Neisseria gonorrhoeae is able to deploy many virulence factors, increasing in number as the infection progresses.
In the initial stage of the infection, adhesion is the main priority with type IV pili being used. This helps prevent the bacteria from being washed away by urination. Additional proteins are then expressed to form tighter adhesion with the epithelial cells lining the genito-urinary tract.
A capsule is produced to reduce the risk of phagocytosis.
IgA protease helps prevent antibodies from function by degrading the protein. Tbp and Lbp improve iron uptake from surrounding cells.
LPS is produced last, and this is the virulence factor that results in the pain associated with Neisseria gonorrhoeae infection.