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Inhibition of Neisseria gonorrhoeae complement-mediated killing during acute gonorrhea is dependent upon the IgG2:IgG3 antibody ratio

Title: Inhibition of Neisseria gonorrhoeae complement-mediated killing during acute gonorrhea is dependent upon the IgG2:IgG3 antibody ratio
Authors: McKeand, Samantha A.; Faustini, Sian E.; Cook, Alex; Kennett, Nikki; Drayson, Mark T.; Cunningham, Adam F.; Henderson, Ian R.; Tang, Christoph M.; Ross, Jonathan D. C.; Cole, Jeffrey A.; Rossiter-Pearson, Amanda E.
Contributors: Whiteley, Marvin; Wellcome Trust
Source: mBio ; volume 17, issue 3 ; ISSN 2150-7511
Publisher Information: American Society for Microbiology
Publication Year: 2026
Description: Excessive binding of antibodies to the bacterial cell surface can paradoxically increase resistance of some Gram-negative pathogens to complement-mediated killing (CMK). We examined the CMK of 336 Neisseria gonorrhoeae isolates from 283 participants recruited to a clinical trial. Serum bactericidal assays revealed 3% (9/283) of the autologous participant sera blocked CMK. Gonococci isolated from these participants were resistant to the autologous host serum, but sensitive to pooled healthy control sera (HCS) and protected by autologous host serum in a 1:1 mixture with HCS. Analysis of clinical metadata showed that there was a significantly higher proportion of blocking sera found in participants with urethral infection and from men within the transmission network of men who have sex with women, when compared to the whole cohort. Following antibody purification from participants with blocking sera (5/9), total IgG protected autologous isolates from HCS-mediated killing. A closer examination of IgG subclasses using whole gonococcal cell ELISAs revealed a significant correlation between increased IgG2 binding and decreased IgG3 binding to the cell surface of isolates that were resistant to CMK. This indicates that IgG2 prevents bactericidal IgG3 from initiating CMK, with an increased IgG2:IgG3 ratio blocking CMK of gonococci. We therefore reveal a previously unrecognized mechanism by which blocking antibodies prevent CMK of N. gonorrhoeae . IMPORTANCE The antigenic variation of Neisseria gonorrhoeae and a limited mechanistic understanding of immune responses to this bacterium have presented multiple challenges to generating a protective vaccine. Here, we use a collection of N. gonorrhoeae clinical isolates ( n = 336) for a robust analysis of the host immune response to infection. We reveal a mechanism for serum resistance in which some isolates of N. gonorrhoeae drive the production of inhibitory IgG2 antibodies, which block the activity of IgG3 bactericidal antibodies. Importantly, an increased ratio of ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1128/mbio.03367-23
Availability: https://doi.org/10.1128/mbio.03367-23; https://journals.asm.org/doi/pdf/10.1128/mbio.03367-23
Rights: https://creativecommons.org/licenses/by/4.0/ ; https://journals.asm.org/non-commercial-tdm-license
Accession Number: edsbas.1B08E8DF
Database: BASE