Mycoplasma genitalium is a sexually transmitted human pathogen, causing numerous reproductive tract diseases in both genders, including urethritis, cervicitis, and adverse pregnancy outcomes (
1).
Mycoplasma genitalium infection has become a serious public health issue. A meta-analysis indicated that the prevalence in developed and developing countries was 1.3% and 3.9% respectively (
2). In China, the infection rate of
M. genitalium in the genitourinary tract was 0.94% of the healthy population and 11.58% among patients from sexually transmitted disease (STD) clinics or hospitals (
3).
Mycoplasma genitalium uses terminal organelles to adhere, move and participate in cell division. After
M. genitalium adheres to host epithelial cells, the innate immune sensors, which are highly expressed in the host, bind to
M. genitalium and its lipoproteins, leading to the activation of NF-κB and the production of chemokines, and eventually recruiting leukocytes to the infection site (
4).
Surface exposure proteins (MgpB and MgpC) at the top of organelles mediate adhesion to eukaryotic cells (
5). The immune escape and persistent infection of
M. genitalium are linked to the mutation and recombination of MgpBC. Burgos and Totten (
6) concluded that MG428 has positive regulation on the recombination of MgpB and MgpC and an alternative sigma factor. MG428 coordinates the expression of recA, ruvA, ruvB and other proteins involved in recombination. Through a pig-tailed macaque model, academics have discovered that mutations in MgpBC/MgPar are linked with immune escape and persistent infection of
M. genitalium (
7).