Fig. 7: Conceptual model of the role of cadD in GBS pathogenesis.

GBS infects the gravid reproductive tract and encounters sentinel innate immune cells such as macrophages within the tissues. Macrophages can perform phagocytosis to engulf GBS which deploys enhanced expression of cadD within the phagosome to overcome divalent cation stress, including zinc intoxication, to turn the macrophage intracellular space into a replicative niche. Replication and survival within macrophages aids in GBS penetrance and proliferation within the gravid reproductive tract. Concomitantly, ascending infection of the reproductive tract results in enhanced proinflammatory cytokine production in discrete tissue compartments.