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Kim AE, Nelson A, Stimpert K, Flyckt RL, Thirumavalavan N, Baker KC, Weinmann SC, Hoimes CJ. Minding the Bathwater: Fertility and Reproductive Toxicity in the Age of Immuno-Oncology. JCO Oncol Pract 2022; 18:815-822. [PMID: 36174117 PMCID: PMC10166412 DOI: 10.1200/op.22.00469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/29/2022] [Indexed: 01/05/2023] Open
Abstract
Immune checkpoint inhibition has resulted in significant efficacy across many cancer types, including melanoma. Melanoma is the second most common cancer among those of reproductive age, yet the reproductive toxicities of adjuvant and first-line immunotherapy are largely unknown.The normal innate and adaptive immune systems play a vital role in reproductive organ homeostasis of men and women and are essential for implantation, fertility, and a successful pregnancy. The programmed cell death-1 receptor/programmed cell death receptor ligand-1 (PD-1/PD-L1) pathway is essential in several aspects of fertility and pregnancy. Recent studies have largely focused on the role of the PD-1/PD-L1 pathway in fetomaternal tolerance, highlighting the importance of intact immune regulation in promoting a successful pregnancy.In this review, we describe a case of a reproductive-aged female with stage IIIC melanoma who sought guidance on family planning after pembrolizumab therapy. We discuss the known fertility-related toxicities of immune checkpoint inhibitors, the potential targets for reproductive toxicity in males and nonpregnant females, and the implications of anti-PD-1 therapy in relation to fetomaternal tolerance. Informed decision making will benefit from data and consensus.
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Affiliation(s)
- Anne E. Kim
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Ariel Nelson
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
- Department of Medicine, Division of Hematology and Oncology, The Medical College of Wisconsin, Milwaukee, WI
| | - Kyle Stimpert
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
- VA Northeast Ohio Healthcare System, Cleveland, OH
| | | | - Nannan Thirumavalavan
- Department of Urology, University Hospitals, Case Western Reserve University, Cleveland, OH
| | | | - Sophia C. Weinmann
- Division of Rheumatology and Immunology, Duke University, Durham, NC
- Center for Cancer Immunotherapy, Duke University, Durham, NC
| | - Christopher J. Hoimes
- Center for Cancer Immunotherapy, Duke University, Durham, NC
- Duke Cancer Institute, Duke University, Durham, NC
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Bick AJ, Avenant C, Tomasicchio M, van der Spuy Z, Hapgood JP. Increased HIV-1 infection in PBMCs treated in vitro with menstrual cycle phase hormones or medroxyprogesterone acetate likely occurs via different mechanisms. Am J Reprod Immunol 2022; 88:e13643. [PMID: 36302121 PMCID: PMC9884997 DOI: 10.1111/aji.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 02/01/2023] Open
Abstract
PROBLEM Both luteal phase progesterone (P4) levels and use of the intramuscular (IM) injectable progestin-only contraceptive depo-medroxyprogesterone acetate (DMPA-IM) have been linked to increased S/HIV acquisition in animal, clinical and in vitro models. Several plausible mechanisms could explain MPA-induced HIV-1 acquisition while those for the luteal phase are underexplored. METHOD OF STUDY Peripheral blood mononuclear cells (PBMCs) were treated with P4 and estrogen at concentrations mimicking the luteal phase, follicular phase or with levels of MPA mimicking peak serum levels in DMPA-IM users. Cells were infected with an R5-tropic infectious molecular clone and HIV-1 infection was measured. A role for the glucocorticoid receptor (GR) was investigated using the GR/PR antagonist RU486. CCR5 protein levels and activation status, assessed by levels of the activation marker CD69, were measured by flow cytometry after treatment in vitro and in PBMCs from naturally-cycling women or DMPA-IM users. RESULTS Both MPA and luteal phase hormones significantly increased HIV-1 infection in vitro. However, MPA but not luteal phase hormones increased the CD4+/CD8+ T cell ratio, CCR5 protein expression on CD4+ T cells and increased expression of the activation marker CD69. The GR is involved in MPA-induced, but not luteal phase hormone-induced increased HIV-1 infection. In DMPA-IM users, the frequency of CCR5-expressing CD3+ and CD8+ cells was higher than for women in the luteal phase. CONCLUSIONS MPA increases HIV-1 infection in a manner different from that of luteal phase hormones, most likely involving the GR and at least in part changes in the frequency and/or expression of CCR5 and CD69.
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Affiliation(s)
- Alexis J. Bick
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa
| | - Chanel Avenant
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa
| | - Michele Tomasicchio
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine, University of Cape Town and UCT Lung Institute, South Africa.,South African MRC Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa
| | - Zephne van der Spuy
- Department of Obstetrics and Gynaecology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Janet P. Hapgood
- Department of Molecular and Cell Biology, University of Cape, Cape Town, South Africa.,Institute of Infectious Disease and Molecular Medicine, University of Cape Town South Africa.,Corresponding author:
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Shen Z, Patel MV, Rodriguez-Garcia M, Wira CR. Aging beyond menopause selectively decreases CD8+ T cell numbers but enhances cytotoxic activity in the human endometrium. Immun Ageing 2022; 19:55. [PMID: 36371240 PMCID: PMC9652910 DOI: 10.1186/s12979-022-00312-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/23/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Regulation of endometrial (EM) CD8+ T cells, which provide protection through cell-mediated cytotoxicity, is essential for successful reproduction, and protection against sexually transmitted infections and potential tumors. We have previously demonstrated that EM CD8+ T cell cytotoxicity is suppressed directly and indirectly by sex hormones and enhanced after menopause. What remains unclear is whether CD8+ T cell protection and the contribution of tissue-resident (CD103+) and non-resident (CD103-) T cell populations in the EM change as women age following menopause. RESULTS Using hysterectomy EM tissues, we found that EM CD8+ T cell numbers declined significantly in the years following menopause. Despite an overall decline in CD8+ T cells, cytotoxic activity per cell for both CD103- and CD103 + CD8+ T cells increased with age. Investigation of the underlying mechanisms responsible for cytotoxicity indicated that the percentage of total granzyme A and granzyme B positive CD8+ T cells, but not perforin, increased significantly after menopause and remained high and constant as women aged. Additionally, baseline TNFα production by EM CD8+ T cells increased significantly in the years following menopause, and estradiol suppressed TNFα secretion. Moreover, in response to PMA activation, TNFα and IFNγ were significantly up-regulated, and CD103-CD8+ T cells up-regulation of TNFα, IFNγ and IL-6 increased as women aged. CONCLUSIONS Understanding the underlying factors involved in regulating cell-mediated protection of the EM by CD8+ T cells will contribute to the foundation of information essential for developing therapeutic tools to protect women against gynecological cancers and infections as they age.
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Affiliation(s)
- Zheng Shen
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, 03756, USA
| | - Mickey V Patel
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, 03756, USA
| | | | - Charles R Wira
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, 03756, USA.
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Collins MK, McCutcheon CR, Petroff MG. Impact of Estrogen and Progesterone on Immune Cells and Host–Pathogen Interactions in the Lower Female Reproductive Tract. THE JOURNAL OF IMMUNOLOGY 2022; 209:1437-1449. [DOI: 10.4049/jimmunol.2200454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
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Hughes SM, Levy CN, Katz R, Lokken EM, Anahtar MN, Hall MB, Bradley F, Castle PE, Cortez V, Doncel GF, Fichorova R, Fidel PL, Fowke KR, Francis SC, Ghosh M, Hwang LY, Jais M, Jespers V, Joag V, Kaul R, Kyongo J, Lahey T, Li H, Makinde J, McKinnon LR, Moscicki AB, Novak RM, Patel MV, Sriprasert I, Thurman AR, Yegorov S, Mugo NR, Roxby AC, Micks E, Hladik F. Changes in concentrations of cervicovaginal immune mediators across the menstrual cycle: a systematic review and meta-analysis of individual patient data. BMC Med 2022; 20:353. [PMID: 36195867 PMCID: PMC9533580 DOI: 10.1186/s12916-022-02532-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/16/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hormonal changes during the menstrual cycle play a key role in shaping immunity in the cervicovaginal tract. Cervicovaginal fluid contains cytokines, chemokines, immunoglobulins, and other immune mediators. Many studies have shown that the concentrations of these immune mediators change throughout the menstrual cycle, but the studies have often shown inconsistent results. Our understanding of immunological correlates of the menstrual cycle remains limited and could be improved by meta-analysis of the available evidence. METHODS We performed a systematic review and meta-analysis of cervicovaginal immune mediator concentrations throughout the menstrual cycle using individual participant data. Study eligibility included strict definitions of the cycle phase (by progesterone or days since the last menstrual period) and no use of hormonal contraception or intrauterine devices. We performed random-effects meta-analyses using inverse-variance pooling to estimate concentration differences between the follicular and luteal phases. In addition, we performed a new laboratory study, measuring select immune mediators in cervicovaginal lavage samples. RESULTS We screened 1570 abstracts and identified 71 eligible studies. We analyzed data from 31 studies, encompassing 39,589 concentration measurements of 77 immune mediators made on 2112 samples from 871 participants. Meta-analyses were performed on 53 immune mediators. Antibodies, CC-type chemokines, MMPs, IL-6, IL-16, IL-1RA, G-CSF, GNLY, and ICAM1 were lower in the luteal phase than the follicular phase. Only IL-1α, HBD-2, and HBD-3 were elevated in the luteal phase. There was minimal change between the phases for CXCL8, 9, and 10, interferons, TNF, SLPI, elafin, lysozyme, lactoferrin, and interleukins 1β, 2, 10, 12, 13, and 17A. The GRADE strength of evidence was moderate to high for all immune mediators listed here. CONCLUSIONS Despite the variability of cervicovaginal immune mediator measurements, our meta-analyses show clear and consistent changes during the menstrual cycle. Many immune mediators were lower in the luteal phase, including chemokines, antibodies, matrix metalloproteinases, and several interleukins. Only interleukin-1α and beta-defensins were higher in the luteal phase. These cyclical differences may have consequences for immunity, susceptibility to infection, and fertility. Our study emphasizes the need to control for the effect of the menstrual cycle on immune mediators in future studies.
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Affiliation(s)
- Sean M Hughes
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Claire N Levy
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Ronit Katz
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Erica M Lokken
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Melis N Anahtar
- Ragon Institute of MIT and Harvard, Massachusetts General Hospital, Boston, MA, USA
| | | | - Frideborg Bradley
- Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Philip E Castle
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Valerie Cortez
- Department of Molecular, Cell & Developmental Biology, University of California, Santa Cruz, Santa Cruz, CA, USA
| | | | - Raina Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Paul L Fidel
- Louisiana State University Health, New Orleans, LA, USA
| | - Keith R Fowke
- Department of Medical Microbiology & Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Suzanna C Francis
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Mimi Ghosh
- Department of Epidemiology, The George Washington University, Washington, DC, USA
| | - Loris Y Hwang
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Mariel Jais
- Office of Laboratory Safety, The George Washington University, Washington, DC, USA
| | | | - Vineet Joag
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Rupert Kaul
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jordan Kyongo
- Virology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Timothy Lahey
- University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, Los Angeles, CA, USA
| | - Julia Makinde
- IAVI Human Immunology Laboratory, Imperial College, London, England, UK
- IAVI, New York, NY, USA
| | - Lyle R McKinnon
- Department of Medical Microbiology & Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
| | - Anna-Barbara Moscicki
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Mickey V Patel
- Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Intira Sriprasert
- Department of OB/GYN, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Sergey Yegorov
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nelly Rwamba Mugo
- Department of Global Health, University of Washington, Seattle, WA, USA
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Alison C Roxby
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutch, Seattle, WA, USA
| | - Elizabeth Micks
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
| | - Florian Hladik
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
- Department of Medicine, University of Washington, Seattle, WA, USA.
- Vaccine and Infectious Disease Division, Fred Hutch, Seattle, WA, USA.
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ÖNER SZ, KALELİ İ, KALELİ B. Vajinal Mikrobiyal Türlerin Bakteriyel Vajinozis ve Human Papillomavirus ile İlişkisinin Araştırılması. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1132919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: This study was aim to investigate the relationship of vaginal bacterial species with High-Risk Human Papillomavirus (HR-HPV) and bacterial vaginosis (BV).Methods: One hundred and twenty-one women were included in the study. Gram stain was performed for the diagnosis of BV and evaluated according to the Nugent score. HR-HPV diagnosis was made by real-time PCR . Detection of vaginal microbial species and Gardnerella vaginalis subtypes were also performed by real-time PCR.Results: The prevalence of BV was found as 38.8%. The mean number of species was found significantly higher in BV-positive samples compared to BV-intermediate and BV-negative samples (p=0.001). Lactobacillus iners (p=0.036), BVAB2 (p=0.043), Provetella spp. (p=0.015), Leptotrichia/Sneathia (p=0.001), Megaspheara (p=0.048) were found to be associated with bacterial vaginosis. Gardnerella vaginalis subtypes were evaluated in 50 randomly selected samples. The most common strain that was found was “clade 4”. The prevalence of HR-HPV was 9.9%. HPV 16 was the most common HR-HPV type (58.3%). There was no significant difference between the mean value of Lactobacillus sp. HR-HPV-positive and negative samples (p=0.23). No association was found between the specified species and HR-HPV-positive samples (p=0.436).Conclusion: Bacterial diversity was greater in BV-positive patients and BV was significantly associated with Lactobacillus iners, Megaspheara, BVAB2, Provetella spp. and Leptotrichia / Sneathia.
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Zhai YJ, Feng Y, Ma X, Ma F. Defensins: defenders of human reproductive health. Hum Reprod Update 2022; 29:126-154. [PMID: 36130055 PMCID: PMC9825273 DOI: 10.1093/humupd/dmac032] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/31/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Reproductive tract infection is an important factor leading to male and female infertility. Among female infertility factors, microbial and viral infections are the main factors affecting female reproductive health and causing tubal infertility, ectopic tubal pregnancy and premature delivery. Among male infertility factors, 13-15% of male infertility is related to infection. Defensins are cationic antibacterial and antiviral peptides, classified into α-defensins, β-defensins and θ-defensins. Humans only have α-defensins and β-defensins. Apart from their direct antimicrobial functions, defensins have an immunomodulatory function and are involved in many physiological processes. Studies have shown that defensins are widely distributed in the female reproductive tract (FRT) and male reproductive tract (MRT), playing a dual role of host defence and fertility protection. However, to our knowledge, the distribution, regulation and function of defensins in the reproductive tract and their relation to reproduction have not been reviewed. OBJECTIVE AND RATIONALE This review summarizes the expression, distribution and regulation of defensins in the reproductive tracts to reveal the updated research on the dual role of defensins in host defence and the protection of fertility. SEARCH METHODS A systematic search was conducted in PubMed using the related keywords through April 2022. Related data from original researches and reviews were integrated to comprehensively review the current findings and understanding of defensins in the human reproductive system. Meanwhile, female and male transcriptome data in the GEO database were screened to analyze defensins in the human reproductive tracts. OUTCOMES Two transcriptome databases from the GEO database (GSE7307 and GSE150852) combined with existing researches reveal the expression levels and role of the defensins in the reproductive tracts. In the FRT, a high expression level of α-defensin is found, and the expression levels of defensins in the vulva and vagina are higher than those in other organs. The expression of defensins in the endometrium varies with menstrual cycle stages and with microbial invasion. Defensins also participate in the local immune response to regulate the risk of spontaneous preterm birth. In the MRT, a high expression level of β-defensins is also found. It is mainly highly expressed in the epididymal caput and corpus, indicating that defensins play an important role in sperm maturation. The expression of defensins in the MRT varies with androgen levels, age and the status of microbial invasion. They protect the male reproductive system from bacterial infections by neutralizing lipopolysaccharide and downregulating pro-inflammatory cytokines. In addition, animal and clinical studies have shown that defensins play an important role in sperm maturation, motility and fertilization. WIDER IMPLICATIONS As a broad-spectrum antimicrobial peptide without drug resistance, defensin has great potential for developing new natural antimicrobial treatments for reproductive tract infections. However, increasing evidence has shown that defensins can not only inhibit microbial invasion but can also promote the invasion and adhesion of some microorganisms in certain biological environments, such as human immunodeficiency virus. Therefore, the safety of defensins as reproductive tract anti-infective drugs needs more in-depth research. In addition, the modulatory role of defensins in fertility requires more in-depth research since the current conclusions are based on small-size samples. At present, scientists have made many attempts at the clinical transformation of defensins. However, defensins have problems such as poor stability, low bioavailability and difficulties in their synthesis. Therefore, the production of safe, effective and low-cost drugs remains a challenge.
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Affiliation(s)
| | | | - Xue Ma
- Correspondence address. Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7781-821X (F.M.); Department of Pediatric Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7650-6214 (X.M.)
| | - Fang Ma
- Correspondence address. Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7781-821X (F.M.); Department of Pediatric Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. E-mail: https://orcid.org/0000-0002-7650-6214 (X.M.)
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Lu D, Hu W, Tian T, Wang M, Zhou M, Wu C. The Mechanism of Lipopolysaccharide’s Effect on Secretion of Endometrial Mucins in Female Mice during Pregnancy. Int J Mol Sci 2022; 23:ijms23179972. [PMID: 36077364 PMCID: PMC9456203 DOI: 10.3390/ijms23179972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
The main toxic component of endotoxins released from the death or dissolution of Gram-negative bacteria is lipopolysaccharide (LPS), which exists widely in the natural environment, and a large amount of endotoxin can significantly inhibit the reproductive performance of animals. A previous study showed that endotoxins mainly damaged the physiological function of mucins in the endometrium, but the mechanism is not clear. In this study, the PI3K/Akt signaling pathway was not activated, and the NF-κB signaling pathway was inhibited by LPS treatment; the expression of occludin and E-cadherin proteins were decreased and ZO-1 protein expression was increased, because LPS can lead to the mucous layer becoming thinner, so that the embryonic survival rate is significantly reduced in early pregnancy. In middle and late pregnancy, LPS translocated to the epithelial cells of the uterus and the expression of claudin-1, JAMA, and E-cadherin proteins were decreased; at this time, a large number of glycosaminoglycan particles were secreted by endometrial gland cells through the PI3K/Akt/NF-κB signaling pathway that was activated after LPS treatment, However, there was no significant difference between the survival rates of fetal mice in the LPS (+) and LPS (-) groups. Glycosaminoglycan particles and mucins are secreted by gland cells, which can protect and maintain the pregnancy in the middle and late gestational periods.
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Moldenhauer LM, Jin M, Wilson JJ, Green ES, Sharkey DJ, Salkeld MD, Bristow TC, Hull ML, Dekker GA, Robertson SA. Regulatory T Cell Proportion and Phenotype Are Altered in Women Using Oral Contraception. Endocrinology 2022; 163:6628694. [PMID: 35786711 PMCID: PMC9354970 DOI: 10.1210/endocr/bqac098] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Indexed: 11/19/2022]
Abstract
Regulatory T (Treg) cells are a specialized CD4+ T cell subpopulation that are essential for immune homeostasis, immune tolerance, and protection against autoimmunity. There is evidence that sex-steroid hormones estrogen and progesterone modulate Treg cell abundance and phenotype in women. Since natural oscillations in these hormones are modified by hormonal contraceptives, we examined whether oral contraception (OC) use impacts Treg cells and related T cell populations. T cells were analyzed by multiparameter flow cytometry in peripheral blood collected across the menstrual cycle from healthy women either using OC or without hormonal contraception and from age-matched men. Compared to naturally cycling women, women using OC had fewer Treg cells and an altered Treg cell phenotype. Notably, Treg cells exhibiting a strongly suppressive phenotype, defined by high FOXP3, CD25, Helios, HLADR, CTLA4, and Ki67, comprised a lower proportion of total Treg cells, particularly in the early- and mid-cycle phases. The changes were moderate compared to more substantial differences in Treg cells between women and men, wherein women had fewer Treg cells-especially of the effector memory Treg cell subset-associated with more T helper type 1 (Th1) cells and CD8+ T cells and lower Treg:Th1 cell and Treg:CD8+ T cell ratios than men. These findings imply that OC can modulate the number and phenotype of peripheral blood Treg cells and raise the possibility that Treg cells contribute to the physiological changes and altered disease susceptibility linked with OC use.
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Affiliation(s)
| | | | - Jasmine J Wilson
- Robinson Research Institute and School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Ella S Green
- Robinson Research Institute and School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - David J Sharkey
- Robinson Research Institute and School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Mark D Salkeld
- Robinson Research Institute and School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - Thomas C Bristow
- Robinson Research Institute and School of Biomedicine, University of Adelaide, Adelaide, Australia
| | - M Louise Hull
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gustaaf A Dekker
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Sarah A Robertson
- Correspondence: Sarah A. Robertson, PhD, Robinson Research Institute and the School of Biomedicine, University of Adelaide, Adelaide, SA 5005, Australia.
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Abudukeyoumu A, Lai ZZ, Lu JJ, Zhang X, Hou DY, Dong J, Wu JN, Li MQ, Xie F. A LIGHT-HVEM/LTβR axis contributes to the fibrosis of intrauterine adhesion. J Reprod Immunol 2022; 153:103693. [PMID: 35987137 DOI: 10.1016/j.jri.2022.103693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022]
Abstract
Intrauterine adhesion (IUA) is a fibrotic disease, with complex and multifactorial process, causing menstrual disorders, pregnancy loss or infertility. LIGHT (also named TNFSF14), mainly expressed by immune cells, has been reported to be associated with tissue fibrosis. However, the features of immunocyte subsets, the expression and roles of LIGHT and its receptor HVEM (herpes virus entry mediator) and LTβR (lymphotoxin beta receptor) in IUA remain largely unknown. Compared with the control group, we observed increased ratios of CD45+ cells, neutrophils, T cells, macrophages and decreased natural killer cells proportion, and high LIGHT expression on CD4+ T cells and macrophages in IUA endometrium. Further analysis showed there was a positive correlation between upregulated profibrotic factors (e.g., ɑ-smooth muscle actin, transforming growth factor β1) and HVEM in IUA endometrial tissue. More importantly, recombinant human LIGHT protein directly up-regulated the expression of HVEM, LTβR, profibrotic and proinflammatory factors expression in human endometrial stromal cells. These findings reveal abnormal changes of immune cell subsets proportion and the overexpression of LIGHT-HVEM/LTβR axis in IUA endometrium, should contribute to inflammation and fibrosis formation of IUA.
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Affiliation(s)
- Ayitila Abudukeyoumu
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China
| | - Zhen-Zhen Lai
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, People's Republic of China
| | - Jia-Jing Lu
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China
| | - Xing Zhang
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China
| | - Ding-Yu Hou
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China
| | - Jing Dong
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China
| | - Jiang-Nan Wu
- Clinical Epidemiology, Clinical Research Center, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200080, People's Republic of China
| | - Ming-Qing Li
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, People's Republic of China; NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Fudan University, Shanghai 201203, People's Republic of China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, People's Republic of China.
| | - Feng Xie
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China.
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Zhu N, Yang X, Liu Q, Chen Y, Wang X, Li H, Gao H. “Iron triangle” of regulating the uterine microecology: Endometrial microbiota, immunity and endometrium. Front Immunol 2022; 13:928475. [PMID: 36016947 PMCID: PMC9396262 DOI: 10.3389/fimmu.2022.928475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
The uterus is the core place for breeding new life. The balance and imbalance of uterine microecology can directly affect or even dominate the female reproductive health. Emerging data demonstrate that endometrial microbiota, endometrium and immunity play an irreplaceable role in regulating uterine microecology, forming a dynamic iron triangle relationship. Up to nowadays, it remains unclear how the three factors affect and interact with each other, which is also a frontier topic in the emerging field of reproductive tract microecology. From this new perspective, we aim to clarify the relationship and mechanism of the interaction of these three factors, especially their pairwise interactions. Finally, the limitations and future perspectives of the current studies are summarized. In general, these three factors have a dynamic relationship of mutual dependence, promotion and restriction under the physiological or pathological conditions of uterus, among which the regulatory mechanism of microbiota and immunity plays a role of bridge. These findings can provide new insights and measures for the regulation of uterine microecology, the prevention and treatment of endometrial diseases, and the further multi-disciplinary integration between microbiology, immunology and reproductive medicine.
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Affiliation(s)
- Na Zhu
- Department of Nursing, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- School of Nursing, University of South China, Hengyang, China
| | - Xuyan Yang
- Department of Nursing, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qiao Liu
- School of Nursing, University of South China, Hengyang, China
| | - Yahui Chen
- School of Nursing, University of South China, Hengyang, China
| | - Xiaolan Wang
- Center for Reproductive Medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Huanhuan Li
- Department of Gynecology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Hong Gao
- Department of Nursing, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- *Correspondence: Hong Gao,
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Zeng S, Liu X, Liu D, Song W. Research update for the immune microenvironment of chronic endometritis. J Reprod Immunol 2022; 152:103637. [PMID: 35576684 DOI: 10.1016/j.jri.2022.103637] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023]
Abstract
Chronic endometritis (CE) is a persistent and subtle local inflammatory disease characterized by abnormal plasma cell infiltration in the endometrial stroma.The incidence of chronic endometritis is as high as 15-57.5% in women suffering from infertility, implantation failure of in vitro fertilization (IVF) and unexplained recurrent abortion. Many studies both at home and abroad have shown that CE can reduce the receptivity of endometrium and affect embryo implantation. According to the existing reproductive immunity research, the abnormality of immune cell subsets in endometrium is an important factors leading to pregnancy failure. The immune microenvironment in endometrium consists of immune cells and immune molecules, and their influence on embryo implantation can not be ignored. This review paper discusses the controversy of pathogenesis, diagnosis and treatment of CE from the perspective of immune microenvironment by referring to related literature at home and abroad, and investigates the possible ways to improve the diagnosis and treatment of CE.
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Affiliation(s)
- Shuli Zeng
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Xinqiong Liu
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Dongzhou Liu
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Wencong Song
- The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
- Hainan Vocational University of Science and Technology, No.18 Qiongshan Avenue, Meilan District, Haikou City 571126, Hainan Province, China
- Shenzhen Children's Hospital Affiliated to Shantou University Medical College, Shenzhen 518038, China
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Radzey N, Harryparsad R, Meyer B, Chen PL, Gao X, Morrison C, Taku O, Williamson A, Mehou‐Loko C, Lefebvre d'Hellencourt F, Buck G, Smit J, Strauss J, Nanda K, Ahmed K, Beksinska M, Serrano M, Bailey V, Masson L, Deese J. Genital inflammatory status and the innate immune response to contraceptive initiation. Am J Reprod Immunol 2022; 88:e13542. [PMID: 35394678 PMCID: PMC10909525 DOI: 10.1111/aji.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
PROBLEM Data on the effects of contraceptives on female genital tract (FGT) immune mediators are inconsistent, possibly in part due to pre-existing conditions that influence immune mediator changes in response to contraceptive initiation. METHODS This study included 161 South African women randomised to injectable depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (IUD), or levonorgestrel (LNG) implant in the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial. We measured thirteen cytokines and antimicrobial peptides previously associated with HIV acquisition in vaginal swabs using Luminex and ELISA, before, and at 1 and 3 months after contraceptive initiation. Women were grouped according to an overall baseline inflammatory profile. We evaluated modification of the relationships between contraceptives and immune mediators by baseline inflammation, demographic, and clinical factors. RESULTS Overall, LNG implant and copper IUD initiation were associated with increases in inflammatory cytokines, while no changes were observed following DMPA-IM initiation. However, when stratifying by baseline inflammatory profile, women with low baseline inflammation in all groups experienced significant increases in inflammatory cytokines, while those with a high baseline inflammatory profile experienced no change or decreases in inflammatory cytokines. CONCLUSION We conclude that pre-contraceptive initiation immune profile modifies the effect of contraceptives on the FGT innate immune response.
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Affiliation(s)
- Nina Radzey
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Rushil Harryparsad
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Bahiah Meyer
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | | | | | | | - Ongeziwe Taku
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Anna‐Lise Williamson
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | - Celia Mehou‐Loko
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
| | | | - Gregory Buck
- Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Jennifer Smit
- MatCH Research Unit (MRU), Department of Obstetrics and GynaecologyUniversity of the WitwatersrandDurbanSouth Africa
| | | | | | - Khatija Ahmed
- Setshaba Research CentreTshwaneSouth Africa
- Department of Medical MicrobiologyUniversity of PretoriaPretoriaSouth Africa
| | - Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and GynaecologyUniversity of the WitwatersrandDurbanSouth Africa
| | | | | | - Lindi Masson
- Institute of Infectious Disease and Molecular Medicine (IDM)University of Cape TownCape TownSouth Africa
- Disease Elimination Program, Life Sciences DisciplineBurnet InstituteMelbourneAustralia
- Centre for the AIDS Programme of Research in South AfricaDurbanSouth Africa
- Central Clinical SchoolMonash UniversityMelbourneAustralia
| | - Jennifer Deese
- RTI InternationalResearch Triangle ParkNorth CarolinaUSA
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Bourke NM, Achilles SL, Huang SUS, Cumming HE, Lim SS, Papageorgiou I, Gearing LJ, Chapman R, Thakore S, Mangan NE, Mesiano S, Hertzog PJ. Spatiotemporal regulation of human IFNε and innate immunity in the female reproductive tract. JCI Insight 2022; 7:135407. [PMID: 35862222 DOI: 10.1172/jci.insight.135407] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Although published studies have demonstrated that interferon epsilon (IFNε) has a crucial role in regulating protective immunity in the mouse female reproductive tract (mFRT), expression and regulation of IFNε in the human female reproductive tract (hFRT) have not been characterised. To characterise human IFNε, we obtained hFRT samples from a well- characterized cohort of women, enabling us to comprehensively assess ex vivo IFNε expression in the hFRT at various stages of the menstrual cycle. We found that among the various types of IFNs, IFNε is uniquely selectively and constitutively expressed in the hFRT epithelium. It has distinct expression patterns in the surface and glandular epithelia of the upper hFRT compared with basal layers of the stratified squamous epithelia of the lower hFRT. There is cyclical variation of IFNε expression in the endometrial epithelium of the upper hFRT and not in the distal FRT, consistent with selective endometrial expression of the progesterone receptor and regulation of the IFNE promoter by progesterone. Since we show IFNε stimulates important protective IFN-regulated genes (IRGs) in FRT epithelium, this characterisation is a key element in understanding the mechanisms of hormonal control of mucosal immunity.
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Affiliation(s)
| | | | - Stephanie U-Shane Huang
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - Helen E Cumming
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - San S Lim
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - Irene Papageorgiou
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - Linden J Gearing
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - Ross Chapman
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - Suruchi Thakore
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, United States of America
| | - Niamh E Mangan
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
| | - Sam Mesiano
- Department of Reproductive Biology, Case Western Reserve University, Cleveland, United States of America
| | - Paul J Hertzog
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Australia
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Ruan LY, Lai ZZ, Shi JW, Yang HL, Ye JF, Xie F, Qiu XM, Zhu XY, Li MQ. Excess Heme Promotes the Migration and Infiltration of Macrophages in Endometrial Hyperplasia Complicated with Abnormal Uterine Bleeding. Biomolecules 2022; 12:biom12060849. [PMID: 35740976 PMCID: PMC9221196 DOI: 10.3390/biom12060849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
In patients, endometrial hyperplasia (EH) is often accompanied by abnormal uterine bleeding (AUB), which is prone to release large amounts of heme. However, the role of excess heme in the migration and infiltration of immune cells in EH complicated by AUB remains unknown. In this study, 45 patients with AUB were divided into three groups: a proliferative phase group (n = 15), a secretory phase group (n = 15) and EH (n = 15). We observed that immune cell subpopulations were significantly different among the three groups, as demonstrated by flow cytometry analysis. Of note, there was a higher infiltration of total immune cells and macrophages in the endometrium of patients with EH. Heme up-regulated the expression of heme oxygenase-1 (HO-1) and nuclear factor erythroid-2-related factor 2 (Nrf2) in endometrial epithelial cells (EECs) in vitro, as well as chemokine (e.g., CCL2, CCL3, CCL5, CXCL8) levels. Additionally, stimulation with heme led to the increased recruitment of THP-1 cells in an indirect EEC-THP-1 co-culture unit. These data suggest that sustained and excessive heme in patients with AUB may recruit macrophages by increasing the levels of several chemokines, contributing to the accumulation and infiltration of macrophages in the endometrium of EH patients, and the key molecules of heme metabolism, HO-1 and Nrf2, are also involved in this regulatory process.
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Affiliation(s)
- Lu-Yu Ruan
- NHC Key Lab of Reproduction Regulation, Shanghai Institute of Planned Parenthood Research, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China;
- Laboratory for Reproductive Immunology, Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China; (Z.-Z.L.); (J.-W.S.); (H.-L.Y.)
| | - Zhen-Zhen Lai
- Laboratory for Reproductive Immunology, Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China; (Z.-Z.L.); (J.-W.S.); (H.-L.Y.)
| | - Jia-Wei Shi
- Laboratory for Reproductive Immunology, Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China; (Z.-Z.L.); (J.-W.S.); (H.-L.Y.)
| | - Hui-Li Yang
- Laboratory for Reproductive Immunology, Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China; (Z.-Z.L.); (J.-W.S.); (H.-L.Y.)
| | - Jiang-Feng Ye
- Institute for Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore 138632, Singapore;
| | - Feng Xie
- Medical Center of Diagnosis and Treatment for Cervical and Intrauterine Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
- Correspondence: (F.X.); (X.-M.Q.); (X.-Y.Z.); (M.-Q.L.)
| | - Xue-Min Qiu
- Clinical Research Center, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200011, China
- Correspondence: (F.X.); (X.-M.Q.); (X.-Y.Z.); (M.-Q.L.)
| | - Xiao-Yong Zhu
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200011, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200011, China
- Correspondence: (F.X.); (X.-M.Q.); (X.-Y.Z.); (M.-Q.L.)
| | - Ming-Qing Li
- NHC Key Lab of Reproduction Regulation, Shanghai Institute of Planned Parenthood Research, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China;
- Laboratory for Reproductive Immunology, Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200080, China; (Z.-Z.L.); (J.-W.S.); (H.-L.Y.)
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai 200011, China
- Correspondence: (F.X.); (X.-M.Q.); (X.-Y.Z.); (M.-Q.L.)
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Abril-Parreño L, Meade KG, Krogenæs AK, Druart X, Cormican P, Fair S. Ewe breed differences in the cervical transcriptome at the follicular phase of a synchronised oestrous cycle. BMC Genomics 2022; 23:363. [PMID: 35546662 PMCID: PMC9097332 DOI: 10.1186/s12864-022-08603-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/26/2022] [Indexed: 12/13/2022] Open
Abstract
Background Cervical artificial insemination (AI) with frozen-thawed semen results in unacceptably low pregnancy rates internationally. The exception is in Norway, where vaginal deposition of frozen-thawed semen to a natural oestrous routinely yields pregnancy rates in excess of 70%. Previous studies by our group has demonstrated that this is due to differences in cervical sperm transport. However, a potentially important contributory factor is that ewes are inseminated to a natural oestrous in Norway but to a synchronised oestrous across most of the rest of the world. In this study, we interrogated the gene expression of the sheep cervix of four ewe breeds with known differences in pregnancy rates following cervical AI using frozen-thawed semen under the effect of exogenous hormones to synchronise the oestrous cycle. These four ewe breeds (n = 8 to 11 ewes per breed) are from two countries: Ireland (Belclare and Suffolk; medium and low fertility, respectively) and Norway (Norwegian White Sheep (NWS) and Fur; both with high fertility compared to the Irish ewe breeds). Results RNA extracted from cervical biopsies collected from these breeds was analysed by RNA-sequencing and differential gene expression analysis. Using the low-fertility Suffolk breed as a reference level; 27, 1827 and 2641 genes were differentially expressed in Belclare, Fur and NWS ewes, respectively (P < 0.05 and FC > 1.5). Gene ontology (GO) analysis revealed that Fur and NWS had an up-regulation of enriched pathways involved in muscle contraction and development compared to Suffolk. However, there was a down-regulation of the immune response pathway in NWS compared to Suffolk. In addition, GO analysis showed similar expression patterns involved in muscle contraction, extracellular matrix (ECM) development and cell-cell junction in both Norwegian ewe breeds, which differed to the Irish ewe breeds. Conclusions This novel study has identified a number of conserved and breed-specific biological processes under the effect of oestrous synchronisation that may impact cervical sperm transport during the follicular phase of the reproductive cycle. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-022-08603-8.
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Affiliation(s)
- Laura Abril-Parreño
- Laboratory of Animal Reproduction, Department of Biological Sciences, School of Natural Sciences, Biomaterials Research Cluster, Bernal Institute, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | - Kieran G Meade
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Xavier Druart
- UMR 6175 INRA, CNRS-Université de Tours-Haras Nationaux, Station de Physiologie de la Reproduction et des Comportements Institut National de la Recherche Agronomique, Nouzilly, France
| | - Paul Cormican
- Animal & Bioscience Research Department, Animal & Grassland Research and Innovation Centre, Teagasc, Grange, Co, Meath, Ireland
| | - Sean Fair
- Laboratory of Animal Reproduction, Department of Biological Sciences, School of Natural Sciences, Biomaterials Research Cluster, Bernal Institute, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland.
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Patient-derived and mouse endo-ectocervical organoid generation, genetic manipulation and applications to model infection. Nat Protoc 2022; 17:1658-1690. [PMID: 35546639 DOI: 10.1038/s41596-022-00695-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 03/10/2022] [Indexed: 11/08/2022]
Abstract
The cervix is the gateway to the upper female reproductive tract, connecting the uterus and vagina. It plays crucial roles in fertility and pregnancy maintenance from onset until delivery of the fetus, and prevents pathogen ascension. Compromised functionality of the cervix can lead to disorders, including infertility, chronic infections and cancers. The cervix comprises two regions: columnar epithelium-lined endocervix and stratified squamous epithelium-lined ectocervix, meeting at the squamocolumnar transition zone. So far, two-dimensional cultures of genetically unstable immortalized or cancer cell lines have been primarily used to study cervix biology in vitro. The lack of an in vitro system that reflects the cellular, physiological and functional properties of the two epithelial types has hampered the study of normal physiology, disease development and infection processes. Here we describe a protocol for cell isolation, establishment, long-term culture and expansion of adult epithelial stem cell-derived endocervical and ectocervical organoids from human biopsies and mouse tissue. These two organoid types require unique combinations of growth factors reminiscent of their in vivo tissue niches and different culturing procedures. They recapitulate native three-dimensional tissue architecture and patterning. The protocol to generate these organoids takes 4-6 weeks. We also describe procedures to introduce human papillomavirus oncogenes into the cervical stem cells by genetic manipulation to model cervical cancer and infection of the organoids with the highly prevalent sexually transmitted bacterial pathogen Chlamydia trachomatis. These organoid systems open new possibilities to study cervix biology, infections and cancer evolution, and have potential applications in personalized medicine, drug screening, genome editing and disease modeling.
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Bradley F, Franzén Boger M, Kaldhusdal V, Åhlberg A, Edfeldt G, Lajoie J, Bergström S, Omollo K, Damdimopoulos A, Czarnewski P, Månberg A, Oyugi J, Kimani J, Nilsson P, Fowke K, Tjernlund A, Broliden K. Multi-omics analysis of the cervical epithelial integrity of women using depot medroxyprogesterone acetate. PLoS Pathog 2022; 18:e1010494. [PMID: 35533147 PMCID: PMC9119532 DOI: 10.1371/journal.ppat.1010494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/19/2022] [Accepted: 04/03/2022] [Indexed: 11/30/2022] Open
Abstract
Depot medroxyprogesterone acetate (DMPA) is an injectable hormonal contraceptive used by millions of women worldwide. However, experimental studies have associated DMPA use with genital epithelial barrier disruption and mucosal influx of human immunodeficiency virus (HIV) target cells. We explored the underlying molecular mechanisms of these findings. Ectocervical biopsies and cervicovaginal lavage (CVL) specimens were collected from HIV-seronegative Kenyan sex workers using DMPA (n = 32) or regularly cycling controls (n = 64). Tissue samples were assessed by RNA-sequencing and quantitative imaging analysis, whereas protein levels were measured in CVL samples. The results suggested a DMPA-associated upregulation of genes involved in immune regulation, including genes associated with cytokine-mediated signaling and neutrophil-mediated immunity. A transcription factor analysis further revealed DMPA-associated upregulation of RELA and NFKB1 which are involved in several immune activation pathways. Several genes significantly downregulated in the DMPA versus the control group were involved in epithelial structure and function, including genes encoding keratins, small proline-rich proteins, and cell-cell adhesion proteins. Pathway analyses indicated DMPA use was associated with immune activation and suppression of epithelium development, including keratinization and cornification processes. The cervicovaginal microbiome composition (Lactobacillus dominant and non-Lactobacillus dominant) had no overall interactional impact on the DMPA associated tissue gene expression. Imaging analysis verified that DMPA use was associated with an impaired epithelial layer as illustrated by staining for the selected epithelial junction proteins E-cadherin, desmoglein-1 and claudin-1. Additional staining for CD4+ cells revealed a more superficial location of these cells in the ectocervical epithelium of DMPA users versus controls. Altered protein levels of SERPINB1 and ITIH2 were further observed in the DMPA group. Identification of specific impaired epithelial barrier structures at the gene expression level, which were verified at the functional level by tissue imaging analysis, illustrates mechanisms by which DMPA adversely may affect the integrity of the genital mucosa. Sexual transmission accounts for the majority of all new HIV infections in women, and alterations to the mucosal environment of the female genital tract have been associated with an increase in the risk of acquiring HIV. Observational epidemiological studies have implied that the use of the injectable hormonal contraceptive depot medroxyprogesterone acetate (DMPA) may be associated with increased HIV-acquisition. However, a prospective clinical study has not confirmed this association and the controversial findings are currently evaluated in the context of international reproductive health policies. Several studies using various model systems indicate that DMPA affects the integrity of the genital epithelial barrier as well as the mucosal immune system, but the exact mechanisms remain largely unknown. To characterize the effect of DMPA on the genital mucosal environment, we used a multi-omics approach to assess paired genital secretions and cervical tissue samples from long-term regular DMPA users living in Kenya. This unique cohort represents a population at risk of HIV infection in which DMPA is one of the most commonly used hormonal contraceptives. We identified impaired cervical epithelial barrier structures, including DMPA-associated reduction in the expression of cell-cell adhesion molecules, keratins, small proline-rich proteins and a thinner upper epithelial layer with more superficially located CD4+ cells. Gene set enrichment pathway analyses indicated DMPA use was associated with immune activation and suppression of epithelium development including keratinization and cornification pathways. Protein analysis identified altered levels of selected anti-proteases. Our findings illustrate mechanisms by which DMPA adversely may affect the integrity of the genital mucosa.
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Affiliation(s)
- Frideborg Bradley
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Mathias Franzén Boger
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Vilde Kaldhusdal
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Alexandra Åhlberg
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Gabriella Edfeldt
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Julie Lajoie
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Sofia Bergström
- Division of Affinity Proteomics, Department of Protein Science, SciLifeLab, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Kenneth Omollo
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Anastasios Damdimopoulos
- Bioinformatics and Expression Analysis core facility, Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Paulo Czarnewski
- Department of Biochemistry and Biophysics, National Bioinformatics Infrastructure Sweden, SciLifeLab, Stockholm University, Solna, Sweden
| | - Anna Månberg
- Division of Affinity Proteomics, Department of Protein Science, SciLifeLab, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Julius Oyugi
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Joshua Kimani
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Peter Nilsson
- Division of Affinity Proteomics, Department of Protein Science, SciLifeLab, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Keith Fowke
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Partners for Health and Development in Africa, Nairobi, Kenya
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Annelie Tjernlund
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
| | - Kristina Broliden
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, Department of Infectious Diseases, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden
- * E-mail:
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69
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Intranasal Immunization with Zika Virus Envelope Domain III-Flagellin Fusion Protein Elicits Systemic and Mucosal Immune Responses and Protection against Subcutaneous and Intravaginal Virus Challenges. Pharmaceutics 2022; 14:pharmaceutics14051014. [PMID: 35631599 PMCID: PMC9144594 DOI: 10.3390/pharmaceutics14051014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
Zika virus (ZIKV) infections in humans are mainly transmitted by the mosquito vectors, but human-to-human sexual transmission is also another important route. Developing a ZIKV mucosal vaccine that can elicit both systemic and mucosal immune responses is of particular interest. In this study, we constructed a recombinant ZIKV envelope DIII (ZDIII) protein genetically fused with Salmonella typhimurium flagellin (FliC-ZDIII) as a novel mucosal antigen for intranasal immunization. The results indicated that the FliC-ZDIII fusion proteins formulated with E. coli heat-labile enterotoxin B subunit (LTIIb-B5) adjuvant greatly increased the ZDIII-specific IgG, IgA, and neutralizing titers in sera, and the ZDIII-specific IgA titers in bronchoalveolar lavage and vaginal fluids. Protective immunity was further assessed by subcutaneous and intravaginal ZIKV challenges. The second-generation FliCΔD3-2ZDIII was shown to result in a reduced titer of anti-FliC IgG antibodies in sera and still retained the same levels of serum IgG, IgA, and neutralizing antibodies and mucosal IgA antibodies without compromising the vaccine antigenicity. Therefore, intranasal immunization with FliCΔD3-2ZDIII fusion proteins formulated with LTIIb-B5 adjuvant elicited the greatest protective immunity against subcutaneous and intravaginal ZIKV challenges. Our findings indicated that the combination of FliCΔD3-2ZDIII fusion proteins and LTIIb-B5 adjuvant for intranasal immunization can be used for developing ZIKV mucosal vaccines.
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70
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Bagri P, Anipindi VC, Kaushic C. The Role of IL-17 During Infections in the Female Reproductive Tract. Front Immunol 2022; 13:861444. [PMID: 35493460 PMCID: PMC9046847 DOI: 10.3389/fimmu.2022.861444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/22/2022] [Indexed: 11/15/2022] Open
Abstract
Interleukin-17 (IL-17A) is a cytokine involved in a complex array of both protective and detrimental processes. Although early biological studies focused on the pro-inflammatory function of IL-17 in the context of autoimmune and inflammatory disorders, it has become increasingly evident that the roles of IL-17 are far more nuanced. Recent work has demonstrated that the functions of IL-17 are highly context- and tissue-dependent, and there is a fine balance between the pathogenic and protective functions of IL-17. This is especially evident in mucosal tissues such as the female reproductive tract, where IL-17 has been shown to play an important role in the immune response generated during fungal, bacterial and viral infections associated with protection, but also with inflammation. In this review, we discuss the evolving landscape of IL-17 biology within the context of the vaginal mucosa, focusing on key findings that highlight the importance of this cytokine in genital mucosal immunity.
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Affiliation(s)
- Puja Bagri
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Varun C. Anipindi
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Charu Kaushic
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- *Correspondence: Charu Kaushic,
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71
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Adapen C, Réot L, Nunez N, Cannou C, Marlin R, Lemaître J, d'Agata L, Gilson E, Ginoux E, Le Grand R, Nugeyre MT, Menu E. Local Innate Markers and Vaginal Microbiota Composition Are Influenced by Hormonal Cycle Phases. Front Immunol 2022; 13:841723. [PMID: 35401577 PMCID: PMC8990777 DOI: 10.3389/fimmu.2022.841723] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/28/2022] [Indexed: 12/12/2022] Open
Abstract
Background The female reproductive tract (FRT) mucosa is the first line of defense against sexually transmitted infection (STI). FRT environmental factors, including immune-cell composition and the vaginal microbiota, interact with each other to modulate susceptibility to STIs. Moreover, the menstrual cycle induces important modifications within the FRT mucosa. Cynomolgus macaques are used as a model for the pathogenesis and prophylaxis of STIs. In addition, their menstrual cycle and FRT morphology are similar to women. The cynomolgus macaque vaginal microbiota is highly diverse and similar to dysbiotic vaginal microbiota observed in women. However, the impact of the menstrual cycle on immune markers and the vaginal microbiota in female cynomolgus macaques is unknown. We conducted a longitudinal study covering three menstrual cycles in cynomolgus macaques. The evolution of the composition of the vaginal microbiota and inflammation (cytokine/chemokine profile and neutrophil phenotype) in the FRT and blood was determined throughout the menstrual cycle. Results Cervicovaginal cytokine/chemokine concentrations were affected by the menstrual cycle, with a peak of production during menstruation. We observed three main cervicovaginal neutrophil subpopulations: CD11bhigh CD101+ CD10+ CD32a+, CD11bhigh CD101+ CD10- CD32a+, and CD11blow CD101low CD10- CD32a-, of which the proportion varied during the menstrual cycle. During menstruation, there was an increase in the CD11bhigh CD101+ CD10+ CD32a+ subset of neutrophils, which expressed higher levels of CD62L. Various bacterial taxa in the vaginal microbiota showed differential abundance depending on the phase of the menstrual cycle. Compilation of the factors that vary according to hormonal phase showed the clustering of samples collected during menstruation, characterized by a high concentration of cytokines and an elevated abundance of the CD11bhigh CD101+ CD10+ CD32a+ CD62L+ neutrophil subpopulation. Conclusions We show a significant impact of menstruation on the local environment (cytokine production, neutrophil phenotype, and vaginal microbiota composition) in female cynomolgus macaques. Menstruation triggers increased production of cytokines, shift of the vaginal microbiota composition and the recruitment of mature/activated neutrophils from the blood to the FRT. These results support the need to monitor the menstrual cycle and a longitudinal sampling schedule for further studies in female animals and/or women focusing on the mucosal FRT environment.
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Affiliation(s)
- Cindy Adapen
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France
| | - Louis Réot
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France
| | | | - Claude Cannou
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France.,Mucosal Immunity and Sexually Transmitted Infection Control (MISTIC) Group, Department of Virology, Institut Pasteur, Paris, France
| | - Romain Marlin
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France
| | - Julien Lemaître
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France
| | | | | | | | - Roger Le Grand
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France
| | - Marie-Thérèse Nugeyre
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France.,Mucosal Immunity and Sexually Transmitted Infection Control (MISTIC) Group, Department of Virology, Institut Pasteur, Paris, France
| | - Elisabeth Menu
- Université Paris-Saclay, Inserm, Commissariat à l'énergie Atomique et aux énergies Alternatives (CEA), Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases [IMVA-HB/Infectious Disease Models and Innovative Therapies (IDMIT)], Fontenay-aux-Roses, France.,Mucosal Immunity and Sexually Transmitted Infection Control (MISTIC) Group, Department of Virology, Institut Pasteur, Paris, France
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72
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Wang Y, Wang X, Zhu M, Ge L, Liu X, Su K, Chen Z, Zhao W. The Interplay Between Cervicovaginal Microbial Dysbiosis and Cervicovaginal Immunity. Front Immunol 2022; 13:857299. [PMID: 35359942 PMCID: PMC8960256 DOI: 10.3389/fimmu.2022.857299] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/21/2022] [Indexed: 12/02/2022] Open
Abstract
The cervicovaginal microbiota plays a key role in the health and reproductive outcomes of women. In reality epidemiological studies have demonstrated that there is an association between the structure of cervicovaginal microbiota and reproductive health, although key mechanistic questions regarding these effects remain unanswered and understanding the interplay between the immune system and the structure of the cervicovaginal microbiota. Here, we review existing literature relating to the potential mechanisms underlying the interaction between vaginal microbes and the immune system; we also describe the composition and function of the microbiome and explain the mechanisms underlying the interactions between these microbial communities and various aspects of the immune system. Finally, we also discuss the diseases that are caused by disorders of the reproductive tract and how the immune system is involved. Finally, based on the data presented in this review, the future perspectives in research directions and therapeutic opportunities are explored.
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Affiliation(s)
- Ya Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Xiaoli Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Meiling Zhu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Li Ge
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Xiaochen Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Kaikai Su
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Zhengzheng Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Weidong Zhao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
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73
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Taylor BD, Criscitiello MF, Hernandez T, Norwood B, Noah A, Bazer FW. Interferon epsilon and preterm birth subtypes; a new piece of the type I interferon puzzle during pregnancy? Am J Reprod Immunol 2022; 87:e13526. [PMID: 35147251 PMCID: PMC9978937 DOI: 10.1111/aji.13526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/06/2022] [Accepted: 02/04/2022] [Indexed: 12/25/2022] Open
Abstract
PROBLEM Interferon epsilon (IFNε) is a unique type I IFN that is expressed in response to sex steroids. Studies suggest that type I IFNs regulate inflammation-induced preterm birth (PTB), but no study has examined the role of IFNε in human pregnancy. METHOD OF STUDY We used stored vaginal swabs between 8 and 26 weeks of gestation from the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) biobank and measured IFNε by enzyme-linked immunosorbent assay (ELISA). A total of 29 women with spontaneous preterm births, 34 women with medically indicated preterm births, and 134 women with term births were included. Secondary outcomes included a preterm birth with chorioamnionitis and preeclampsia with a preterm birth. Logistic regression calculated odds ratios (OR) and 95% confidence intervals (CI) adjusting for maternal age, race, body mass index, prior pregnancy complications, lower genital tract infections, chronic health conditions, and gestational age at blood draw. RESULTS AND CONCLUSIONS There was no significant association between IFNε and spontaneous preterm birth (ORadj 1.0, 0.8-1.3) or chorioamnionitis (ORadj 1.6, 0.7-3.5). A trend toward increased odds of medically indicated preterm birth (ORadj . 1.3, 1.0-1.8) was observed. This was likely due to elevated IFNε among women with preterm preeclampsia (ORadj . 2.0, 95% CI 1.3-3.2). While exploratory, our novel findings suggest that larger longitudinal studies of IFNε across human pregnancy may be warranted.
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Affiliation(s)
- Brandie DePaoli Taylor
- Department of Obstetrics and Gynecology, Division of Basic and Translational Research, University of Texas Medical Branch, Galveston, TX, 77555,Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, Texas,Correspondence: Brandie DePaoli Taylor, PhD, MPH, Department of Obstetrics and Gynecology, Division of Basic and Translational Research, University of Texas Medical Branch ; phone: 409-772-7592
| | - Michael F. Criscitiello
- Comparative Immunogenetics Laboratory, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas 77843,Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M University, College Station, Texas 77843
| | - Tyne Hernandez
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, 19143
| | - Brooke Norwood
- Comparative Immunogenetics Laboratory, Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas 77843
| | - Akawinyene Noah
- Department of Obstetrics and Gynecology, Division of Basic and Translational Research, University of Texas Medical Branch, Galveston, TX, 77555,Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, Texas
| | - Fuller W. Bazer
- Department of Animal Science, Texas A&M University, College Station, Texas 77843
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Fenizia C, Cetin I, Mileto D, Vanetti C, Saulle I, Di Giminiani M, Saresella M, Parisi F, Trabattoni D, Clerici M, Biasin M, Savasi V. Pregnant Women Develop a Specific Immunological Long-Lived Memory Against SARS-COV-2. Front Immunol 2022; 13:827889. [PMID: 35251011 PMCID: PMC8889908 DOI: 10.3389/fimmu.2022.827889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
It is well established that pregnancy induces deep changes in the immune system. This is part of the physiological adaptation of the female organism to the pregnancy and the immunological tolerance toward the fetus. Indeed, over the three trimesters, the suppressive T regulatory lymphocytes are progressively more represented, while the expression of co-stimulatory molecules decreases overtime. Such adaptations relate to an increased risk of infections and progression to severe disease in pregnant women, potentially resulting in an altered generation of long-lived specific immunological memory of infection contracted during pregnancy. How potent is the immune response against SARS-CoV-2 in infected pregnant women and how long the specific SARS-CoV-2 immunity might last need to be urgently addressed, especially considering the current vaccinal campaign. To address these questions, we analyzed the long-term immunological response upon SARS-CoV-2 infection in pregnant women from delivery to a six-months follow-up. In particular, we investigated the specific antibody production, T cell memory subsets, and inflammation profile. Results show that 80% developed an anti-SARS-CoV-2-specific IgG response, comparable with the general population. While IgG were present only in 50% of the asymptomatic subjects, the antibody production was elicited by infection in all the mild-to-critical patients. The specific T-cell memory subsets rebalanced over-time, and the pro-inflammatory profile triggered by specific SARS-CoV-2 stimulation faded away. These results shed light on SARS-CoV-2-specific immunity in pregnant women; understanding the immunological dynamics of the immune system in response to SARS-CoV-2 is essential for defining proper obstetric management of pregnant women and fine tune gender-specific vaccinal plans.
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Affiliation(s)
- Claudio Fenizia
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Irene Cetin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Department of Woman, Mother and Neonate Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudia Vanetti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Irma Saulle
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Maria Di Giminiani
- Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Francesca Parisi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Fondazione don Carlo Gnocchi, IRCCS, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Valeria Savasi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy
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75
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Chan D, Bennett PR, Lee YS, Kundu S, Teoh TG, Adan M, Ahmed S, Brown RG, David AL, Lewis HV, Gimeno-Molina B, Norman JE, Stock SJ, Terzidou V, Kropf P, Botto M, MacIntyre DA, Sykes L. Microbial-driven preterm labour involves crosstalk between the innate and adaptive immune response. Nat Commun 2022; 13:975. [PMID: 35190561 PMCID: PMC8861006 DOI: 10.1038/s41467-022-28620-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 01/28/2022] [Indexed: 01/04/2023] Open
Abstract
There has been a surge in studies implicating a role of vaginal microbiota in spontaneous preterm birth (sPTB), but most are associative without mechanistic insight. Here we show a comprehensive approach to understand the causative factors of preterm birth, based on the integration of longitudinal vaginal microbiota and cervicovaginal fluid (CVF) immunophenotype data collected from 133 women at high-risk of sPTB. We show that vaginal depletion of Lactobacillus species and high bacterial diversity leads to increased mannose binding lectin (MBL), IgM, IgG, C3b, C5, IL-8, IL-6 and IL-1β and to increased risk of sPTB. Cervical shortening, which often precedes preterm birth, is associated with Lactobacillus iners and elevated levels of IgM, C3b, C5, C5a and IL-6. These data demonstrate a role for the complement system in microbial-driven sPTB and provide a scientific rationale for the development of live biotherapeutics and complement therapeutics to prevent sPTB. Gaining mechanistic insight into the microbiological and immunological factors that are associated with spontaneous preterm birth is important for the development of prevention strategies. Here authors show that the complement system in conjunction with specific vaginal microbial and associated immunological changes are contributing to this condition.
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76
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Lujan AL, Croci DO, Rabinovich GA, Damiani MT. Galectins as potential therapeutic targets in STIs in the female genital tract. Nat Rev Urol 2022; 19:240-252. [PMID: 35105978 DOI: 10.1038/s41585-021-00562-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2021] [Indexed: 12/12/2022]
Abstract
Every day, more than one million people worldwide acquire a sexually transmitted infection (STI). This public health problem has a direct effect on women's reproductive and sexual health as STIs can cause irreversible damage to fertility and can have negative consequences associated with discrimination and social exclusion. Infection with one sexually transmitted pathogen predisposes to co-infection with others, suggesting the existence of shared pathways that serve as molecular links between these diseases. Galectins, a family of β-galactoside-binding proteins, have emerged as endogenous mediators that facilitate cell-surface binding, internalization and cell invasion of many sexually transmitted pathogens, including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Candida albicans, HIV and herpes simplex virus. The ability of certain galectins to dimerize or form multimeric complexes confers the capacity to interact simultaneously with glycosylated ligands on both the pathogen and the cervico-vaginal tissue on these proteins. Galectins can act as a bridge by engaging glycans from the pathogen surface and glycosylated receptors from host cells, which is a mechanism that has been shown to be shared by several sexually transmitted pathogens. In the case of viruses and obligate intracellular bacteria, binding to the cell surface promotes pathogen internalization and cell invasion. Inflammatory responses that occur in cervico-vaginal tissue might trigger secretion of galectins, which in turn control the establishment, evolution and severity of STIs. Thus, galectin-targeted therapies could potentially prevent or decrease STIs caused by a diverse array of pathogenic microorganisms; furthermore, anti-galectin agents might reduce treatment costs of STIs and reach the most vulnerable populations.
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Affiliation(s)
- Agustin L Lujan
- Laboratorio de Bioquímica e Inmunidad, Instituto de Bioquímica y Biotecnología, Facultad de Ciencias Médicas, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Universidad Nacional de Cuyo (UNCUYO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina.,Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Diego O Croci
- Laboratorio de Inmunopatología, Facultad de Ciencias Exactas y Naturales, Instituto de Histología y Embriología de Mendoza (IHEM), Universidad Nacional de Cuyo (UNCUYO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
| | - Gabriel A Rabinovich
- Laboratorio de Glicomedicina, Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina. .,Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), C1428AGE, Buenos Aires, Argentina.
| | - Maria T Damiani
- Laboratorio de Bioquímica e Inmunidad, Instituto de Bioquímica y Biotecnología, Facultad de Ciencias Médicas, Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Universidad Nacional de Cuyo (UNCUYO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina.
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77
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Vela-Patiño S, Salazar MI, Remba-Shapiro I, Peña-Martínez E, Silva-Roman G, Andoneui-Elguera S, Ordoñez-Garcia JDJ, Taniguchi-Ponciano K, Bonifaz L, Aguilar-Flores C, Marrero-Rodríguez D, Mercado M. Neuroendocrine-immune Interface: Interactions of Two Complex Systems in Health and Disease. Arch Med Res 2022; 53:240-251. [DOI: 10.1016/j.arcmed.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/25/2021] [Accepted: 01/24/2022] [Indexed: 11/02/2022]
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78
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Biswas S, Chen E, Gao Y, Lee S, Hewlett I, Devadas K. Modulation of HIV Replication in Monocyte-Derived Macrophages (MDM) by Host Antiviral Factors Secretory Leukocyte Protease Inhibitor and Serpin Family C Member 1 Induced by Steroid Hormones. Viruses 2022; 14:v14010095. [PMID: 35062299 PMCID: PMC8777669 DOI: 10.3390/v14010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Abstract
The impact of steroid hormones estrogen and progesterone on human immunodeficiency virus type 1 (HIV-1) replication is well documented. However, the exact mechanism involved in the regulation of HIV-1 replication by estrogen and progesterone is still unclear. In the present study, we wanted to elucidate the molecular mechanisms underlying the modulation of HIV-1 replication by estrogen and progesterone. To achieve this goal, we used real-time quantitative PCR arrays (PCR arrays) to identify differentially expressed host genes in response to hormone treatments that are involved in antiviral responses. Our in vitro results suggest that treatment with high doses of estrogen and progesterone promotes the expression of host antiviral factors Secretory leukocyte protease inhibitor (SLPI) and Serpin family C member 1 (SERPIN C1) among others produced in response to HIV-1 infection. SLPI is an enzyme that inhibits human leukocyte elastase, human cathepsin G, human trypsin, neutrophil elastase, and mast cell chymase. SERPIN C1 is a plasma protease inhibitor that regulates the blood coagulation cascade by the inhibition of thrombin and other activated serine proteases of the coagulation system. A dose dependent downmodulation of HIV-1 replication was observed in monocyte-derived macrophages (MDMs) pre-treated with the two proteins SLPI and SERPIN C1. Further investigations suggests that the host antiviral factors, SLPI and SERPIN C1 act at the pre-integration stage, inhibiting HIV-1 viral entry and leading to the observed downmodulation of HIV-1 replication. Our studies would help identify molecular mechanisms and pathways involved in HIV-1 pathogenesis.
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Affiliation(s)
- Santanu Biswas
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA; (S.B.); (E.C.); (S.L.)
| | - Emily Chen
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA; (S.B.); (E.C.); (S.L.)
| | - Yamei Gao
- Laboratory of Respiratory Viral Diseases, Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA;
| | - Sherwin Lee
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA; (S.B.); (E.C.); (S.L.)
| | - Indira Hewlett
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA; (S.B.); (E.C.); (S.L.)
- Correspondence: (I.H.); (K.D.)
| | - Krishnakumar Devadas
- Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, USA; (S.B.); (E.C.); (S.L.)
- Correspondence: (I.H.); (K.D.)
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79
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Granne I, Shen M, Rodriguez-Caro H, Chadha G, O’Donnell E, Brosens JJ, Quenby S, Child T, Southcombe JH. Characterisation of peri-implantation endometrial Treg and identification of an altered phenotype in recurrent pregnancy loss. Mucosal Immunol 2022; 15:120-129. [PMID: 34552206 PMCID: PMC8732268 DOI: 10.1038/s41385-021-00451-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 02/04/2023]
Abstract
Recurrent Pregnancy Loss (RPL) affects 2-4% of couples, and with increasing numbers of pregnancy losses the risk of miscarrying a euploid pregnancy is increased, suggesting RPL is a pathology distinct from sporadic miscarriage that is due largely to lethal embryonic aneuploidy. There are a number of conditions associated with RPL including unspecified "immune" pathologies; one of the strongest candidates for dysregulation remains T regulatory cells as depletion in the very early stages of pregnancy in mice leads to pregnancy loss. Human endometrial Treg and conventional CD4T cells were isolated during the peri-implantation period of the menstrual cycle in normal women. We identified an endometrial Treg transcriptomic signature and validated an enhanced regulatory phenotype compared to peripheral blood Treg. Parous women had an altered endometrial Treg transcriptome compared to nulliparity, indicating acquired immune memory of pregnancy within the Treg population, by comparison endometrial conventional CD4T cells were not altered. We compared primary and secondary RPL to nulliparous or parous controls respectively. Both RPL subgroups displayed differentially expressed Treg gene transcriptomes compared to controls. We found increased cell surface S1PR1 and decreased TIGIT protein expression by Treg in primary RPL, confirming the presence of altered Treg in the peri-implantation RPL endometrium.
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Affiliation(s)
- Ingrid Granne
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Mengni Shen
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Helena Rodriguez-Caro
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Gurmeher Chadha
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Elizabeth O’Donnell
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Jan J. Brosens
- grid.7372.10000 0000 8809 1613Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV2 2DX UK ,grid.15628.380000 0004 0393 1193Tommy’s National Centre for Miscarriage Research, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, CV2 2DX UK
| | - Siobhan Quenby
- grid.7372.10000 0000 8809 1613Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV2 2DX UK ,grid.15628.380000 0004 0393 1193Tommy’s National Centre for Miscarriage Research, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, CV2 2DX UK
| | - Tim Child
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK ,grid.477692.90000 0004 0379 0597Oxford Fertility, The Fertility Partnership, Oxford, OX4 2HW UK
| | - Jennifer H. Southcombe
- grid.4991.50000 0004 1936 8948Nuffield Department of Women’s and Reproductive Health, L3 Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
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80
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Miller JE, Lingegowda H, Symons LK, Bougie O, Young SL, Lessey BA, Koti M, Tayade C. IL-33 activates group 2 innate lymphoid cell expansion and modulates endometriosis. JCI Insight 2021; 6:149699. [PMID: 34699382 PMCID: PMC8675188 DOI: 10.1172/jci.insight.149699] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/22/2021] [Indexed: 01/01/2023] Open
Abstract
Chronic inflammation and localized alterations in immune cell function are suspected to contribute to the progression of endometriosis and its associated symptoms. In particular, the alarmin IL-33 is elevated in the plasma, peritoneal fluid, and endometriotic lesions from patients with endometriosis; however, the exact role of IL-33 in the pathophysiology of endometriosis is not well understood. In this study, we demonstrate, in both humans and a murine model, that IL-33 contributes to the expansion of group 2 innate lymphoid cells (ILC2s), and this IL-33–induced ILC2 expansion modulates the endometriosis lesion microenvironment. Importantly, we show that IL-33 drives hallmarks of severe endometriosis, including elevated inflammation, lesion proliferation, and fibrosis, and that this IL-33–induced aggravation is mediated by ILC2s. Finally, we demonstrate the functionality of IL-33 neutralization as a promising and potentially novel therapeutic avenue for treating the debilitating symptoms of endometriosis.
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Affiliation(s)
- Jessica E Miller
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - Lindsey K Symons
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Olga Bougie
- Department of Obstetrics and Gynecology, Kingston General Hospital, Kingston, Ontario, Canada
| | - Steven L Young
- Department of Obstetrics and Gynecology University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bruce A Lessey
- Department of Obstetrics and Gynecology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Madhuri Koti
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.,Department of Obstetrics and Gynecology, Kingston General Hospital, Kingston, Ontario, Canada
| | - Chandrakant Tayade
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
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81
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Wu J, Ning Y, Tan L, Chen Y, Huang X, Zhuo Y. Characteristics of the vaginal microbiome in women with premature ovarian insufficiency. J Ovarian Res 2021; 14:172. [PMID: 34879874 PMCID: PMC8655991 DOI: 10.1186/s13048-021-00923-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate the relationship between vaginal microbial community structure and premature ovarian insufficiency (POI). METHODS Twenty-eight women with POI and 12 healthy women were recruited at Shenzhen Maternity and Child Healthcare Hospital between August and September 2020. Blood samples were collected for glucose tests and detection of sex hormone levels and vaginal secretions were collected for microbial group determination. Vaginal microbial community profiles were analysed by 16S rRNA gene sequencing using the Illumina MiSeq system (Illumina Inc., San Diego, CA, USA). RESULTS Compared to the controls, the serum levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and the follicle-stimulating hormone/luteinizing hormone ratio, significantly increased, and oestradiol and anti-Müllerian hormone levels significantly decreased in women with POI. Higher weighted UniFrac values were observed in women with POI than in healthy women. Bacteria in the genera Lactobacillus, Brevundimonas, and Odoribacter were more abundant in the microbiomes of healthy women, while the quantity of bacteria in the genus Streptococcus was significantly increased in the microbiomes of women with POI. Moreover, these differences in microbes in women with POI were closely related to follicle-stimulating hormone, luteinizing hormone, oestradiol, and anti-Müllerian hormone levels and to the follicle-stimulating hormone/luteinizing hormone ratio. CONCLUSIONS Women with POI had altered vaginal microbial profiles compared to healthy controls. The alterations in their microbiomes were associated with serum hormone levels. These results will improve our understanding of the vaginal microbial community structure in women with POI. TRIAL REGISTRATION CHICTR, ChiCTR2000029576 . Registered 3 August 2020 - Retrospectively registered, https://www.chictr.org.cn/showproj.aspx?proj=48844 .
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Affiliation(s)
- Jiaman Wu
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Yan Ning
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Liya Tan
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Yan Chen
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Xingxian Huang
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518033, China
| | - Yuanyuan Zhuo
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518033, China.
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82
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Lee YS, Jeon H, Her YM, Lee DE, Jeong YJ, Kim EJ, Choe TH, Suh HJ, Shin SY, Park DW, Lee YG, Kang SC. Lomens-P0 (mixed extracts of Hordeum vulgare and Chrysanthemum zawadskii) regulate the expression of factors affecting premenstrual syndrome symptoms. Nutr Res Pract 2021; 15:715-731. [PMID: 34858550 PMCID: PMC8601943 DOI: 10.4162/nrp.2021.15.6.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/12/2021] [Accepted: 04/08/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES Premenstrual syndrome (PMS) is a disorder characterized by repeated emotional, behavioral, and physical symptoms before menstruation, and the exact cause and mechanism are uncertain. Hyperprolactinemia interferes with the normal production of estrogen and progesterone, leading to PMS symptoms. Thus, we judged that the inhibition of prolactin hypersecretion could mitigate PMS symptoms. MATERIALS/METHODS Hordeum vulgare L. extract (HVE), Chrysanthemum zawadskii var. latilobum extract (CZE), and Lomens-P0 the mixture of these extracts were tested in subsequent experiments. The effect of extracts on prolactin secretion at the in vitro level was measured in GH3 cells. Nitric oxide and pro-inflammatory mediator expression were measured in RAW 264.7 cells to confirm the anti-inflammatory effect. Also, the hyperprolactinemic Institute for Cancer Research (ICR) mice model was used to measure extract effects on prolactin and hormone secretion and uterine inflammation. RESULTS Anti-inflammatory effects of and prolactin secretion suppress by HVE and CZE were confirmed through in vitro experiments (P < 0.05). Treatment with Lomens-P0 inhibited prolactin secretion (P < 0.05) and restored normal sex hormone secretion in the hyperprolactinemia mice model. In addition, extracts significantly inhibited the expression of pro-inflammatory biomarkers, including interleukin-1β, and -6, tumor necrosis factor-α, inducible nitric oxide synthase, and cyclooxygenase-2 (P < 0.01). We used high-performance liquid chromatography analyses to identify tricin and chlorogenic acid as the respective components of HVE and CZE that inhibit prolactin secretion. The Lomens-P0, which includes tricin and chlorogenic acid, is expected to be effective in improving PMS symptoms in the human body. CONCLUSIONS The Lomens-P0 suppressed the prolactin secretion in hyperprolactinemia mice, normalized the sex hormone imbalance, and significantly suppressed the expression of inflammatory markers in uterine tissue. This study suggests that Lomens-P0 may have the potential to prevent or remedy materials to PMS symptoms.
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Affiliation(s)
- Yoon Seo Lee
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Hyelin Jeon
- BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea.,Research Institute, Genencell Co. Ltd., Yongin 16950, Korea
| | - Yang-Mi Her
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Da Eun Lee
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea
| | | | - Eun Jeong Kim
- Research Institute, Genencell Co. Ltd., Yongin 16950, Korea
| | - Tae Hwan Choe
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Hee Ju Suh
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Seung-Yeon Shin
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Dae Won Park
- BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Yeong-Geun Lee
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
| | - Se Chan Kang
- Department of Oriental Medicine Biotechnology, College of Life Sciences, Kyung Hee University, Yongin 17104, Korea.,BioMedical Research Institute, Kyung Hee University, Yongin 17104, Korea
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83
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Gu C, Duluc D, Wiest M, Xue Y, Yi J, Gorvel JP, Joo H, Oh S. Cell type-specific expression of estrogen and progesterone receptors in the human vaginal mucosa. Clin Immunol 2021; 232:108874. [PMID: 34740841 DOI: 10.1016/j.clim.2021.108874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/30/2022]
Abstract
Female sex hormones affect the immune response in the lower female genital tract. To understand their mechanisms of action, it is essential to define cell types expressing estrogen receptor (ER) and/or progesterone receptor (PR) in the human vaginal mucosa (VM). Here, we report that none of the dendritic cell (DC) subsets in the human VM expressed ERα or PR in situ. However, they were capable of expressing ERα, but not PR, after in vitro culture of the whole VM tissues. Similarly, ERα and/or PR expression by T cells in the VM tissues was also inducible rather than constitutive. In contrast, ERα and/or PR were constitutively expressed in HLA-DR- non-immune cell types (vimentin+, desmin+, or CD10+). These new findings will help us understand the mechanisms of action of female sex hormones in the modulation of immune response in the human VM and lower female genital tract.
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Affiliation(s)
- Chao Gu
- Department of Immunology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, USA
| | - Dorothee Duluc
- Immunoconcept, CNRS UMR 5164, Bordeaux University, Bordeaux, France
| | - Matthew Wiest
- Department of Immunology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, USA
| | - Yaming Xue
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA
| | - Johnny Yi
- Department of Medical and Surgery Gynecology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, USA
| | - Jean-Pierre Gorvel
- Centre d'Immunologie de Marseille-Luminy, CIML, Aix Marseille Université, INSERM, CNRS, Marseille, France
| | - HyeMee Joo
- Department of Immunology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, USA.
| | - SangKon Oh
- Department of Immunology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, USA.
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84
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Jewanraj J, Ngcapu S, Liebenberg LJP. Semen: A modulator of female genital tract inflammation and a vector for HIV-1 transmission. Am J Reprod Immunol 2021; 86:e13478. [PMID: 34077596 PMCID: PMC9286343 DOI: 10.1111/aji.13478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
In order to establish productive infection in women, HIV must transverse the vaginal epithelium and gain access to local target cells. Genital inflammation contributes to the availability of HIV susceptible cells at the female genital mucosa and is associated with higher HIV transmission rates in women. Factors that contribute to genital inflammation may subsequently increase the risk of HIV infection in women. Semen is a highly immunomodulatory fluid containing several bioactive molecules with the potential to influence inflammation and immune activation at the female genital tract. In addition to its role as a vector for HIV transmission, semen induces profound mucosal changes to prime the female reproductive tract for conception. Still, most studies of mucosal immunity are conducted in the absence of semen or without considering its immune impact on the female genital tract. This review discusses the various mechanisms by which semen exposure may influence female genital inflammation and highlights the importance of routine screening for semen biomarkers in vaginal specimens to account for its impact on genital inflammation.
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Affiliation(s)
- Janine Jewanraj
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)DurbanSouth Africa
- Department of Medical MicrobiologyUniversity of KwaZulu‐NatalDurbanSouth Africa
| | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)DurbanSouth Africa
- Department of Medical MicrobiologyUniversity of KwaZulu‐NatalDurbanSouth Africa
| | - Lenine J. P. Liebenberg
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)DurbanSouth Africa
- Department of Medical MicrobiologyUniversity of KwaZulu‐NatalDurbanSouth Africa
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85
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He Y, Tang R, Deng J, Cai T, He P, Wu J, Cao Y. Effects of oestrogen on vulvovaginal candidosis. Mycoses 2021; 65:4-12. [PMID: 34699636 DOI: 10.1111/myc.13385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 01/04/2023]
Abstract
As a frequently occurring infectious disease mainly caused by Candida albicans, vulvovaginal candidosis (VVC) affects more than 100 million women worldwide every year. Multiple factors that influence C. albicans colonisation have been linked to the incidence of VVC, including high levels of circulating oestrogen due to pregnancy, the use of oral contraceptives, and hormone replacement therapy. This review provides an overview of the current understanding of the mechanism(s) by which oestrogen contributes to VVC, which might provide meaningful guidance to the prevention and treatment of this disease.
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Affiliation(s)
- Yufei He
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, China.,Institute of Vascular Disease, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ruoyu Tang
- Department of Immunology and Pathogen Biology, School of Medicine, Tongji University, Shanghai, China
| | - Jie Deng
- Institute of Vascular Disease, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tongkai Cai
- Shanghai Diacart Biomedical Science and Technology Limited Company, Shanghai, China
| | - Ping He
- Renji Hospital, Medical School of Shanghai Jiaotong University, Shanghai, China
| | - Jianhua Wu
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yongbing Cao
- Institute of Vascular Disease, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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86
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Cai W, Chen W, Wang Y, Bu X, Xia X, Nie L. Sperm storage in the oviduct of the Chinese pond turtle Mauremys reevesii depends on oestrogen-based suppression of the TLR2/4 immune pathway. Reprod Fertil Dev 2021; 33:736-745. [PMID: 34602123 DOI: 10.1071/rd20341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 07/08/2021] [Indexed: 11/23/2022] Open
Abstract
The long-term storage of spermatozoa in the female reproductive tract is limited by the innate immune system. Oestrogen plays a role in regulating the innate immune system. Thus, exploring the expression of genes in the Toll-like receptor (TLR) 2/4 pathway and oestrogen receptors in the oviduct of Mauremys reevesii could contribute to our understanding of the mechanism of sperm storage. In this study, three parts of the oviduct (isthmus, uterus and vagina) in three mated and unmated female turtles were used to perform immunohistochemistry and real-time quantitative polymerase chain reaction (qPCR). Immunohistochemistry revealed that the TLR2/4 protein was mainly distributed in epithelial tissues and glandular cell membranes, and that TLR2/4 levels in the oviduct were significantly decreased in mated compared with unmated turtles. Real-time qPCR indicated that TLR2/4, myeloid differentiation factor 88 (MyD88), interleukin 1 receptor associated kinase 4 (IRAK4), TNF receptor associated factor 6 (TRAF6), interferon regulatory factor 3 (IRF3) and interleukin 6 (IL6) mRNA expression was significantly higher in the oviduct of unmated than mated turtles, whereas the opposite was true for the expression of oestrogen receptor 1 (ESR1) and progesterone receptor (PGR). These results indicate that when spermatozoa are stored in the oviduct, an increase in oestrogen suppresses the immune response induced by the TLR2/4 pathway so that spermatozoa are not removed as a foreign substance, but stored until fertilisation. The findings of this study are relevant to our understanding of the relationship between sperm storage and the innate immune system in the oviduct of reptiles.
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Affiliation(s)
- Wenlong Cai
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu 241000, Anhui, China
| | - Wei Chen
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu 241000, Anhui, China
| | - Yajie Wang
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu 241000, Anhui, China
| | - Xingjiang Bu
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu 241000, Anhui, China; and Corresponding author.
| | - Xingquan Xia
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu 241000, Anhui, China
| | - Liuwang Nie
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu 241000, Anhui, China
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87
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Ormsby TJR, Owens SE, Horlock AD, Davies D, Griffiths WJ, Wang Y, Cronin JG, Bromfield JJ, Sheldon IM. Oxysterols protect bovine endometrial cells against pore-forming toxins from pathogenic bacteria. FASEB J 2021; 35:e21889. [PMID: 34569656 PMCID: PMC9272411 DOI: 10.1096/fj.202100036r] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/16/2021] [Accepted: 08/16/2021] [Indexed: 11/11/2022]
Abstract
Many species of pathogenic bacteria secrete toxins that form pores in mammalian cell membranes. These membrane pores enable the delivery of virulence factors into cells, result in the leakage of molecules that bacteria can use as nutrients, and facilitate pathogen invasion. Inflammatory responses to bacteria are regulated by the side-chain-hydroxycholesterols 27-hydroxycholesterol and 25-hydroxycholesterol, but their effect on the intrinsic protection of cells against pore-forming toxins is unclear. Here, we tested the hypothesis that 27-hydroxycholesterol and 25-hydroxycholesterol help protect cells against pore-forming toxins. We treated bovine endometrial epithelial and stromal cells with 27-hydroxycholesterol or 25-hydroxycholesterol, and then challenged the cells with pyolysin, which is a cholesterol-dependent cytolysin from Trueperella pyogenes that targets these endometrial cells. We found that treatment with 27-hydroxycholesterol or 25-hydroxycholesterol protected both epithelial and stomal cells against pore formation and the damage caused by pyolysin. The oxysterols limited pyolysin-induced leakage of potassium and lactate dehydrogenase from cells, and reduced cytoskeletal changes and cytolysis. This oxysterol cytoprotection against pyolysin was partially dependent on reducing cytolysin-accessible cholesterol in the cell membrane and on activating liver X receptors. Treatment with 27-hydroxycholesterol also protected the endometrial cells against Staphylococcus aureus α-hemolysin. Using mass spectrometry, we found 27-hydroxycholesterol and 25-hydroxycholesterol in uterine and follicular fluid. Furthermore, epithelial cells released additional 25-hydroxycholesterol in response to pyolysin. In conclusion, both 27-hydroxycholesterol and 25-hydroxycholesterol increased the intrinsic protection of bovine endometrial cells against pore-forming toxins. Our findings imply that side-chain-hydroxycholesterols may help defend the endometrium against pathogenic bacteria.
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Affiliation(s)
| | - Sian E Owens
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Daphne Davies
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Yuqin Wang
- Swansea University Medical School, Swansea University, Swansea, UK
| | - James G Cronin
- Swansea University Medical School, Swansea University, Swansea, UK
| | - John J Bromfield
- Department of Animal Sciences, University of Florida, Gainesville, Florida, USA
| | - Iain M Sheldon
- Swansea University Medical School, Swansea University, Swansea, UK
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88
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Primary HSV-2 Infection in Early Pregnancy Results in Transplacental Viral Transmission and Dose-Dependent Adverse Pregnancy Outcomes in a Novel Mouse Model. Viruses 2021; 13:v13101929. [PMID: 34696359 PMCID: PMC8538385 DOI: 10.3390/v13101929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
Herpes simplex virus type 2 (HSV-2) infection affects 24 million births annually and is associated with adverse pregnancy outcomes, including neonatal herpes; however, the mechanisms underlying in utero transmission of HSV-2 are largely unknown. We examined the effects of primary HSV-2 infection during early pregnancy on gestational outcomes in a novel, clinically relevant mouse model. Pregnant C57BL/6 mice were infected intravaginally with 102–105 pfu/mL HSV-2 on gestation day (gd) 4.5. Controls were infected, nonpregnant, diestrus-staged mice and pregnant, uninfected mice. Compared to nonpregnant mice, pregnant mice were 100-fold more susceptible to HSV-2 infection. Three days post-inoculation (gd7.5), viral DNA was present in implantation sites, but pregnancy outcomes were largely unaffected by infection. Eight days post-inoculation (gd12.5), HSV-2 DNA persisted in placental tissues, resulting in inflammation and hemorrhage. Fetal and placental weights were reduced and fetal loss was observed with high viral doses. HSV-2 DNA and increased expression of pro-inflammatory mediators were detected in fetal tissues at gd12.5, signifying viral transmission and fetal infection, even with low viral doses. This mouse model shows a dose-dependent effect of primary HSV-2 infection on pregnancy outcomes and suggests that fetal loss may occur due to placental inflammation, thus providing valuable insight into in utero transmission of HSV-2.
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Patel MV, Hopkins DC, Barr FD, Wira CR. Sex Hormones and Aging Modulate Interferon Lambda 1 Production and Signaling by Human Uterine Epithelial Cells and Fibroblasts. Front Immunol 2021; 12:718380. [PMID: 34630393 PMCID: PMC8497887 DOI: 10.3389/fimmu.2021.718380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
Estradiol (E2) and progesterone (P) have potent effects on immune function in the human uterine endometrium which is essential for creating an environment conducive for successful reproduction. Type III/lambda (λ) interferons (IFN) are implicated in immune defense of the placenta against viral pathogens, which occurs against the backdrop of high E2 and P levels. However, the effect of E2 and P in modulating the expression and function of IFNλ1 in the non-pregnant human uterine endometrium is unknown. We generated purified in vitro cultures of human uterine epithelial cells and stromal fibroblast cells recovered from hysterectomy specimens. Poly (I:C), a viral dsRNA mimic, potently increased secretion of IFNλ1 by both epithelial cells and fibroblasts. The secretion of IFNλ1 by epithelial cells significantly increased with increasing age following poly (I:C) stimulation. Stimulation of either cell type with E2 (5x10-8M) or P (1x10-7M) had no effect on expression or secretion of IFNλ1 either alone or in the presence of poly (I:C). E2 suppressed the IFNλ1-induced upregulation of the antiviral IFN-stimulated genes (ISGs) MxA, OAS2 and ISG15 in epithelial cells, but not fibroblasts. Estrogen receptor alpha (ERα) blockade using Raloxifene indicated that E2 mediated its inhibitory effects on ISG expression via ERα. In contrast to E2, P potentiated the upregulation of ISG15 in response to IFNλ1 but had no effect on MxA and OAS2 in epithelial cells. Our results demonstrate that the effects of E2 and P on IFNλ1-induced ISGs are cell-type specific. E2-mediated suppression, and selective P-mediated stimulation, of IFNλ1-induced ISG expression in uterine epithelial cells suggest that the effects of IFNλ1 varies with menstrual cycle stage, pregnancy, and menopausal status. The suppressive effect of E2 could be a potential mechanism by which ascending pathogens from the lower reproductive tract can infect the pregnant and non-pregnant endometrium.
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Affiliation(s)
- Mickey V. Patel
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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90
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Cunha G, Bastos LB, Freitas SF, Cavalli RC, Quintana SM. Genital mycoplasma infection and spontaneous preterm birth outcome: a prospective cohort study. BJOG 2021; 129:273-281. [PMID: 34559945 DOI: 10.1111/1471-0528.16949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the risk of spontaneous preterm birth (sPTB) associated with genital mycoplasma infection in asymptomatic women. DESIGN Prospective cohort. SETTING Public and private health services in Ribeirão Preto, SP, Brazil. POPULATION A cohort of 1349 asymptomatic women with a singleton pregnancy at 20-25 weeks of gestation. METHODS Participants completed a sociodemographic and clinical history questionnaire during the prenatal visit and provided cervicovaginal samples for the evaluation of Mycoplasma hominis (Mh), Ureaplasma spp. and bacterial vaginosis (BV). For gestational outcome, information about the delivery was assessed and sPTB was defined as a birth that occurred before 37 weeks of gestation. The association between variables and the risk of sPTB was evaluated using logistic regression analysis to estimate the odds ratios (ORs). MAIN OUTCOME MEASURES Genital mycoplasma infection and prematurity. RESULTS The prevalence of sPTB and genital mycoplasma was 6.8 and 18%, respectively. The infection was not a risk factor for sPTB (aOR 0.66, 95% CI 0.32-1.35), even when Mh and Ureaplasma spp. were found together (P = 0.83). Pregnant women with genital mycoplasma infections had greater BV (P < 0.0001), but this vaginal microbiota condition was not associated with sPTB (P = 0.35). Regarding the risk factors associated with sPTB, a previous history of sPTB (aOR 12.06, 95% CI 6.21-23.43) and a cervical length of ≤2.5 cm (aOR 3.97, 95% CI 1.67-9.47) were significant. CONCLUSIONS Genital mycoplasma infection was not a risk factor for sPTB, even in the presence of other abnormal vaginal microbiota. TWEETABLE ABSTRACT Genital mycoplasma infection was not a risk for sPTB, even when associated with bacterial vaginosis (BV).
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Affiliation(s)
- Gkp Cunha
- Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - L B Bastos
- Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - S F Freitas
- Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - R C Cavalli
- Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - S M Quintana
- Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Aboussahoud WS, Smith H, Stevens A, Wangsaputra I, Hunter HR, Kimber SJ, Seif MW, Brison DR. The expression and activity of Toll-like receptors in the preimplantation human embryo suggest a new role for innate immunity. Hum Reprod 2021; 36:2661-2675. [PMID: 34517414 PMCID: PMC8450873 DOI: 10.1093/humrep/deab188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
STUDY QUESTION Is the innate immunity system active in early human embryo development? SUMMARY ANSWER The pattern recognition receptors and innate immunity Toll-like receptor (TLR) genes are widely expressed in preimplantation human embryos and the pathway appears to be active in response to TLR ligands. WHAT IS KNOWN ALREADY Early human embryos are highly sensitive to their local environment, however relatively little is known about how embryos detect and respond to specific environmental cues. While the maternal immune response is known to be key to the establishment of pregnancy at implantation, the ability of human embryos to detect and signal the presence of pathogens is unknown. STUDY DESIGN, SIZE, DURATION Expression of TLR family and related genes in human embryos was assessed by analysis of published transcriptome data (n = 40). Day 5 (D-5) human embryos (n = 25) were cultured in the presence of known TLR ligands and gene expression and cytokine production measured compared to controls. PARTICIPANTS/MATERIALS, SETTING, METHODS Human embryos surplus to treatment requirements were donated with informed consent from several ART centres. Embryos were cultured to Day 6 (D-6) in the presence of the TLR3 and TLR5 ligands Poly (I: C) and flagellin, with gene expression measured by quantitative PCR and cytokine release into medium measured using cytometric bead arrays. MAIN RESULTS AND THE ROLE OF CHANCE TLR and related genes, including downstream signalling molecules, were expressed variably at all human embryo developmental stages. Results showed the strongest expression in the blastocyst for TLRs 9 and 5, and throughout development for TLRs 9, 5, 2, 6 and 7. Stimulation of Day 5 blastocysts with TLR3 and TLR5 ligands Poly (I: C) and flagellin produced changes in mRNA expression levels of TLR genes, including the hyaluronan-mediated motility receptor (HMMR), TLR5, TLR7, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and monocyte chemoattractant Protein-1 (MCP-1) (P < 0.05, P < 0.001 compared to unstimulated controls), and release into culture medium of cytokines and chemokines, notably IL8 (P = 0.00005 and 0.01277 for flagellin and Poly (I: C), respectively). LIMITATIONS, REASONS FOR CAUTION This was a descriptive and experimental study which suggests that the TLR system is active in human embryos and capable of function, but does not confirm any particular role. Although we identified embryonic transcripts for a range of TLR genes, the expression patterns were not always consistent across published studies and expression levels of some genes were low, leaving open the possibility that these were expressed from the maternal rather than embryonic genome. WIDER IMPLICATIONS OF THE FINDINGS This is the first report of the expression and activity of a number of components of the innate immunity TLR system in human embryos. Understanding the role of TLRs during preimplantation human development may be important to reveal immunological mechanisms and potential clinical markers of embryo quality and pregnancy initiation during natural conception and in ART. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by the Ministry of Higher Education, The State of Libya, the UK Medical Research Council, and the NIHR Local Comprehensive Research Network and NIHR Manchester Clinical Research Facility and the European Union's Horizon 2020 Research and Innovation Programmes under the Marie Skłodowska-Curie Grant Agreement No. 812660 (DohART-NET). In accordance with H2020 rules, no new human embryos were sacrificed for research activities performed from the EU funding, which concerned only in silico analyses of recorded time-lapse and transcriptomics datasets. None of the authors has any conflict of interest to declare. TRIAL REGISTRATION NUMBER n/a.
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Affiliation(s)
- Wedad S Aboussahoud
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Helen Smith
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Adam Stevens
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Ivan Wangsaputra
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Maternal and Fetal Health Research Centre, St. Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Helen R Hunter
- Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Susan J Kimber
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Mourad W Seif
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
- Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Daniel R Brison
- Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
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Fan X, Yang Y, Wen Q, Li Y, Meng F, Liao J, Chen H, Lu GX, Lin G, Gong F. CD19 and intraglandular CD163-positivity as prognostic indicators of pregnancy outcome in CD138-negative women with a previous fresh-embryo-transfer failure. J Reprod Immunol 2021; 147:103362. [PMID: 34482188 DOI: 10.1016/j.jri.2021.103362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/27/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
Many factors impede embryonic implantation, and excluding obvious known factors such as chronic endometritis, the immune status of the endometrium may be related to pregnancy. Although an abundantly large number of immune cells infiltrate the endometrium during the secretory phase, whether these immune cells can be used as a predictor of prognosis in ART has not yet been clarified. In the present study we therefore retrospectively analyzed 97 CD138-negative women with a previous fresh-embryo-transfer failure. We assessed the expression of CD56+ uNK cells, CD16+ NK cells, CD57+ NK cells, CD68+ pan-macrophages, CD163+ M2 macrophages, CD4+T cells, CD8+T cells, FOXP3+ regulatory T cells, and CD19+ B cells in the endometrium by IHC to evaluate mid-luteal endometrial immune cells as prognostic indicators of pregnancy outcome in the next frozen-embryo-transfer cycle. CD19-positive cells and the intraglandular CD163-positivity rate increased significantly in the clinically non-pregnant group (0.47 % vs. 0.20 %, P = 0.021; 61 % vs. 30 %, P = 0.017). The ratios of CD4/CD8 were also higher in the non-pregnant group (1.96 vs. 1.45, P = 0.005).The area under the ROC curve of CD19 cell number alone, the intraglandular CD163-positivity alone, and CD19 number combined with the intraglandular CD163-positivity were 0.692 (95 % CI, 0.55-0.834), 0.661 (95 % CI, 0.514-0.809), and 0.748 (95 % CI, 0.614-0.882), respectively. The optimal cut-off value of CD19 was 0.464 %, and the clinical pregnancy rate and live-birth rate diminished significantly when the CD19 level was above this cut-off value. Our study suggests that CD19-positive cells and intraglandular CD163-positivity can be used as prognostic indicators of pregnancy outcome in CD138-negative patients who experienced first-fresh-embryo transfer failure.
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Affiliation(s)
- Xiangxiu Fan
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China
| | - Yuanyuan Yang
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Quan Wen
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Yuan Li
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Fei Meng
- Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Jingnan Liao
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Huijun Chen
- Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Guang-Xiu Lu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China
| | - Fei Gong
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, People's Republic of China; Clinical Research Center for Reproduction and Genetics In Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, People's Republic of China; NHC Key Laboratory of Human Reproductive and Stem Cell Engineering, People's Republic of China.
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Deese J, Heffron R, Jaspan H, Masson L, Smit JA, Sibeko S. Recent Advances and New Challenges in Cisgender Women's Gynecologic and Obstetric Health in the Context of HIV. Clin Obstet Gynecol 2021; 64:475-490. [PMID: 34323229 PMCID: PMC8322601 DOI: 10.1097/grf.0000000000000627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although rates of human immunodeficiency virus (HIV) have declined globally over the past 10 years, United Nations Programme on HIV/AIDS estimates 1.7 million new infections occurred in 2019, with cisgender women (cis women) and girls accounting for 48%. Acquired immune deficiency syndrome-related illnesses are the leading global cause of mortality in cis women aged 15 to 49, and in many sub-Saharan Africa countries, young women face substantially higher HIV risk than their male counterparts. Drivers of this increased risk include sexual and reproductive health characteristics unique to cis women. This review discusses the role of sexually transmitted infections, contraception and pregnancy in HIV risk, and biomedical HIV prevention technologies available and in development.
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Affiliation(s)
- Jennifer Deese
- Women's Global Health Imperative, RTI International, Research Triangle Park, Raleigh, North Carolina
| | | | - Heather Jaspan
- Departments of Global Health
- Pediatrics, University of Washington
- Seattle Children's Research Institute, Seattle, Washington
- Department of Pathology
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town
| | - Lindi Masson
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)
- Disease Elimination Program, Life Sciences Discipline, Burnet Institute
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jennifer A Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban
| | - Sengeziwe Sibeko
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Shen M, Child T, Mittal M, Sarodey G, Salim R, Granne I, Southcombe JH. B Cell Subset Analysis and Gene Expression Characterization in Mid-Luteal Endometrium. Front Cell Dev Biol 2021; 9:709280. [PMID: 34447753 PMCID: PMC8383145 DOI: 10.3389/fcell.2021.709280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
The human endometrium is the innermost mucosal membrane of the uterus and is the first point of contact for an implanting blastocyst. A wide variety of immune cells are found amongst the endometrial epithelial layers and stromal cells which both provide host immune responses against pathogens and also assist with placentation and pregnancy establishment, however, B cells have not been characterized, despite being a vital player in both adaptive and mucosal immunity. Through analysis of mid-luteal endometrial biopsies, we find 1–5% of endometrial immune cells are B cells, the majority were naïve or memory B cells, with few plasma cells. Compared with circulating B cells, endometrial B cells had an activated phenotype, with increased expression of CD69, HLA-DR, CD74, and CD83, and IL-10 production capacities. PD1+CXCR5+ICOS+ T follicular helper-like cells and FAS+IgD–BCL6+ germinal center B cells were also present in the endometrium, which may indicate that endometrial B cells are playing an active role through germinal center reactions in the human endometrial environment.
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Affiliation(s)
- Mengni Shen
- Nuffield Department of Women's and Reproductive Health, L3 Women's Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Tim Child
- Nuffield Department of Women's and Reproductive Health, L3 Women's Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.,Oxford Fertility, The Fertility Partnership, Oxford, United Kingdom
| | - Monica Mittal
- Department of Obstetrics and Gynaecology, Wolfson Fertility Center, St Mary's and Hammersmith Hospitals, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Geet Sarodey
- Department of Obstetrics and Gynaecology, Wolfson Fertility Center, St Mary's and Hammersmith Hospitals, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Rehan Salim
- Department of Obstetrics and Gynaecology, Wolfson Fertility Center, St Mary's and Hammersmith Hospitals, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Ingrid Granne
- Nuffield Department of Women's and Reproductive Health, L3 Women's Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Jennifer H Southcombe
- Nuffield Department of Women's and Reproductive Health, L3 Women's Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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Crowe HM, Wesselink AK, Wise LA, Wang TR, Horsburgh CR, Mikkelsen EM, Hatch EE. Antibiotics and fecundability among female pregnancy planners: a prospective cohort study. Hum Reprod 2021; 36:2761-2768. [PMID: 34269389 DOI: 10.1093/humrep/deab173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION To what extent is female preconception antibiotic use associated with fecundability? SUMMARY ANSWER Preconception antibiotic use overall was not appreciably associated with fecundability. WHAT IS KNOWN ALREADY Antibiotics are commonly used by women and are generally thought to be safe for use during pregnancy. However, little is known about possible effects of antibiotic use on fecundability, the per-cycle probability of conception. Previous research on this question has been limited to occupational rather than therapeutic exposure. STUDY DESIGN, SIZE, DURATION We analyzed data from an Internet-based preconception cohort study of 9524 female pregnancy planners aged 21-45 years residing in the USA and Canada who had been attempting to conceive for six or fewer cycles at study entry. Participants enrolled between June 2013 and September 2020 and completed baseline and bimonthly follow-up questionnaires for up to 12 months or until a reported pregnancy, whichever came first. The questions pertaining to antibiotic type and indication were added to the PRESTO questionnaires in March 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS We assessed antibiotic use in the previous 4 weeks at baseline and on each follow-up questionnaire. Participants provided the name of the specific antibiotic and the indication for use. Antibiotics were classified based on active ingredient (penicillins, macrolides, nitrofurantoin, nitroimidazole, cephalosporins, sulfonamides, quinolones, tetracyclines, lincosamides), and indications were classified by type of infection (respiratory, urinary tract, skin, vaginal, pelvic, and surgical). Participants reported pregnancy status on follow-up questionnaires. We used proportional probabilities regression to estimate fecundability ratios (FR), the per-cycle probability of conception comparing exposed with unexposed individuals, and 95% CI, adjusting for sociodemographics, lifestyle factors, and reproductive history. MAIN RESULTS AND THE ROLE OF CHANCE Overall, women who used antibiotics in the past 4 weeks at baseline had similar fecundability to those who had not used antibiotics (FR: 0.98, 95% CI: 0.89-1.07). Sulfonamides and lincosamides were associated with slightly increased fecundability (FR: 1.39, 95% CI: 0.90-2.15, and FR: 1.58 95% CI: 0.96-2.60, respectively), while macrolides were associated with slightly reduced fecundability (FR: 0.70, 95% CI: 0.47-1.04). Analyses of the indication for antibiotic use suggest that there is likely some confounding by indication. LIMITATIONS, REASONS FOR CAUTION Findings were imprecise for some antibiotic classes and indications for use owing to small numbers of antibiotic users in these categories. There are likely heterogeneous effects of different combinations of indications and treatments, which may be obscured in the overall null results, but cannot be further elucidated in this analysis. WIDER IMPLICATIONS OF THE FINDINGS There is little evidence that most antibiotics are associated with reduced fecundability. Antibiotics and the infections they treat are likely associated with fecundability through differing mechanisms, resulting in their association with increased fecundability in some circumstances and decreased fecundability in others. STUDY FUNDING/COMPETING INTEREST(S) This study was supported through funds provided by the National Institute of Child Health and Human Development, National Institutes of Health (R01-HD086742, R21-HD072326). L.A.W. has received in-kind donations from Swiss Precision Diagnostics, Sandstone Diagnostics, Fertility Friend, and Kindara for primary data collection in PRESTO. The other authors have no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Holly Michelle Crowe
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Amelia Kent Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lauren Anne Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tanran R Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | - Ellen Margrethe Mikkelsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus N, Denmark
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Anderson KM, Ghosh M, Karris MY, Capozzi E, Granger DA, Stockman JK. The biobehavioral impacts of sexual violence: Findings from an acute repeat survivor of vaginal rape. ACTA ACUST UNITED AC 2021; 17:17455065211031079. [PMID: 34253106 PMCID: PMC8280840 DOI: 10.1177/17455065211031079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Individuals who have experienced repeat sexual violence victimization face
adverse mental and physical health outcomes, including immune and stress
response functioning. We aim to further understand repeat sexual violence
victimization to develop responsive and appropriate treatment for survivors
of sexual violence. Methods: We present the immunological and contextual findings of a participant
(N = 1) who experienced repeat sexual violence
victimization during her enrollment in The THRIVE Study, a prospective
case–control study of women aged 14–45 years, who have experienced recent
consensual vaginal penetration (“controls”) or forced vaginal penetration
(“cases”). Participants complete a survey, HIV/sexually transmitted
infection, and pregnancy testing, blood sampling for C-reactive protein and
adrenocorticotrophic hormone, collection of cervicovaginal fluid for
immunological biomarkers, and self-collection of saliva samples for cortisol
measurements, across study visits (Baseline, 1, and 3 months). Results: The case study participant, aged 18 years upon enrollment, experienced sexual
trauma before four of five study visits. Trends in the mental health
indicators demonstrate reciprocal fluctuations in adverse mental health and
resilience in accordance with revictimization and circumstantial changes.
Suppressed immune biomarkers appear to correlate with increased adverse
mental health, while mental health recovery trends with immunological
recovery. The participant presents with dysregulated
hypothalamic–pituitary–adrenal axis diurnal profile. Conclusions: This profile illustrates the intra-individual biobehavioral impact of
experience with revictimization over the course of 6 months, capturing
experiences that are rarely studied either longitudinally or with the depth
of the current research. The findings underscore the value of monitoring
cervicovaginal immune functioning and hypothalamic–pituitary–adrenal axis
dysregulation in coordination with changes in mental health over the course
of repeated sexual trauma.
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Affiliation(s)
- Katherine M Anderson
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA.,Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mimi Ghosh
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Maile Y Karris
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Eleanor Capozzi
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.,School of Medicine and School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA
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97
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Perry WA, Chow JK, Snydman DR. Difference in absolute lymphocyte count among male and female heart transplant recipients. Clin Transplant 2021; 35:e14412. [PMID: 34245177 DOI: 10.1111/ctr.14412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
The impact of sex on immune composition in the setting of solid organ transplantation is unknown. Immunocompetent men and women have quantitative differences in multiple markers of immunity, including lymphocyte subsets. Lymphocytes are of particular interest given the routine use of medications targeted at cell-mediated immunity. The objective of this retrospective cohort study was to compare absolute lymphocyte count (ALC) measurements of male and female heart recipients immediately before, and 1 month after, transplantation. Data was collected on 375 adult recipients (104 female and 271 male) from 2000 to 2018 at a single center. Mean ALC was compared using Student's t-test. Women had higher mean ALC both at baseline (female 1.6 × 103 cells/μl vs. male 1.3 × 103 cells/μl; P < .001) and at 1 month post-transplantation (mean 1.2 × 103 cells/μl vs. .8 × 103 cells/μl; P < .001). This finding could have important implications for sex-based differences in predisposition to rejection or response to infection or vaccination.
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Affiliation(s)
- Whitney A Perry
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
| | - Jennifer K Chow
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
| | - David R Snydman
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
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98
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Devalraju KP, Tripathi D, Neela VSK, Paidipally P, Radhakrishnan RK, Singh KP, Ansari MS, Jaeger M, Netea-Maier RT, Netea MG, Park S, Cheng SY, Valluri VL, Vankayalapati R. Reduced thyroxine production in young household contacts of tuberculosis patients increases active tuberculosis disease risk. JCI Insight 2021; 6:e148271. [PMID: 34236051 PMCID: PMC8410087 DOI: 10.1172/jci.insight.148271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/26/2021] [Indexed: 12/03/2022] Open
Abstract
In the current study, we followed 839 household contacts (HHCs) of tuberculosis (TB) patients for 2 years and identified the factors that enhanced the development of TB. Fourteen of the 17 HHCs who progressed to TB were in the 15- to 30-year-old age group. At baseline (the “0“ time point, when all the individuals were healthy), the concentration of the thyroid hormone thyroxine (T4) was lower, and there were increased numbers of Tregs in PBMCs of TB progressors. At baseline, PBMCs from TB progressors stimulated with early secretory antigenic target 6 (ESAT-6) and 10 kDa culture filtrate antigen (CFP-10) produced less IL-1α. Thyroid hormones inhibited Mycobacterium tuberculosis (Mtb) growth in macrophages in an IL-1α–dependent manner. Mtb-infected Thra1PV/+ (mutant thyroid hormone receptor) mice had increased mortality and reduced IL-1α production. Our findings suggest that young HHCs who exhibit decreased production of thyroid hormones are at high risk of developing active TB disease.
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Affiliation(s)
- Kamakshi Prudhula Devalraju
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Deepak Tripathi
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
| | - Venkata Sanjeev Kumar Neela
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Padmaja Paidipally
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
| | - Rajesh Kumar Radhakrishnan
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
| | - Karan P Singh
- Department of Epidemiology and Biostatistics, School of Community and Rural Health, University of Texas Health Science Center, Tyler, Texas, USA
| | - Mohammad Soheb Ansari
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Martin Jaeger
- Department of Internal Medicine, Division of Endocrinology, and.,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sunmi Park
- Laboratory of Molecular Biology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Sheue-Yann Cheng
- Laboratory of Molecular Biology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Vijaya Lakshmi Valluri
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Ramakrishna Vankayalapati
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
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99
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Swaims-Kohlmeier A, Sheth AN, Brody J, Hardnett FP, Sharma S, Bonning EW, Ofotokun I, Massud I, García-Lerma JG. Proinflammatory oscillations over the menstrual cycle drives bystander CD4 T cell recruitment and SHIV susceptibility from vaginal challenge. EBioMedicine 2021; 69:103472. [PMID: 34229275 PMCID: PMC8264117 DOI: 10.1016/j.ebiom.2021.103472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/02/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The menstrual cycle influences HIV infection-risk in women, although the timing and underlying mechanism are unclear. Here we investigated the contribution of the menstrual cycle to HIV susceptibility through evaluating immune behavior with infection-risk over time. METHODS Blood and vaginal lavage samples were collected from 18 pig-tailed macaques to evaluate immune changes over reproductive cycles, and from 5 additional animals undergoing repeated vaginal exposures to simian HIV (SHIV). Peripheral blood mononuclear cell (PBMC) samples from healthy women (n = 10) were prospectively collected over the course of a menstrual cycle to profile T cell populations. Immune properties from PBMC and vaginal lavage samples were measured by flow cytometry. Plasma progesterone was measured by enzyme immunoassay. The oscillation frequency of progesterone concentration and CCR5 expression on CD4 T cells was calculated using the Lomb-Scargle periodogram. SHIV infection was monitored in plasma by RT-PCR. Immune measures were compared using generalized estimating equations (GEE). FINDINGS Macaques cycle-phases were associated with fluctuations in systemic immune properties and a type-1 inflammatory T cell response with corresponding CCR5+ memory CD4 T cell (HIV target cell) infiltration into the vaginal lumen at the late luteal phase. Power spectral analysis identified CCR5 oscillation frequencies synchronized with reproductive cycles. In a repetitive low-dose vaginal challenge model, productive SHIV163P3 infection only occurred during intervals of mounting type-1 T cell responses (n = 5/5). Finally, we identify similar type-1 inflammatory T cell responses over the menstrual cycle are occurring in healthy women. INTERPRETATION These data demonstrate that periodic shifts in the immune landscape under menstrual cycle regulation drives bystander CCR5+ CD4 T cell recruitment and HIV susceptibility in the female reproductive tract. FUNDING This study was supported by the U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329 and NIH grants to Emory University (K23AI114407 to A.N.S., the Emory University Center for AIDS research [P30AI050409], and Atlanta Clinical and Translational Sciences Institute [KLR2TR000455, UL1TR000454]). DISCLAIMER The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention or the Department of Health and Human Services.
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Affiliation(s)
- Alison Swaims-Kohlmeier
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States..
| | - Anandi N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA 30322, United States
| | - Jed Brody
- Department of Physics, Emory University, Atlanta, GA 30322, United States
| | - Felicia P Hardnett
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
| | - Sunita Sharma
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
| | - Erin Wells Bonning
- Department of Physics, Emory University, Atlanta, GA 30322, United States
| | - Igho Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA 30322, United States
| | - Ivana Massud
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
| | - J Gerardo García-Lerma
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
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100
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Moron‐Lopez S, Xie G, Kim P, Siegel DA, Lee S, Wong JK, Price JC, Elnachef N, Greenblatt RM, Tien PC, Roan NR, Yukl SA. Tissue-specific differences in HIV DNA levels and mechanisms that govern HIV transcription in blood, gut, genital tract and liver in ART-treated women. J Int AIDS Soc 2021; 24:e25738. [PMID: 34235864 PMCID: PMC8264406 DOI: 10.1002/jia2.25738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/18/2021] [Accepted: 04/22/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Sex-specific differences affect multiple aspects of HIV infection, yet few studies have quantified HIV levels in tissues from women. Since an HIV functional cure will likely require a major reduction of infected cells from most tissues, we measured total and intact HIV DNA and the HIV transcription profile in blood, gut, genital tract and liver from HIV-positive antiretroviral therapy (ART) -treated women. METHODS Peripheral blood mononuclear cells (PBMC) and biopsies from the gastrointestinal (ileum, colon, rectosigmoid +/- liver) and genital (ectocervix, endocervix and endometrium) tracts were collected from 6 ART-treated (HIV RNA < 200 copies/mL) women. HIV DNA (total and intact) and levels of read-through, initiated (total), 5'elongated, polyadenylated and multiply spliced HIV transcripts were measured by droplet digital PCR. Immunophenotyping of cells was performed using Cytometry by time of flight (CyTOF). RESULTS We detected total HIV DNA in all tissues and intact HIV DNA in blood, ileum, colon, rectosigmoid and ectocervix. Initiated HIV transcripts per provirus were higher in PBMC and endometrium than in ileum, colon, rectosigmoid, ectocervix or endocervix, and higher in the rectum than either ileum or colon. 5'Elongated HIV transcripts per provirus were comparable in PBMC and endometrium, but higher than in gut or cervical samples. Polyadenylated and multiply spliced HIV transcripts were detected in PBMC (6/6 and 3/6 individuals respectively), but rarely in the tissues. CONCLUSIONS These results suggest tissue-specific differences in the mechanisms that govern HIV expression, with lower HIV transcription in most tissues than blood. Therapies aimed at disrupting latency, such as latency-reversing or latency-silencing agents, will be required to penetrate into multiple tissues and target different blocks to HIV transcription.
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Affiliation(s)
- Sara Moron‐Lopez
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
- Department of MedicineSan Francisco VA Medical CenterSan FranciscoCAUSA
| | - Guorui Xie
- Department of UrologyUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
- Gladstone InstitutesSan FranciscoCAUSA
| | - Peggy Kim
- Department of MedicineSan Francisco VA Medical CenterSan FranciscoCAUSA
| | - David A Siegel
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - Sulggi Lee
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - Joseph K Wong
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
- Department of MedicineSan Francisco VA Medical CenterSan FranciscoCAUSA
| | - Jennifer C Price
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - Najwa Elnachef
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - Ruth M Greenblatt
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
| | - Phyllis C Tien
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
- Department of MedicineSan Francisco VA Medical CenterSan FranciscoCAUSA
| | - Nadia R Roan
- Department of UrologyUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
- Gladstone InstitutesSan FranciscoCAUSA
| | - Steven A Yukl
- Department of MedicineUniversity of California San Francisco (UCSF)San FranciscoCAUSA
- Department of MedicineSan Francisco VA Medical CenterSan FranciscoCAUSA
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