Adherence to host uroepithelial cells is a crucial step during the infection that allows uropathogenic
E.coli to colonize the urinary tract and prevents bacterial removal during micturition. The binding of the P fimbriae to epithelial cells is mediated by the tip adhesin PapG. Four different alleles of PapG have been described, which bind to different
glycolipid structures on host cells. In humans, especially variant papGII and papGIII have shown to be clinically relevant. Variant PapGII binds preferentially to
globoside (GbO4), found abundantly on human kidney epithelial cells. PapGII triggers a strong inflammatory response which leads to tissue damage. Most
E. coli strains causing
pyelonephritis, urinary-source
bacteremia and
urosepsis produce P pili with PapGII. PapGIII binds to the
Forssmann antigen (GbO5) as well as isoreceptors present in the urinary tract of humans.
E. coli strains carrying the papGIII gene are associated with
lower urinary tract infections (cystitis) and
asymptomatic bacteriuria. PapGI adhesins bind preferentially to
globotriaosylceramide (GbO3), while the isoreceptors of PapGIV are unknown.
E. coli carrying genes for PapGI and PapGIV are rarely found in
E. coli causing infections in humans. == References ==