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Patricia Totten, PhD

  • Research Professor, Division of Allergy and Infectious Diseases, Department of Medicine
    Adjunct Research Professor, Department of Global Health
    Interdisciplinary Program in Pathology
  • Research Affiliate, Washington National Primate Research Center
  • University of Washington

Research in the Totten group includes the discovery, epidemiology, and molecular pathogenesis of novel bacteria that cause sexually transmitted, reproductive tract diseases in men and women, with a focus on Mycoplasma genitalium. In collaborative studies, we have shown that this bacterium, which remarkably contains the smallest genome of any known free-living cellular form of life, causes urethritis in men and cervicitis, acute endometritis, and pelvic inflammatory disease in women. Our finding that M. genitalium can persists for months, if not years, in infected women lead to our hypothesis that antigenic variation among two of its immunodominant surface-exposed proteins contributes to the ability of this organism to evade the immune response and resist killing by its host. Supporting this hypothesis, we have demonstrated that the genes encoding these proteins are extremely heterogeneous and vary by reciprocal recombination between the expression site of these two proteins and archived non-coding DNA sequences distributed throughout its minimal chromosome. The potentially novel recombination and regulatory mechanisms used for this process, the biologic significance of the resulting antigenic variation, and the characterization of the immunopathology of M. genitalium infection in our experimental primate model are ongoing studies in the Totten laboratory.


Selected Publications


Totten PA, Schwartz MA, Sjostrom KE, et al. Association of Mycoplasma genitalium with nongonococcal urethritis in heterosexual men. J Infect Dis. 2001; 183, 269-276. PMID: 11120932.
Oxford Journals Abstract


Manhar LE, Critchlow CW, Holmes KK, Dutro SM, Eschenbach DA, Stevens CE, Totten PA. Mucopurulent cervicitis and Mycoplasma genitalium. J Infect Dis. 2003; 187, 650-7.
• PubMed Abstract


Iverson-Cabral SL, Astete SG, Cohen CR, Rocha EPC, Totten PA. Intrastrain heterogeneity of the mgpB gene in Mycoplasma genitalium is extensive in vitro and in vivo and suggests that variation is generated via recombination with repetitive chromosomal sequences. Infect Immun. 2006; 74: 3715-26.
PubMed Abstract


Cohen CR, Nosek M, Meier A, Astete AG, Iverson-Cabral SL, Mugo NR, Totten PA. Mycoplasma genitalium infection and persistence in a cohort of female sex workers in Nairobi, Kenya. Sex Transm Dis. 2007; 34, 274-9.
PubMed Abstract


Iverson-CabraSL, Astete SG., Cohen CR, Totten PA. mgpB and mgpC sequence diversity in Mycoplasma genitalium is generated by segmental reciprocal recombination with repetitive chromosomal sequences. Mol Microbiol. 2008; 66, 56-75.
• PubMedAbstract


Burgos R, Wood GE, Young L, Glass JO, Totten PA. RecA mediates MgpB and MgpC phase and antigenic variation in Mycoplasma genitalium, but plays a minor role in DNA repair. Mol Microbiol. 2012; 85, 669-683. PMID: 2268642
PubMed Abstract

Wood GE, Iverson-Cabral SL, Patton DL, Cummings PK, Cosgrove Sweeney YT and Totten PA Persistence, immune response, and antigenic variation of Mycoplasma genitalium in an experimentally infected pig-tailed macaque (Macacca nemestrina). Infect. Immun.2013 812938-2951.
PubMed Abstract


Burgos R and Totten PA Characterization of the operons encoding the Holliday junction helicase RuvAB from Mycoplasma genitalium and its role in mgpB and mgpC gene variation. J. Bacteriol. 2014:196:1608—1618.
PubMed Abstract

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