Understanding the role of the cytadhesins on the pathogenesis and transmission of Mycoplasma genitalium infection: a minireview.

First isolated in 1981, Mycoplasma genitalium is now well recognized as a frequent cause of urethritis and several other urogenital syndromes in both men and women. The cytoadhesins P110 (MgpC) and P140 (MgpB), located in the terminal organelle of the bacterium, mediate the establishment and persistence of M. genitalium infection in the reproductive tract tissues. This adhesion complex exposes a large extracellular domain, mediating bacterial adhesion to the anogenital tissue. The antigenic variation promoted by reciprocal recombination contribute to the efficient colonization of the urogenital environment and the immune evasion strategy of the bacterium. Although M. genitalium was traditionally detected in ano-genital samples, sexual transmission was not postulated until the early 2000s. Now, it is well accepted that M. genitalium can lead to a sexually transmitted infection. While vaginal sex may constitute the primary transmission route in terms of risk, anal intercourse in men who have sex with men is likely the most common cause of spread. Acknowledging the exquisite adaptation of the bacterium to diverse ecological niches in the human body, the unique features of the proteins P110 and P140 may influence transmission, dissemination and disease.