS (dihydropteroate synthase). One type of resistant DHPS has high sequence divergence compared to DHPS from susceptible strains. This divergent DHPS has a duplication of two amino acids, crucial for resistance, and an altered amino acid in position 68, important for both resistance and substrate binding. When introduced into a susceptible DHPS, these two alterations did not incur resistance and resulted in abnormal substrate binding properties. This indicated that the divergent DHPS was not directly developed by mutations, but rather had been acquired by horizontal transfer of <i>folP</i> from another species.</p><p>Commensal <i>Neisseria</i> species are implied as the origin of the horizontally transferred resistance. Sulphonamide-resistant commensal <i>Neisseria</i> isolates were detected in throat swabs from healthy individuals not exposed to these drugs; however, transformation of resistance from these commensals to <i>N. meningitidis</i> was restricted in the laboratory. A comparison of the genomic region surrounding <i>folP</i> revealed differences in gene organisation and in the DNA uptake sequence between <i>N. meningitidis</i> and distantly related commensals. These differences are likely to restrict transformation between distantly related <i>Neisseria</i> species.</p><p>DHPS participates in the folate biosynthesis pathway. The enzyme preceding DHPS in the pathway, HPPK (hydroxymethyl-dihydropterin pyrophosphokinase), from <i>N. meningitidis</i> was characterised and a method for studying substrate channelling from HPPK to DHPS was developed. The information gained could be exploited in the search for new antibiotics.</p><p>In conclusion, well-adapted sulphonamide-resistant strains of <i>N. meningitidis</i> and commensal <i>Neisseria</i> are established in the bacterial population and resistance can be horizontally spread by natural transformation. This may explain the abundance of sulphonamide-resistant <i>N. meningitidis</i>, although these drugs are no longer used against this bacterium.</p>

<p>Availability of genome sequences for numerous bacterial species comprising of different bacterial strains allows elucidation of species and strain specific adaptations that facilitate their survival in widely fluctuating micro-environments and enhance their pathogenic potential. Different bacterial species use different strategies in their pathogenesis and the pathogenic potential of a bacterial species is dependent on its genomic complement of virulence factors. A bacterial virulence factor, within the context of this study, is defined as any endogenous protein product encoded by a gene that aids in the adhesion, invasion, colonization, persistence and pathogenesis of a bacterium within a host. Anecdotal evidence suggests that bacterial virulence genes are undergoing diversifying evolution to counteract the rapid adaptability of its host&rsquo / s immune defences. Genome sequences of pathogenic bacterial species and strains provide unique opportunities to study the action of diversifying selection operating on different classes of bacterial genes.</p>

Extensive use of the sulphonamide drugs against the bacterium Neisseria meningitidis has resulted in drug resistance development. Sulphonamide resistance in N. meningitidis is caused by alterations in the chromosomal folP gene, coding for DHPS (dihydropteroate synthase). One type of resistant DHPS has high sequence divergence compared to DHPS from susceptible strains. This divergent DHPS has a duplication of two amino acids, crucial for resistance, and an altered amino acid in position 68, important for both resistance and substrate binding. When introduced into a susceptible DHPS, these two alterations did not incur resistance and resulted in abnormal substrate binding properties. This indicated that the divergent DHPS was not directly developed by mutations, but rather had been acquired by horizontal transfer of folP from another species. Commensal Neisseria species are implied as the origin of the horizontally transferred resistance. Sulphonamide-resistant commensal Neisseria isolates were detected in throat swabs from healthy individuals not exposed to these drugs; however, transformation of resistance from these commensals to N. meningitidis was restricted in the laboratory. A comparison of the genomic region surrounding folP revealed differences in gene organisation and in the DNA uptake sequence between N. meningitidis and distantly related commensals. These differences are likely to restrict transformation between distantly related Neisseria species. DHPS participates in the folate biosynthesis pathway. The enzyme preceding DHPS in the pathway, HPPK (hydroxymethyl-dihydropterin pyrophosphokinase), from N. meningitidis was characterised and a method for studying substrate channelling from HPPK to DHPS was developed. The information gained could be exploited in the search for new antibiotics. In conclusion, well-adapted sulphonamide-resistant strains of N. meningitidis and commensal Neisseria are established in the bacterial population and resistance can be horizontally spread by natural transformation. This may explain the abundance of sulphonamide-resistant N. meningitidis, although these drugs are no longer used against this bacterium.

Francisella tularensis is a Gram-negative intracellular pathogen causing the zoonotic disease tularemia. F. tularensis can be found almost all over the world and has been recovered from several animal species, even though the natural reservoir of the bacterium and parts of its life cycle are still unknown. Humans usually get infected after handling infected animals or from bites of blood-feeding arthropod vectors. There are four subspecies of F. tularensis: the highly virulent tularensis (Type A) that causes a very aggressive form of the disease, with mortality as high as 60% if untreated, the moderately virulent holarctica (Type B) and mediasiatica, and the essentially avirulent subspecies F. novicida. So far, our knowledge of the molecular mechanisms that would explain these differences in virulence among the subspecies is poor. However, recent developments of genetic tools and access to genomic sequences have laid the ground for progress in this research field. Analysis of genome sequences have identified several regions that differ between F. tularensis subspecies. One of these regions, RD19, encodes proteins postulated to be involved in assembly of type IV pili (Tfp), organelles that have been implicated in processes like twitching motility, biofilm formation and cell-to-cell communication in pathogenic bacteria. While there have been reports of pili-like structures on the surface of F. tularensis, these have not been linked to the Tfp encoding gene clusters until now. Herein, I present evidence that the Francisella pilin, PilA, can complement pilin-like characteristics and promote assembly of fibers in a heterologous system in Neisseria gonorrhoeae. pilA was demonstrated to be required for full virulence of both type A and type B strains in mice when infected via peripheral routes. A second region, RD18, encoding a protein unique to F. tularensis and without any known function, was verified to be essential for virulence in a type A strain. Interestingly, the non-licensed live vaccine strain, LVS (Type B), lacks both RD18 and RD19 (pilA) due to deletion events mediated by flanking direct repeats. The loss of RD18 and RD19 is responsible for the attenuation of LVS, since re-introducing them in cis could restore the virulence to a level similar to a virulent type B strain. Significantly, these deletion events are irreversible, preventing LVS to revert to a more virulent form. Therefore, this important finding could facilitate the licensing of LVS as a vaccine against tularemia.

Gonorrhea, caused by the human pathogen Neisseria gonorrhoeae, is a severe public health problem worldwide with more than 82 million new infections each year. N. gonorrhoeae is transmitted by sexual contact and primarily causes urogenital mucosal infections in men and women. Left untreated, this infection may cause severe complications, especially in females. Eye infections of the newborn can occur. Gonorrhea infections enhance HIV transmission. The highly prevalent antibiotic resistance and the emergence of new drug resistances render treatment of the infections increasingly difficult. Close monitoring of antimicrobial susceptibility of this pathogen is crucial, and enhanced knowledge of molecular mechanisms of gonococcal antimicrobial resistance is urgently needed. There are no vaccines available against N. gonorrhoeae. Control of gonorrhea relies on comprehensive strategies which can be better formulated by understanding, at molecular levels, how N. gonorrhoeae is transmitted in communities. My research aimed to illustrate the severe burden of antimicrobial resistance in N. gonorrhoeae temporally and geographically in China and to reveal the molecular mechanisms of antibiotic resistance particularly the development of reduced susceptibility to ceftriaxone in N. gonorrhoeae isolates. To determine specific strain distributions, N. gonorrhoeae isolates were characterized using molecular typing methods such as a modified porB-based typing scheme and the N. gonorrhoeae Multi-Antigen Typing (NG-MAST) method, compared to traditional epidemiological approaches. The ultimate goal was to provide information for better formulating disease control strategies for gonorrhea. In this research, male patients with gonorrhea and their sex partners were recruited in Shanghai (2005 and 2008) and in Urumchi (2007-2008), China. Epidemiological information pertaining to sexual contacts was collected. N. gonorrhoeae isolates were investigated for their antimicrobial susceptibility. Molecular mechanisms of antimicrobial resistance were explored by analysis of potential resistant determinants (gyrA, parC, porB, mtrR, ponA and penA). The molecular data were combined with bioinformatic analysis and traditional epidemiological data. High percentages of N. gonorrhoeae isolates (11% - 19% in Shanghai, 4.5% in Urumchi) exhibited reduced susceptibility to ceftriaxone (MICs = 0.125-0.25 mg/L), the first line drug recommended for the treatment of gonorrhea in China. The majority of isolates (>98%) were susceptible to spectinomycin, an alternative regimen for gonorrhea treatment; however, the proportion of isolates having intermediate levels of susceptibility increased from 1.9% in 2005 to 9.9% in 2008. The majority of isolates tested were resistant to penicillin (80% - 93%), tetracycline (56% - 65%) and ciprofloxacin (98% - 100%). Plasmid-mediated resistance in N. gonorrhoeae isolates were highly prevalent (51% - 79%) in Shanghai and Urumchi. Analysis of 60 clinical isolates revealed that reduced susceptibility to ceftriaxone is mediated by porB1b allele and is associated with specific mutations in penicillin binding protein 2 and in the DNA binding and dimerization domains of MtrR. Penicillin binding protein 1 is not involved in reduced susceptibility to ceftriaxone. Although mutation patterns in quinolone resistant determinant regions (QRDRs) varied, the majority of ciprofloxacin resistant isolates had double mutations in GyrA (S91F and D95G/A/N) and most isolates also carried a S87R/N mutation in ParC. The presence of mutations in the QRDR of ParC is correlated with elevated ciprofloxacin MICs. A modified porB-based molecular typing scheme was developed and involved ~82% of the DNA sequence of gonococcal porB. This typing method proved to have high discriminatory ability (index of discrimination = 0.93 0.96), and was cost effective and easy to perform as compared to the NG-MAST analysis. Using the modified porB-based typing method, N. gonorrhoeae isolates were reliably differentiated, and transmission clusters were identified. Molecular epidemiology using the porB-based method confirmed direct sexual connections and identified sexual networks otherwise unrevealed by the patient self-reporting or traditional case-tracing methods.