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Notbohm HL, Moser F, Goh J, Feuerbacher JF, Bloch W, Schumann M. The effects of menstrual cycle phases on immune function and inflammation at rest and after acute exercise: A systematic review and meta-analysis. Acta Physiol (Oxf) 2023; 238:e14013. [PMID: 37309068 DOI: 10.1111/apha.14013] [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: 04/16/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
The immune system plays an important role in mediating exercise responses and adaptations. However, whether fluctuating hormone concentrations across the menstrual cycle may impact these processes remains unknown. The aim of this systematic review with meta-analysis was to compare baseline concentrations as well as exercise-induced changes in immune and inflammatory parameters between menstrual cycle phases. A systematic literature search was conducted according to the PRISMA guidelines using Pubmed/MEDLINE, ISI Web of Science, and SPORTDiscus. Of the 159 studies included in the qualitative synthesis, 110 studies were used for meta-analysis. Due to the designs of the included studies, only the follicular and luteal phase could be compared. The estimated standardized mean differences based on the random-effects model revealed higher numbers of leukocytes (-0.48 [-0.73; -0.23], p < 0.001), monocytes (-0.73 [-1.37; -0.10], p = 0.023), granulocytes (-0.85 [-0.1.48; -0.21], p = 0.009), neutrophils (-0.32 [-0.52; -0.12], p = 0.001), and leptin concentrations (-0.37 [-0.5; -0.23], p = 0.003) in the luteal compared to the follicular phase at rest. Other parameters (adaptive immune cells, cytokines, chemokines, and cell adhesion molecules) showed no systematic baseline differences. Seventeen studies investigated the exercise-induced response of these parameters, providing some indications for a higher pro-inflammatory response in the luteal phase. In conclusion, parameters of innate immunity showed cycle-dependent regulation at rest, while little is known on the exercise responses. Due to a large heterogeneity and a lack of cycle phase standardization among the included studies, future research should focus on comparing at least three distinct hormonal profiles to derive more specific recommendations for exercise prescription.
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Affiliation(s)
- H L Notbohm
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - F Moser
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - J Goh
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
- Centre for Healthy Longevity, National University Health System (NUHS), Singapore, Singapore
| | - J F Feuerbacher
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - W Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - M Schumann
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
- Division of Training and Movement Science, University of Potsdam, Potsdam, Germany
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2
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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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3
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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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High-intensity intermittent exercise induces a potential anti-inflammatory response in healthy women across the menstrual cycle. Cytokine 2022; 154:155872. [DOI: 10.1016/j.cyto.2022.155872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/17/2022] [Accepted: 03/25/2022] [Indexed: 11/18/2022]
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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] [MESH Headings] [Grants] [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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Boily-Larouche G, Lajoie J, Dufault B, Omollo K, Cheruiyot J, Njoki J, Kowatsch M, Kimani M, Kimani J, Oyugi J, Fowke KR. Characterization of the Genital Mucosa Immune Profile to Distinguish Phases of the Menstrual Cycle: Implications for HIV Susceptibility. J Infect Dis 2020; 219:856-866. [PMID: 30383238 PMCID: PMC6386813 DOI: 10.1093/infdis/jiy585] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Inflammation and immune activation are key factors in sexual transmission of human immunodeficiency virus (HIV). We sought to define the impact of hormonal cycling on the mucosal immune environment and HIV risk in sex workers with a natural menstrual cycle. METHODS We compared soluble mucosal immune factors and cervical mononuclear cells during hormone titer-defined phases of the menstrual cycle among 37 sex workers from Nairobi, Kenya. Systemic and mucosal samples were collected 14 days apart to distinguish the follicular and luteal phases of the menstrual cycle, and phases were confirmed by hormone measurements. Vaginal concentrations of 19 immune modulators and cervical T-cell activation markers were measured. RESULTS The follicular phase signature was characterized by an elevated CCL2 level, decreased interleukin 1α and interleukin 1β cervical concentrations, and a significant increase in the proportion of CD4+ T cells that expressed CD69. The genital concentration of CCL2 was the best marker to distinguish the follicular from the luteal phase in univariate and multivariate analyses and remained independent of elevated genital inflammation and bacterial vaginosis. CONCLUSION The follicular phase of the menstrual cycle was associated with an elevated CCL2 level and retention of resident memory CD4+ T cells, which has implications for increased susceptibility to HIV infection.
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Affiliation(s)
| | - Julie Lajoie
- Department of Medical Microbiology and Infectious Diseases, Winnipeg, Canada.,Department Medical Microbiology, University of Nairobi, Winnipeg, Canada
| | - Brenden Dufault
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada.,Department of Community Health Science, University of Manitoba, Winnipeg, Canada
| | - Kenneth Omollo
- Department Medical Microbiology, University of Nairobi, Winnipeg, Canada
| | | | - Jane Njoki
- Kenya AIDS Control Program, Nairobi, Kenya
| | - Monika Kowatsch
- Department of Medical Microbiology and Infectious Diseases, Winnipeg, Canada
| | | | - Joshua Kimani
- Department of Medical Microbiology and Infectious Diseases, Winnipeg, Canada.,Kenya AIDS Control Program, Nairobi, Kenya
| | - Julius Oyugi
- Department of Medical Microbiology and Infectious Diseases, Winnipeg, Canada.,Department Medical Microbiology, University of Nairobi, Winnipeg, Canada
| | - Keith R Fowke
- Department of Medical Microbiology and Infectious Diseases, Winnipeg, Canada.,Department of Community Health Science, University of Manitoba, Winnipeg, Canada.,Department Medical Microbiology, University of Nairobi, Winnipeg, Canada
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7
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Morrison CS, Fichorova R, Chen PL, Kwok C, Deese J, Yamamoto H, Anderson S, Chipato T, Salata R, Doncel GF. A Longitudinal Assessment of Cervical Inflammation and Immunity Associated with HIV-1 Infection, Hormonal Contraception, and Pregnancy. AIDS Res Hum Retroviruses 2018; 34:889-899. [PMID: 30047279 DOI: 10.1089/aid.2018.0022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hormonal contraception (HC), particularly injectable depot-medroxyprogesterone acetate (DMPA), has been associated with increased HIV acquisition and higher levels of cervical regulated upon activation, normal T-cell expressed, and secreted (RANTES), also associated with HIV seroconversion. Longitudinal changes in cervical immunity associated with DMPA and combined oral contraceptives (COCs) have not been studied. Cervical samples from 216 HIV seroconverters in Uganda and Zimbabwe with matched samples from 727 HIV-uninfected controls were collected at two quarterly visits before (t - 2, t - 1), at (t0), and two visits following (t + 1, t + 2) HIV seroconversion and corresponding visits for HIV-negative controls. We measured 10 biomarkers of inflammation and immunity and used generalized linear models to estimate and compare biomarker levels across HIV status, contraceptive, and pregnancy groups. Biomarkers remained relatively stable across visits for controls, while in HIV-infected women cervical immunity started to change before seroconversion with RANTES and BD-2 increased and secretory leukocyte protease inhibitor (SLPI) decreased at t - 1 and continued to change at t0 with ICAM-1 up and IL-8 down and with more biomarkers after seroconversion (IL-1β, IL-6, MIP-3α, VEGF, and IL-1RA down and IL-1RA:IL-1β ratio up). In multivariable analyses, seroconverters had higher BD-2 at t - 1, higher RANTES and lower SLPI from t - 1 through t + 2, and lower IL-8 and IL-1RA at and/or after seroconversion compared to nonseroconverters. Compared to non-HC users, DMPA users had higher RANTES at all visits and lower BD-2 at t - 2 through t0, while COC users and pregnant women had higher IL-8 and SLPI at all visits; COC users also had lower BD-2 preseroconversion; pregnant women had lower RANTES at t0 - t + 2. Longitudinal patterns of cervical immunity differ between HIV seroconverters and HIV-negative women; seroconverters demonstrate increased RANTES and decreased SLPI starting before and continuing postseroconversion. Furthermore, these patterns are differentially regulated by DMPA, COC, and pregnancy.
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Affiliation(s)
| | - Raina Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Pai-Lien Chen
- Global Health, Population and Nutrition, FHI 360, Durham, North Carolina
| | - Cynthia Kwok
- Global Health, Population and Nutrition, FHI 360, Durham, North Carolina
| | - Jennifer Deese
- Global Health, Population and Nutrition, FHI 360, Durham, North Carolina
| | - Hidemi Yamamoto
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharon Anderson
- CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Arlington, Virginia
| | - Tsungai Chipato
- Department of Obstetrics and Gynaecology, University of Zimbabwe, Harare, Zimbabwe
| | - Robert Salata
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Gustavo F. Doncel
- CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
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8
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Bradley F, Birse K, Hasselrot K, Noël-Romas L, Introini A, Wefer H, Seifert M, Engstrand L, Tjernlund A, Broliden K, Burgener AD. The vaginal microbiome amplifies sex hormone-associated cyclic changes in cervicovaginal inflammation and epithelial barrier disruption. Am J Reprod Immunol 2018; 80:e12863. [PMID: 29709092 DOI: 10.1111/aji.12863] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/28/2018] [Indexed: 12/27/2022] Open
Abstract
PROBLEM Susceptibility to HIV is associated with the menstrual cycle and vaginal microbiome, but their collective impact on vaginal inflammation remains unclear. Here, we characterized the cervicovaginal proteome, inflammation, and microbiome community structure and function during the menstrual cycle. METHOD OF STUDY Cervicovaginal secretions were collected from regularly cycling women (n = 16) at median day 10, 16, and 24 of each menstrual cycle and analyzed by mass spectrometry, 16S rRNA gene sequencing, and a multiplex bead array immunoassay. Follicular, ovulatory, and luteal phases were defined by serum sex hormone levels. RESULTS Ovulation showed the largest mucosal proteome changes, where 30% and 19% of the 406 human proteins identified differed compared to the luteal and follicular phases, respectively. Neutrophil/leukocyte migration pathways were lowest during ovulation and peaked in the luteal phase, while antimicrobial and epithelial barrier promoting proteins were highest during ovulation. Vaginal microbial community structure and function did not vary significantly during the menstrual cycle, with the majority consistently Lactobacillus-dominant (63%) or non-Lactobacillus-dominant (25%). Fluctuations in the epithelial barrier protein RPTN between the ovulatory and luteal phase were amplified in women with Gardnerella vaginalis and anaerobic bacteria and reduced when Lactobacillus was dominant. CONCLUSION This small study demonstrates that sex hormones modulate neutrophil/leukocyte inflammation, barrier function, and antimicrobial pathways in the female genital tract with the strongest changes occurring during ovulation. The data further suggest a microbiome context for hormone-driven changes in vaginal immunity which may have implications for HIV susceptibility.
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Affiliation(s)
- Frideborg Bradley
- Department of Medicine Solna, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska Institutet Karolinska University Hospital, Stockholm, Sweden
| | - Kenzie Birse
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.,National HIV and Retrovirology Labs, JC Wilt Infectious Disease Centre, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Klara Hasselrot
- Department of Medicine Solna, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska Institutet Karolinska University Hospital, Stockholm, Sweden.,Department of Gynaecology, Danderyds Hospital, Stockholm, Sweden
| | - Laura Noël-Romas
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.,National HIV and Retrovirology Labs, JC Wilt Infectious Disease Centre, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Andrea Introini
- Department of Medicine Solna, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska Institutet Karolinska University Hospital, Stockholm, Sweden
| | - Hugo Wefer
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Clinical Genomics Facility, Solna, Sweden
| | - Maike Seifert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Clinical Genomics Facility, Solna, Sweden
| | - Lars Engstrand
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Clinical Genomics Facility, Solna, Sweden
| | - Annelie Tjernlund
- Department of Medicine Solna, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska Institutet Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Broliden
- Department of Medicine Solna, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska Institutet Karolinska University Hospital, Stockholm, Sweden
| | - Adam D Burgener
- Department of Medicine Solna, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska Institutet Karolinska University Hospital, Stockholm, Sweden.,Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.,National HIV and Retrovirology Labs, JC Wilt Infectious Disease Centre, Public Health Agency of Canada, Winnipeg, MB, Canada
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9
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Trepanowski JF, Kroeger CM, Barnosky A, Klempel M, Bhutani S, Hoddy KK, Rood J, Ravussin E, Varady KA. Effects of alternate-day fasting or daily calorie restriction on body composition, fat distribution, and circulating adipokines: Secondary analysis of a randomized controlled trial. Clin Nutr 2017; 37:1871-1878. [PMID: 29258678 DOI: 10.1016/j.clnu.2017.11.018] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS Indirect comparisons suggest that alternate-day fasting (ADF) may produce greater improvements in body composition, fat distribution, and/or the adipokine profile compared to daily calorie restriction (CR), but this has not been tested directly. In a pre-planned secondary analysis of a randomized controlled trial, we compared changes in the VAT:SAT ratio, FFM:total mass ratio, and the adipokine profile between ADF and CR. METHODS Overweight and obese participants (n = 100) were randomized to 1) ADF (alternating every 24-h between consuming 25% or 125% of energy needs); 2) CR (consuming 75% of needs every day); or 3) control (consuming 100% of needs every day) for 24 wk. RESULTS The VAT:SAT ratio did not change in any group. The FFM:total mass ratio increased in both ADF (0.03 ± 0.00) and CR (0.03 ± 0.01) compared to the control group (P < 0.01), with no differences between the intervention groups. Circulating leptin decreased in both the ADF group (-18 ± 6%) and CR group (-31 ± 10%) relative to the control group (P < 0.05), with no differences between the intervention groups. Circulating levels of adiponectin, resistin, IL-6, and TNF-α did not change in either intervention group relative to the control group. CONCLUSION ADF and CR similarly improve the FFM:total mass ratio and reduce leptin after a 24-wk intervention. TRIAL REGISTRATION Clinicaltrials.gov, number NCT00960505.
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Affiliation(s)
- John F Trepanowski
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; Stanford Prevention Research Center, Stanford University, Stanford, CA, USA.
| | - Cynthia M Kroeger
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Adrienne Barnosky
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Monica Klempel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Surabhi Bhutani
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristin K Hoddy
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Jennifer Rood
- Nutrition and Obesity Division, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eric Ravussin
- Nutrition and Obesity Division, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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10
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Gibbs A, Leeansyah E, Introini A, Paquin-Proulx D, Hasselrot K, Andersson E, Broliden K, Sandberg JK, Tjernlund A. MAIT cells reside in the female genital mucosa and are biased towards IL-17 and IL-22 production in response to bacterial stimulation. Mucosal Immunol 2017; 10:35-45. [PMID: 27049062 PMCID: PMC5053908 DOI: 10.1038/mi.2016.30] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/25/2016] [Indexed: 02/07/2023]
Abstract
The female genital tract (FGT) mucosa is a critically important site for immune defense against microbes. Mucosal-associated invariant T (MAIT) cells are an innate-like T-cell population that recognizes microbial riboflavin metabolite antigens in an MR1-dependent manner. The role of MAIT cells in the FGT mucosa is unknown. Here, we found that MAIT cells and MR1+ antigen-presenting cells were present in the upper and lower FGT, with distinct tissue localization of MAIT cells in endometrium vs. cervix. The MAIT cells from the FGT and blood displayed a distinct phenotype with expression of interleukin (IL)-18Rα, CD127, α4β7, PD-1, as well as the transcription factors promyelocytic leukemia zinc finger (PLZF), RORγt, Helios, Eomes, and T-bet. Their expression levels of PLZF and Eomes were lower in the FGT compared with blood. When stimulated with Escherichia coli, MAIT cells from the FGT displayed a bias towards IL-17 and IL-22 expression, whereas blood MAIT cells produced primarily IFN-γ, TNF, and Granzyme B. Furthermore, both FGT- and blood-derived MAIT cells were polyfunctional and contributed to the T-cell-mediated response to E. coli. Thus, MAIT cells in the genital mucosa have a distinct IL-17/IL-22 profile and may have an important role in the immunological homeostasis and control of microbes at this site.
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Affiliation(s)
- Anna Gibbs
- Unit of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - Edwin Leeansyah
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
| | - Andrea Introini
- Unit of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - Dominic Paquin-Proulx
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
| | - Klara Hasselrot
- Unit of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
- Department of Obstetrics and Gynecology, Danderyd Hospital, 182 88 Stockholm, Sweden
| | - Emilia Andersson
- Clinical Pathology/Cytology, Capio St. Göran Hospital, Stockholm, Sweden
| | - Kristina Broliden
- Unit of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - Johan K. Sandberg
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
| | - Annelie Tjernlund
- Unit of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
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11
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Lorenz TK, Demas GE, Heiman JR. Partnered sexual activity moderates menstrual cycle-related changes in inflammation markers in healthy women: an exploratory observational study. Fertil Steril 2016; 107:763-773.e3. [PMID: 27919440 DOI: 10.1016/j.fertnstert.2016.11.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine differences in inflammation markers in sexually active versus abstinent women and observe changes in inflammation markers across the menstrual cycle. Cycle-related immune fluctuations may have evolved to reduce interference with conception. If so, reproductively active (i.e., sexually active) women should show the most variability in cytokine expression. DESIGN Participants provided serum samples at menses and ovulation (from which cytokines were assayed) and saliva samples at menses and during follicular, ovulation, and luteal phases (from which C-reactive protein [CRP] was assayed). Participants self-reported intercourse frequency during the study. SETTING Academic research laboratory. PATIENT(S) Thirty-two healthy, naturally cycling premenopausal women (sexually active, n = 15; abstinent, n = 17). INTERVENTION(S) Observational study. MAIN OUTCOME MEASURE(S) Levels of proinflammatory cytokines (interleukin-6 [IL-6], interferon γ [IFN-γ], tumor necrosis factor-α [TNF-α]), an anti-inflammatory cytokine (interleukin-4 [IL-4]), and a marker of total inflammation (CRP). RESULT(S) Sexually active women had higher levels of all of the immune markers measured, including both pro- and anti-inflammatory cytokines, than abstinent women. Relative to sexually active women, abstinent women had less change across the menstrual cycle in levels of CRP. Among sexually active women, higher intercourse frequency predicted greater midcycle decreases in CRP, IL-6, and IFN-γ and midcycle increases in IL-4. CONCLUSION(S) Sexual activity may stimulate a complex interaction between pro- and anti-inflammatory cytokines that subsequently drives midcycle declines in inflammation.
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Affiliation(s)
- Tierney K Lorenz
- Kinsey Institute, Indiana University, Bloomington, Indiana; Center for Integrative Study for Animal Behavior, Indiana University, Bloomington, Indiana; Department of Psychology, University of North Carolina at Charlotte, Charlotte, North Carolina.
| | - Gregory E Demas
- Center for Integrative Study for Animal Behavior, Indiana University, Bloomington, Indiana; Department of Biology, Indiana University, Bloomington, Indiana
| | - Julia R Heiman
- Kinsey Institute, Indiana University, Bloomington, Indiana; Center for Integrative Study for Animal Behavior, Indiana University, Bloomington, Indiana; Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
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12
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Jais M, Younes N, Chapman S, Cu-Uvin S, Ghosh M. Reduced levels of genital tract immune biomarkers in postmenopausal women: implications for HIV acquisition. Am J Obstet Gynecol 2016; 215:324.e1-324.e10. [PMID: 27026477 DOI: 10.1016/j.ajog.2016.03.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Rates of HIV infections are increasing in older adults. Although it is known that the HIV/AIDS epidemics affects women disproportionately, little is known regarding immune functions in the genital tract of postmenopausal women, as relevant to HIV susceptibility. OBJECTIVE The objective of the study was to compare levels of female reproductive tract immune mediators that are important for HIV-associated immune responses as well as intrinsic anti-HIV activity in the cervical vaginal lavages collected from HIV-negative pre- and postmenopausal women. STUDY DESIGN Cervical vaginal lavage from 20 premenopausal and 20 postmenopausal women were assayed for interleukin-6, interleukin-8, tumor necrosis factor-α, secretory leukocyte protease inhibitor, elafin, human β-defensin-2, and macrophage inflammatory protein-3α using standard enzyme-linked immunosorbent assays. Anti-HIV activity of cervical-vaginal lavage was measured using TZM-bl indicator cells against HIV-1 IIIB and BaL. Whereas each postmenopausal woman provided only 1 sample, each premenopausal woman provided 3 samples, during proliferative, ovulatory, and secretory stages, based on menstrual dates. RESULTS We observed significantly lower levels of tumor necrosis factor-α, MIP-3α, secretory leukocyte protease inhibitor, elafin, and human β-defensin-2 in cervical vaginal lavage from postmenopausal women compared with premenopausal women. Inhibition of HIV-1 infection was observed for both pre- and postmenopausal women, but cervical vaginal lavage from postmenopausal women showed significantly higher inhibition against HIV-1 BaL after adjusting for total protein concentration, genital pH, and reproductive tract infections. No change in mediators or HIV inhibition was observed through the stages of menstrual cycle. In addition, we observed that postmenopausal women with reproductive tract infections had significantly higher levels of tumor necrosis factor-α and significantly lower levels of interleukin-8, which were not observed in premenopausal women. CONCLUSION Our findings suggest that female reproductive tract immune microenvironment is distinct in HIV-negative postmenopausal women. Further studies are needed to assess the risk of HIV acquisition/transmission in this population.
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Affiliation(s)
- Mariel Jais
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC
| | - Naji Younes
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC
| | - Stacey Chapman
- Department of Medicine, Alpert School of Medicine, Brown University, Providence, RI
| | - Susan Cu-Uvin
- Department of Obstetrics and Gynecology, Alpert School of Medicine, Brown University, Providence, RI
| | - Mimi Ghosh
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC.
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13
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Thurman AR, Chandra N, Yousefieh N, Zalenskaya I, Kimble T, Asin S, Rollenhagen C, Anderson SM, Herold B, Mesquita PM, Richardson-Harman N, Cunningham T, Schwartz JL, Doncel GF. Comparison of Follicular and Luteal Phase Mucosal Markers of HIV Susceptibility in Healthy Women. AIDS Res Hum Retroviruses 2016; 32:547-60. [PMID: 26750085 DOI: 10.1089/aid.2015.0264] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The purpose of this study was to evaluate differences in vaginal immune cell populations, vaginal tissue gene expression, antimicrobial activity of the cervicovaginal (CV) lavage (CVL), vaginal flora, and p24 antigen production from CV tissues after ex vivo human immunodeficiency virus (HIV) infection between follicular (FOL) and luteal (LUT) phases of the menstrual cycle. CV tissue biopsies, CV secretions, and blood samples were obtained as part of two longitudinal clinical trials of healthy women (CONRAD D11-119 and A12-124 studies). Participants (n = 39) were HIV-seronegative women not using exogenous hormone supplementation, with normal menstrual cycles, who were screened to exclude sexually transmitted and reproductive tract infections. Serum levels of estradiol and progesterone were significantly higher in the LUT versus the FOL phase of the menstrual cycle. Controlling for race, reported contraceptive use/sexual practices, and clinical trial, we found no differences in vaginal tissue immune cell populations and activation status, transcriptomes, inhibition of HIV, herpes simplex virus type 2 and Escherichia coli by the CVL, vaginal pH or Nugent score, or production of p24 antigen after ex vivo infection by HIV-1BaL between CV samples obtained in the FOL phase versus the LUT phase of the menstrual cycle. There were no significant correlations between serum estradiol and progesterone levels and CV endpoints. The hypothesis that the LUT phase of the menstrual cycle represents a more vulnerable stage for mucosal infection with HIV was not supported by data from samples obtained from the lower genital tract (ectocervix and vagina) from these two clinical trials.
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Affiliation(s)
| | | | | | | | - Thomas Kimble
- CONRAD, Eastern Virginia Medical School, Norfolk, Virginia
| | - Susana Asin
- V.A. Medical Center, White River Junction VT and Geisel School of Medicine at Dartmouth, Dartmouth, New Hampshire
| | - Christiane Rollenhagen
- V.A. Medical Center, White River Junction VT and Geisel School of Medicine at Dartmouth, Dartmouth, New Hampshire
| | | | - Betsy Herold
- Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Tina Cunningham
- School of Public Health, Eastern Virginia Medical School, Norfolk, Virginia
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14
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Engelmann F, Rivera A, Park B, Messerle-Forbes M, Jensen JT, Messaoudi I. Impact of Estrogen Therapy on Lymphocyte Homeostasis and the Response to Seasonal Influenza Vaccine in Post-Menopausal Women. PLoS One 2016; 11:e0149045. [PMID: 26859566 PMCID: PMC4747494 DOI: 10.1371/journal.pone.0149045] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/25/2016] [Indexed: 01/01/2023] Open
Abstract
It is widely recognized that changes in levels of ovarian steroids modulate severity of autoimmune disease and immune function in young adult women. These observations suggest that the loss of ovarian steroids associated with menopause could affect the age-related decline in immune function, known as immune senescence. Therefore, in this study, we determined the impact of menopause and estrogen therapy (ET) on lymphocyte subset frequency as well as the immune response to seasonal influenza vaccine in three different groups: 1) young adult women (regular menstrual cycles, not on hormonal contraception); 2) post-menopausal (at least 2 years) women who are not receiving any form of hormone therapy (HT) and 3) post-menopausal hysterectomized women receiving ET. Although the numbers of circulating CD4 and CD20 B cells were reduced in the post-menopausal group receiving ET, we also detected a better preservation of naïve B cells, decreased CD4 T cell inflammatory cytokine production, and slightly lower circulating levels of the pro-inflammatory cytokine IL-6. Following vaccination, young adult women generated more robust antibody and T cell responses than both post-menopausal groups. Despite similar vaccine responses between the two post-menopausal groups, we observed a direct correlation between plasma 17β estradiol (E2) levels and fold increase in IgG titers within the ET group. These findings suggest that ET affects immune homeostasis and that higher plasma E2 levels may enhance humoral responses in post-menopausal women.
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Affiliation(s)
- Flora Engelmann
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, California, United States of America
| | - Andrea Rivera
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, California, United States of America
| | - Byung Park
- Division of Biostatistics, Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Marci Messerle-Forbes
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Jeffrey T. Jensen
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon, United States of America
- Division of Reproductive Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Ilhem Messaoudi
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, California, United States of America
- Division of Reproductive Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Division of Pathobiology and Immunology, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- * E-mail:
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15
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Francis SC, Hou Y, Baisley K, van de Wijgert J, Watson-Jones D, Ao TT, Herrera C, Maganja K, Andreasen A, Kapiga S, Coulton GR, Hayes RJ, Shattock RJ. Immune Activation in the Female Genital Tract: Expression Profiles of Soluble Proteins in Women at High Risk for HIV Infection. PLoS One 2016; 11:e0143109. [PMID: 26814891 PMCID: PMC4729472 DOI: 10.1371/journal.pone.0143109] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/30/2015] [Indexed: 01/20/2023] Open
Abstract
Soluble cervicovaginal biomarkers of inflammation, immune activation and risk of HIV acquisition are needed to reliably assess the safety of new biomedical prevention strategies including vaccines and microbicides. However, a fuller understanding of expression profiles in women at high risk for HIV infection is crucial to the effective use of these potential biomarkers in Phase 3 trial settings. We have measured 45 soluble proteins and peptides in cervicovaginal lavage samples from 100 HIV negative women at high risk for HIV infection. Women were followed over one menstrual cycle to investigate modulation by hormonal contraception, menstrual cycle phase, recent sexual exposure and intravaginal practices. Women using injectable DMPA had increased concentration of several soluble proteins of the innate and adaptive immune system, including IL-1α, IL-1β, IL-2, MIP-1β, IP-10, IL-8, TGF-β, HBD4, IgA, IgG1, and IgG2. Women using combined oral contraceptives had a similar signature. There were differences in concentrations among samples from post-ovulation compared to pre-ovulation, notably increased immunoglobulins. Increased prostate-specific antigen, indicative of recent sexual exposure, was correlated with increased IL-6, MCP-1, and SLPI, and decreased GM-CSF and HBD3. The identified signature profiles may prove critical in evaluating the potential safety and impact on risk of HIV acquisition of different biomedical intervention strategies.
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Affiliation(s)
- Suzanna C. Francis
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- * E-mail:
| | - Yanwen Hou
- Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom
| | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Janneke van de Wijgert
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Trong T. Ao
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Carolina Herrera
- Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom
| | - Kaballa Maganja
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Aura Andreasen
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saidi Kapiga
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Gary R. Coulton
- Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom
| | - Richard J. Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robin J. Shattock
- Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom
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16
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Chronic fatigue syndrome and circulating cytokines: A systematic review. Brain Behav Immun 2015; 50:186-195. [PMID: 26148446 DOI: 10.1016/j.bbi.2015.07.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/11/2015] [Accepted: 07/02/2015] [Indexed: 01/11/2023] Open
Abstract
There has been much interest in the role of the immune system in the pathophysiology of chronic fatigue syndrome (CFS), as CFS may develop following an infection and cytokines are known to induce acute sickness behaviour, with similar symptoms to CFS. Using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines, a search was conducted on PubMed, Web of Science, Embase and PsycINFO, for CFS related-terms in combination with cytokine-related terms. Cases had to meet established criteria for CFS and be compared with healthy controls. Papers retrieved were assessed for both inclusionary criteria and quality. 38 papers met the inclusionary criteria. The quality of the studies varied. 77 serum or plasma cytokines were measured without immune stimulation. Cases of CFS had significantly elevated concentrations of transforming growth factor-beta (TGF-β) in five out of eight (63%) studies. No other cytokines were present in abnormal concentrations in the majority of studies, although insufficient data were available for some cytokines. Following physical exercise there were no differences in circulating cytokine levels between cases and controls and exercise made no difference to already elevated TGF-β concentrations. The finding of elevated TGF-β concentration, at biologically relevant levels, needs further exploration, but circulating cytokines do not seem to explain the core characteristic of post-exertional fatigue.
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17
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Fichorova RN, Chen PL, Morrison CS, Doncel GF, Mendonca K, Kwok C, Chipato T, Salata R, Mauck C. The Contribution of Cervicovaginal Infections to the Immunomodulatory Effects of Hormonal Contraception. mBio 2015; 6:e00221-15. [PMID: 26330510 PMCID: PMC4556810 DOI: 10.1128/mbio.00221-15] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 07/23/2015] [Indexed: 01/15/2023] Open
Abstract
UNLABELLED Particular types of hormonal contraceptives (HCs) and genital tract infections have been independently associated with risk of HIV-1 acquisition. We examined whether immunity in women using injectable depot medroxyprogesterone acetate (DMPA), combined oral contraceptives (COC), or no HCs differs by the presence of cervicovaginal infections. Immune mediators were quantified in cervical swabs from 832 HIV-uninfected reproductive-age Ugandans and Zimbabweans. Bacterial infections and HIV were diagnosed by PCR, genital herpes serostatus by enzyme-linked immunosorbent assay (ELISA), altered microflora by Nugent score, and Trichomonas vaginalis and Candida albicans infection by wet mount. Generalized linear models utilizing Box-Cox-Power transformation examined associations between levels of mediators, infection status, and HCs. In no-HC users, T. vaginalis was associated with broadest spectrum of aberrant immunity (higher interleukin 1β [IL-1β], IL-8, macrophage inflammatory protein 3α [MIP-3α], β-defensin 2 [BD2], and IL-1 receptor antigen [IL-1RA]). In women with a normal Nugent score and no genital infection, compared to the no-HC group, COC users showed higher levels of IL-1β, IL-6, IL-8, and IL-1RA, while DMPA users showed higher levels of RANTES and lower levels of BD2, both associated with HIV seroconversion. These effects of COC were blunted in the presence of gonorrhea, chlamydia, trichomoniasis, candidiasis, and an abnormal Nugent score; however, RANTES was increased among COC users with herpes, chlamydia, and abnormal Nugent scores. The effect of DMPA was exacerbated by lower levels of IL-1RA in gonorrhea, chlamydia, or herpes, SLPI in gonorrhea, and IL-1β, MIP-3α, and IL-1RA/IL1β ratio in trichomoniasis. Thus, the effects of HC on cervical immunity depend on the genital tract microenvironment, and a weakened mucosal barrier against HIV may be a combined resultant of genital tract infections and HC use. IMPORTANCE In this article, we show that in young reproductive-age women most vulnerable to HIV, hormonal contraceptives are associated with altered cervical immunity in a manner dependent on the presence of genital tract infections. Through altered immunity, hormones may predispose women to bacterial and viral pathogens; conversely, a preexisting specific infection or disturbed vaginal microbiota may suppress the immune activation by levonorgestrel or exacerbate the suppressed immunity by DMPA, thus increasing HIV risk by their cumulative action. Clinical studies assessing the effects of contraception on HIV susceptibility and mucosal immunity may generate disparate results in populations that differ by microbiota background or prevalence of undiagnosed genital tract infections. A high prevalence of asymptomatic infections among HC users that remain undiagnosed and untreated raises even more concerns in light of their combined effects on biomarkers of HIV risk. The molecular mechanisms of the vaginal microbiome's simultaneous interactions with hormones and HIV remain to be elucidated.
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Affiliation(s)
- Raina N Fichorova
- Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Kevin Mendonca
- Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Robert Salata
- Case Western Reserve University, Cleveland, Ohio, USA
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18
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Arslan SY, Yu Y, Burdette JE, Pavone ME, Hope TJ, Woodruff TK, Kim JJ. Novel three dimensional human endocervix cultures respond to 28-day hormone treatment. Endocrinology 2015; 156:1602-9. [PMID: 25635622 PMCID: PMC4399320 DOI: 10.1210/en.2014-1840] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The endocervix has both anatomical and biological functions that participate in the delicate balance between tolerance necessary for conception and protection from pathogens. Our goal was to develop a robust 3-dimensional (3D) endocervix model that was a reliable representation of the in vivo tissues and to identify the physiological responses to changing levels of steroid hormones during a 28-day time period. Human endocervical cells were grown on polystyrene scaffolds, and the morphologic and hormonal responses of cultured cells were assessed in response to fluctuating levels of estradiol (E2) or progesterone (P4). Morphologically, the 3D cultures were composed of a mixed population of cells, including epithelial and stromal cells. Treatment with E2 and P4 (d 28) increased cell growth and proliferation as compared with no treatment control. Cells expressed estrogen receptor and P4 receptor and produced both neutral and acidic mucins, including Mucin 16. In addition, a 45-plex Luminex assay identified numerous factors secreted and regulated by hormones. Specifically, IL-1β and leukemia inhibitory factor significantly decreased in the presence of E2 and P4 as compared with the no hormone control at day 26. Cotreatment with RU486 (mifepristone) attenuated the inhibition of IL-1β and leukemia inhibitory factor secretion. In summary, a robust, novel 3D endocervical culture was developed, and physiologic responses to the menstrual cycle mimic of E2 and P4 levels for a period of 28 days were identified.
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Affiliation(s)
- Sevim Yildiz Arslan
- Division of Reproductive Science in Medicine (S.Y.A., Y.Y., M.E.P., T.K.W., J.J.K.), Department of Obstetrics and Gynecology, and Department of Cell and Molecular Biology (T.J.H.), Northwestern University, Chicago, Illinois 60611; Department of Medicinal Chemistry and Pharmacognosy (J.E.B.), University of Illinois at Chicago, Chicago, Illinois 60607; and Division of Reproductive Endocrinology and Infertility (M.E.P.), Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois 60611
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Kollmann Z, Bersinger N, von Wolff M, Thurman AR, Archer DF, Stute P. Vaginal cytokines do not correlate with postmenopausal vulvovaginal symptoms. Gynecol Endocrinol 2015; 31:317-21. [PMID: 25559048 DOI: 10.3109/09513590.2014.995080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Exploratory pilot study to determine the correlation between postmenopausal vulvovaginal symptoms and vaginal cytokine levels. METHODS Postmenopausal women (n = 34) not using menopausal hormone therapy and presenting with or without symptoms of vulvovaginal irritation were screened. Each participant underwent a vaginal examination and screening for vaginitis. A cervicovaginal lavage (CVL) with sterile saline and a peripheral blood sample were obtained. Main outcome measures were assessed by Luminex® X-map method on the Bio-Plex® platform. Main outcome measures were cervicovaginal and serum interleukin (IL)-4, IL-5, IL-10, IL-12, IL-13, TNF-α, GM-CSF, MIP-1-alpha and RANTES level. Cervicovaginal cytokines were adjusted to total protein concentration [pg/mcg protein]. RESULTS Twenty-six postmenopausal women were enrolled (symptomatic: n = 15; asymptomatic: n = 11). There were no significant differences between groups: age, age at menopause, vaginal pH and all CVL and serum cytokines (IL-4, IL-5, IL-10, IL-12, IL-13, TNF-α, GM-CSF, MIP-1-alpha and RANTES). GM-CSF was the most abundant vaginal cytokine (symptomatic: 146.5 ± 165.6 pg/mcg protein; asymptomatic: 146.0 ± 173.5 pg/mcg protein; p = 0.99). CONCLUSIONS Postmenopausal vulvovaginal symptoms did not correlate with vaginal inflammatory marker. There was no difference in serum or CVL cytokines between symptomatic and asymptomatic postmenopasual women. Vaginal symptoms after menopause are not related to the vaginal cytokine changes associated with loss of estrogen.
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Affiliation(s)
- Zahraa Kollmann
- Department of Obstetrics and Gynecology, University of Berne , Bern , Switzerland and
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20
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The role of sex hormones in immune protection of the female reproductive tract. Nat Rev Immunol 2015; 15:217-30. [PMID: 25743222 DOI: 10.1038/nri3819] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Within the human female reproductive tract (FRT), the challenge of protection against sexually transmitted infections (STIs) is coupled with the need to enable successful reproduction. Oestradiol and progesterone, which are secreted during the menstrual cycle, affect epithelial cells, fibroblasts and immune cells in the FRT to modify their functions and hence the individual's susceptibility to STIs in ways that are unique to specific sites in the FRT. The innate and adaptive immune systems are under hormonal control, and immune protection in the FRT varies with the phase of the menstrual cycle. Immune protection is dampened during the secretory phase of the cycle to optimize conditions for fertilization and pregnancy, which creates a 'window of vulnerability' during which potential pathogens can enter and infect the FRT.
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Wira CR, Rodriguez-Garcia M, Patel MV, Biswas N, Fahey JV. Endocrine Regulation of the Mucosal Immune System in the Female Reproductive Tract. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00110-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Vaginal cytokines do not differ between postmenopausal women with and without symptoms of vulvovaginal irritation. Menopause 2014; 21:840-5. [DOI: 10.1097/gme.0000000000000179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cervical inflammation and immunity associated with hormonal contraception, pregnancy, and HIV-1 seroconversion. J Acquir Immune Defic Syndr 2014; 66:109-17. [PMID: 24413042 DOI: 10.1097/qai.0000000000000103] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Hormonal contraception (HC), younger age, and pregnancy have been associated with increased HIV risk in some studies. We sought to elucidate the biological mechanisms for these associations. DESIGN Case-control selection of specimens from a large, prospective, clinical study. METHODS We enrolled and followed 4531 HIV-negative women from Uganda and Zimbabwe using either the injectable depo-medroxyprogesterone acetate (DMPA), combined oral contraception, or no HC (NH). Innate immunity mediators were measured in cervical samples collected from women at their visit before HIV seroconversion (n = 199) and matched visits from women remaining HIV uninfected (n = 633). Generalized linear models were applied after Box-Cox power transformation. RESULTS Higher RANTES and lower secretory leukocyte protease inhibitor (SLPI) levels were associated with HIV seroconversion. DMPA users had higher RANTES and lower BD-2 levels. Most inflammation-promoting and/or inflammation-inducible mediators were higher [interleukin (IL)-1β, IL-6, IL-8, MIP-3α, vascular endothelial growth factor, and SLPI], and the protective BD-2 and IL-1RA:IL-1β ratio were lower among combined oral contraception users. Pregnant women showed a similar cervical immunity status (higher IL-1β, IL-6, IL-8, vascular endothelial growth factor, SLPI, and IL-1RA; lower IL-1RA:IL-1β). Age <25 years was associated with lower SLPI, IL-8, MIP-3α but higher IL-1RA:IL-1β. Zimbabwean women (with higher HIV seroconversion rates) had overall higher pro-inflammatory and lower anti-inflammatory protein levels than Ugandan women. CONCLUSIONS HC use, pregnancy, and young age alter cervical immunity in different ways known to increase risk of HIV, for example, through increased levels of pro-inflammatory cytokines or decreased levels of SLPI. Higher levels of RANTES may be one factor underlying a possible association between DMPA use and risk of HIV acquisition.
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Patel MV, Ghosh M, Fahey JV, Ochsenbauer C, Rossoll RM, Wira CR. Innate immunity in the vagina (Part II): Anti-HIV activity and antiviral content of human vaginal secretions. Am J Reprod Immunol 2014; 72:22-33. [PMID: 24806967 DOI: 10.1111/aji.12218] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 01/21/2014] [Indexed: 01/23/2023] Open
Abstract
PROBLEM Whether the concentrations of antiviral proteins, and anti-HIV activity, within human vaginal secretions change across the menstrual cycle is unknown. METHOD OF STUDY Using a menstrual cup, vaginal secretions from pre-menopausal women were recovered at the proliferative (d6-8), mid-cycle (d13-15), and secretory (d21-23) stages of the menstrual cycle. Antiviral protein concentration was determined by ELISA, and anti-HIV activity assessed using the TZM-bl reporter cell line. RESULTS CCL20, RANTES, elafin, HBD2, SDF-1α, and IL-8 levels were detectable in the secretions. Vaginal secretions had anti-HIV activity against specific clade B strains of HIV, with significant inhibition of IIIB and increased infectivity of transmitted/founder CH077.t. No significant differences in either antiviral protein concentration or anti-HIV activity with respect to menstrual cycle stage were measured, but marked differences were observed in both parameters over the course of the cycle between different women and in consecutive cycles from the same woman. CONCLUSION The vagina contains a complement of antiviral proteins. The variation in anti-HIV activity demonstrates that immune protection in the vagina is not constant. Intra- and interindividual variations suggest that factors in addition to sex hormones influence antiviral protection. Lastly, the menstrual cup is a new model for recovering undiluted vaginal secretions from women throughout their reproductive life.
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Affiliation(s)
- Mickey V Patel
- Department of Physiology and Neurobiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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Whitcomb BW, Mumford SL, Perkins NJ, Wactawski-Wende J, Bertone-Johnson ER, Lynch KE, Schisterman EF. Urinary cytokine and chemokine profiles across the menstrual cycle in healthy reproductive-aged women. Fertil Steril 2014; 101:1383-91. [PMID: 24581581 DOI: 10.1016/j.fertnstert.2014.01.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 01/15/2014] [Accepted: 01/16/2014] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To assess the utility of urinary cytokines for monitoring reproductive function by considering detection, variation across the menstrual cycle, and relations with hormones. DESIGN Longitudinal cohort study. SETTING Academic institution. PATIENT(S) Healthy, reproductive-aged women with self-reported regular menstrual cycles and at least one observed ovulatory cycle (n = 248). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Urinary cytokines measured by 30-plex immunoassays in 3,550 biospecimens, and nested random-effects analysis of variance (ANOVA) and marginal structural models used to evaluate variability and relations with hormones. RESULT(S) For 24 of 30 evaluated factors, detectable levels were observed in at least 50% of urine samples. Interleukin-6 (IL-6), IL-8, IL-10, IL-15, granulocyte colony stimulating factor (G-CSF), hepatocyte growth factor (HGF), interferon-α (IFN-α), and RANTES (regulated upon activation normal T-cell expressed and secreted) levels varied significantly across the menstrual cycle. The proinflammatory factors IL-1β, IL-6, IL-8, and HGF were 1.5-3 times higher during menses than the late follicular phase. In marginal structural models, IL-1β, IL-6, IL-8 were associated with lower estradiol and progesterone concentrations. CONCLUSION(S) Variability during the menstrual cycle and correlations with reproductive hormone levels support a role of cytokines in the menstrual cycle; however, because of the limited variability for most cytokines considered, the utility of urine as a matrix for assessment of inflammation in menstrual cycle function appears limited for clinical purposes.
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Affiliation(s)
- Brian W Whitcomb
- Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts.
| | - Sunni L Mumford
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Neil J Perkins
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, State University of New York, Buffalo, New York
| | | | - Kristine E Lynch
- Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts
| | - Enrique F Schisterman
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Forcey DS, Hocking JS, Tabrizi SN, Bradshaw CS, Chen MY, Fehler G, Nash JL, Fairley CK. Chlamydia detection during the menstrual cycle: a cross-sectional study of women attending a sexual health service. PLoS One 2014; 9:e85263. [PMID: 24475042 PMCID: PMC3903481 DOI: 10.1371/journal.pone.0085263] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/25/2013] [Indexed: 12/03/2022] Open
Abstract
Background We investigated the detection of chlamydia at different stages of the menstrual cycle. Methods Electronic medical records for women attending Melbourne Sexual Health Centre between March 2011 and 31st December 2012, who were tested for chlamydia by nucleic acid amplification of high vaginal, cervical, or urinary samples, and who recorded a date of last normal menstrual period (LNMP) between 0–28 days were included in the analysis. Logistic regression was used to calculate adjusted odds ratio (aOR) and 95% confidence intervals (CI) for the association of chlamydia with menstrual cycle adjusted by demographics and behavioural variables. Chlamydia and beta globin load were determined on those with stored samples. Results Of the 10,017 consultations that included a test for chlamydia and a valid LNMP, there were 417 in which chlamydia was detected. The proportion of samples with chlamydia was greater in the luteal phase (4.8%, 184/3831) than in the follicular phase (3.4%, 233/6816) both in the crude (OR 1.29 95%CI 1.1–1.6, p = 0.01) and adjusted odds ratio (aOR) 1.4 (95%CI 1.1–1.8, p = 0.004). Among women using hormonal contraception, there was no significant association with the luteal phase of the menstrual cycle (aOR 1.3, 95%CI 0.9, 1.8, p = 0.18). Among women not using hormonal contraception, there was a significant association with the luteal phase (aOR 1.6, (95% CI 1.1–2.3, p = 0.007). The chlamydia load was not significantly different in the 329 positive stored samples in weeks 3 and 4 vs weeks 1 and 2 for any site (P>0.12). Conclusions The higher detection of chlamydia detection in the luteal phase of the menstrual cycle in only those not taking hormonal contraception suggest that hormonal factors influence chlamydia detection. The absence of a significantly highly chlamydia load in women during the luteal phase raises questions about the mechanism.
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Affiliation(s)
- Dana S. Forcey
- Melbourne Sexual Health Centre, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane S. Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sepehr N. Tabrizi
- Department of Clinical Microbiology and Infectious Diseases, Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catriona S. Bradshaw
- Melbourne Sexual Health Centre, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Marcus Y. Chen
- Melbourne Sexual Health Centre, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Glenda Fehler
- Melbourne Sexual Health Centre, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica L. Nash
- Melbourne Sexual Health Centre, Melbourne, Victoria, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- * E-mail:
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Abstract
BACKGROUND Self-administered swabs are used to sample vaginal contents for a variety of clinical purposes including detection of sexually transmitted infections, condom breakage, and vaginal product use. The goal of this study was to determine whether a quantitative glycogen assay can be used to assess whether a swab has been exposed to the vagina to assure study compliance. STUDY DESIGN Buccal, skin, or vaginal samples were tested to determine whether a commercial quantitative glycogen assay can differentiate vaginal specimens. In addition, archived remnant de-identified vaginal swabs from clinical trials were tested. Periodic acid-Schiff stain was used to identify glycogen-positive cells as a confirmation test. RESULTS Glycogen concentrations in eluates of vaginal swabs from reproductive-aged women were significantly higher than those from unused swabs (mean ± SE, 964 ± 135 μg/mL vs. 14.7 ± 2.5 μg/mL, P < 0.001) and swabs exposed to buccal and finger/hand epithelia (40.3 ± 4.8 and 18.5 ± 5.4 μg/mL, P < 0.001). Glycogen concentrations were lower and more variable in vaginal swabs from older perimenopausal/menopausal women (mean ± SE, 235 ± 123, P < 0.01). Semen and sample storage longer than 1 year did not affect glycogen detection. Using a cutoff of 100 μg/mL of glycogen, 30 of 30 vaginal swabs from reproductive-aged women versus 0 of 28 control swabs were positive, for an assay sensitivity of 1 (95% confidence interval, 0.86-1) and specificity of 1 (95% confidence interval, 0.85-1). Periodic acid-Schiff stain correlated with soluble glycogen results but was less specific. CONCLUSIONS The quantitative glycogen assay provides a simple and inexpensive method to validate the use of self-administered swabs for sampling vaginal contents in clinical studies.
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Kyongo JK, Jespers V, Goovaerts O, Michiels J, Menten J, Fichorova RN, Crucitti T, Vanham G, Ariën KK. Searching for lower female genital tract soluble and cellular biomarkers: defining levels and predictors in a cohort of healthy Caucasian women. PLoS One 2012; 7:e43951. [PMID: 22952818 PMCID: PMC3432048 DOI: 10.1371/journal.pone.0043951] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 07/27/2012] [Indexed: 02/04/2023] Open
Abstract
Background High concentrations of pro-inflammatory cytokines have been previously observed in the genital fluids of women enrolled in microbicide trials and may explain observed increased HIV transmission in some of these trials. Although the longitudinal nature of these studies allows within-subject comparisons of post-product levels to baseline levels, the fact that the physiologic variations of these cytokines and other markers of immune activation are not fully defined in different populations, makes it difficult to assess changes that can be directly attributed to microbicide use as opposed to other biological and behavioural factors. Methods Cervicovaginal lavage samples were collected from 30 healthy Caucasian and assayed for concentrations of ten cytokines/chemokines, total protein content and two antimicrobial proteins using a multiplex immunoassay and ELISA. Cellular markers were characterized by flow cytometry on mononuclear cells collected from the endocervix using flocked swabs. Bacterial quantification was performed using quantitative PCR. Results Ectopy, menstrual cycle phase, prostate-specific antigen and presence of leucocytes in endocervical cells' supernatant were associated with the concentrations of cyto-/chemokines in cervicovaginal secretions. Approximately 3% of endocervical cells collected were monocytes of which a median of 52% (SD = 17) expressed both CD4 and CCR5 markers. Approximately 1% of the total cells were T-cells with a median of 61% (SD = 10) CD4 and CCR5 expression. Around 5% of the monocytes and 16% of the T-cells expressed the immune activation marker HLA-DR. Higher percentages of T-cells were associated with greater quantities of IL-1RA, GM-CSF and elafin. Conclusion We demonstrate the presence of selected soluble and cellular immune activation markers and identify their predictors in the female genital tract of healthy women. Future clinical trials should consider ectopy, sexual activity, menstrual cycle phase and presence of bacterial species as possible confounders when evaluating the possible inflammatory effects of microbicide compounds.
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Affiliation(s)
- Jordan K. Kyongo
- Virology Unit, Division of Microbiology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Vicky Jespers
- ITM HIV/AIDS Centre, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Odin Goovaerts
- Immunology Unit, Division of Microbiology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Johan Michiels
- Virology Unit, Division of Microbiology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Joris Menten
- Clinical Trials Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Raina N. Fichorova
- Laboratory of Genital Tract Biology, Department of Obstetrics, Gynaecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Tania Crucitti
- HIV/STI Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Institute of Tropical Medicine, Antwerp, Belgium
| | - Guido Vanham
- Virology Unit, Division of Microbiology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Faculty of Pharmaceutical, Veterinary and Biomedical Sciences, University of Antwerp, Antwerp, Belgium and Faculty of Medicine and Pharmacology, University of Brussels, Brussels, Belgium
| | - Kevin K. Ariën
- Virology Unit, Division of Microbiology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
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Lattie EG, Antoni MH, Fletcher MA, Penedo F, Czaja S, Lopez C, Perdomo D, Sala A, Nair S, Fu SH, Klimas N. Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome. Brain Behav Immun 2012; 26:849-58. [PMID: 22417946 PMCID: PMC3572196 DOI: 10.1016/j.bbi.2012.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Revised: 02/19/2012] [Accepted: 02/22/2012] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Stressors and emotional distress responses impact chronic fatigue syndrome (CFS) symptoms, including fatigue. Having better stress management skills might mitigate fatigue by decreasing emotional distress. Because CFS patients comprise a heterogeneous population, we hypothesized that the role of stress management skills in decreasing fatigue may be most pronounced in the subgroup manifesting the greatest neuroimmune dysfunction. METHODS In total, 117 individuals with CFS provided blood and saliva samples, and self-report measures of emotional distress, perceived stress management skills (PSMS), and fatigue. Plasma interleukin-1-beta (IL-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), and diurnal salivary cortisol were analyzed. We examined relations among PSMS, emotional distress, and fatigue in CFS patients who did and did not evidence neuroimmune abnormalities. RESULTS Having greater PSMS related to less fatigue (p=.019) and emotional distress (p<.001), greater diurnal cortisol slope (p=.023) and lower IL-2 levels (p=.043). PSMS and emotional distress related to fatigue levels most strongly in CFS patients in the top tercile of IL-6, and emotional distress mediated the relationship between PSMS and fatigue most strongly in patients with the greatest circulating levels of IL-6 and a greater inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio. DISCUSSION CFS patients having greater PSMS show less emotional distress and fatigue, and the influence of stress management skills on distress and fatigue appear greatest among patients who have elevated IL-6 levels. These findings support the need for research examining the impact of stress management interventions in subgroups of CFS patients showing neuroimmune dysfunction.
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Affiliation(s)
| | | | - Mary Ann Fletcher
- Department of Medicine, University of Miami, Miller School of Medicine, FL, USA
| | - Frank Penedo
- Department of Psychology, University of Miami, FL, USA,Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, FL, USA
| | - Sara Czaja
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, FL, USA
| | - Corina Lopez
- Department of Psychology, University of Miami, FL, USA
| | - Dolores Perdomo
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, FL, USA
| | - Andreina Sala
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, FL, USA
| | - Sankaran Nair
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, FL, USA
| | - Shih Hua Fu
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miller School of Medicine, FL, USA
| | - Nancy Klimas
- Department of Medicine, University of Miami, Miller School of Medicine, FL, USA
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Measurement of mucosal biomarkers in a phase 1 trial of intravaginal 3% StarPharma LTD 7013 gel (VivaGel) to assess expanded safety. J Acquir Immune Defic Syndr 2012; 59:134-40. [PMID: 22067666 DOI: 10.1097/qai.0b013e31823f2aeb] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to examine the effect of the 3% StarPharma LTD 7013 gel (VivaGel) on mucosal immune markers hypothesized to be associated with HIV-1 acquisition. DESIGN Phase 1, placebo-controlled, randomized, double-blind clinical trial was performed in 54 young women in the United States and Kenya. Participants used carbopol gel with and without (placebo) StarPharma LTD 7013 twice daily over 14 days. Cervical specimens were collected for cytokines, chemokines, T cells, and dendritic cells at days 0, 7, 14, and 21. A negative binomial regression model was used to assess differences between study arms. RESULTS Several mucosal immune parameters were increased in the VivaGel arm compared with placebo. For cytokines D7, IL-6 (P = 0.05); D 14, interferon gamma (P = 0.03), IL-2 (P = 0.04), IL-5 (P = 0.003), and IL-10 (P = 0.001) were increased. On D7, CD8+/CD69+ T cells tended to be increased (P < 0.08); limiting analysis to visits without blood or bacterial vaginosis, these findings were stronger as follows: at D7, CD8+/CD69+ T cells were increased in the VivaGel arm (P < 0.005), as were CD4+/CD69+ cells (P = 0.001) and CD4+/CCR5+ T cells (P = 0.01). The changes described for D7 and 14 were no longer seen at D21. CONCLUSIONS Markers associated with inflammation and epithelial damage were reversibly elevated in the VivaGel arm compared with the placebo arm after 7-14 days of twice daily product use.
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Schapher M, Wendler O, Gröschl M. Salivary cytokines in cell proliferation and cancer. Clin Chim Acta 2011; 412:1740-8. [PMID: 21736875 DOI: 10.1016/j.cca.2011.06.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 06/19/2011] [Accepted: 06/21/2011] [Indexed: 01/08/2023]
Abstract
While the presence of multiple systemic steroids, amines and peptides in saliva has been reported, other hormones of the circulation do not appear in saliva. Substances present within saliva may be classified in different groups: first, those which passively display blood plasma concentrations and constitute a promising alternative to evaluate certain systemic parameters. Second, molecules which seem to play a more active, regulatory role within the upper gastrointestinal tract. Concerning the latter, a growing awareness, especially with regards to salivary peptides has been established. Up to now, understanding the distinct effects of salivary peptides known so far is in its infancy. Various publications, however, emphasize important effects of their presence. Salivary peptides can influence inflammatory processes and cell proliferation in epithelia of the upper digestive tract. These include transforming growth factors (TGFs), epidermal growth factors (EGFs), vascular endothelial growth factors (VEGFs) as well as amines such as melatonin. Of those, candidate cytokines like interleukin 8, tumor necrosis factors (TNFs) and leptin are involved in neoplastic activities of salivary glands and the oral cavity. The exact mechanisms of action are not yet completely understood, but their presence can be utilized for diagnostic purposes. Salivary gland tumors in patients may, in certain circumstances, be identified by saliva diagnostics. Saliva samples of the concerned patients, for instance, reveal significantly higher leptin concentrations than those of healthy individuals. Numerous studies postulate that, beside single indicators, the establishment of salivary hormone profiles may assist clinicians and researchers in detecting tumors and other pathologies of the oral cavity, including adjacent tissues, with high sensitivity and specificity.
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Affiliation(s)
- Mirco Schapher
- University of Erlangen-Nuremberg, Department of Otorhinolaryngology, Head and Neck Surgery, Germany.
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Adipose tissue and reproduction in women. Fertil Steril 2010; 94:795-825. [DOI: 10.1016/j.fertnstert.2009.03.079] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Revised: 03/20/2009] [Accepted: 03/24/2009] [Indexed: 12/20/2022]
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O’Connor MF, Bower JE, Cho HJ, Creswell JD, Dimitrov S, Hamby ME, Hoyt MA, Martin JL, Robles TF, Sloan EK, Thomas KS, Irwin MR. To assess, to control, to exclude: effects of biobehavioral factors on circulating inflammatory markers. Brain Behav Immun 2009; 23:887-97. [PMID: 19389469 PMCID: PMC2749909 DOI: 10.1016/j.bbi.2009.04.005] [Citation(s) in RCA: 384] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 04/14/2009] [Accepted: 04/14/2009] [Indexed: 01/22/2023] Open
Abstract
Behavioral scientists have increasingly included inflammatory biology as mechanisms in their investigation of psychosocial dynamics on the pathobiology of disease. However, a lack of standardization of inclusion and exclusion criteria and assessment of relevant control variables impacts the interpretation of these studies. The present paper reviews and discusses human biobehavioral factors that can affect the measurement of circulating markers of inflammation. Keywords relevant to inflammatory biology and biobehavioral factors were searched through PubMed. Age, sex, and hormonal status, socioeconomic status, ethnicity and race, body mass index, exercise, diet, caffeine, smoking, alcohol, sleep disruption, antidepressants, aspirin, and medications for cardiovascular disease are all reviewed. A tiered set of recommendations as to whether each variable should be assessed, controlled for, or used as an exclusion criteria is provided. These recommendations provide a framework for observational and intervention studies investigating linkages between psychosocial and behavioral factors and inflammation.
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Affiliation(s)
- Mary-Frances O’Connor
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
| | - Julie E. Bower
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA), Department of Psychology, UCLA
| | - Hyong Jin Cho
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
| | | | - Stoyan Dimitrov
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
| | - Mary E. Hamby
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
| | | | - Jennifer L. Martin
- Department of Medicine, UCLA and Veterans Administration Greater Los Angeles Healthcare System, Geriatrics Research, Education and Clinical Center
| | | | - Erica K. Sloan
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
| | - KaMala S. Thomas
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
| | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA)
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O'Connor MF, Irwin MR, Wellisch DK. When grief heats up: pro-inflammatory cytokines predict regional brain activation. Neuroimage 2009; 47:891-6. [PMID: 19481155 DOI: 10.1016/j.neuroimage.2009.05.049] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 05/12/2009] [Accepted: 05/14/2009] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Pro-inflammatory cytokines are associated with sickness behaviors, a set of behaviors including low mood, which are orchestrated by the brain and described as shift in motivational state. The present study investigated the hypothesis that local inflammation is associated with greater subgenual anterior cingulate cortex (sACC) activation in persons undergoing chronic stress. METHODS Women undergoing the emotional stress of bereavement had fMRI scans during a grief elicitation task. Local inflammation was measured by salivary concentrations of two markers of pro-inflammatory cytokine activity (e.g., interleukin-1beta and soluble tumor necrosis factor receptor II). RESULTS Analyses revealed that both inflammatory markers were positively associated with ventral prefrontal activation (e.g., sACC and orbitofrontal cortex) as well as other regions important in the emotional task such as noun retrieval (e.g., temporal cortex), and visual processing (e.g., cuneus and fusiform gyrus). In separate analyses, the ventral prefrontal activations correlated with free recall of grief-related word stimuli, but not neutral word stimuli. CONCLUSIONS This is the first study to demonstrate the relationship between emotional processing, regional brain activation and localized inflammation in a chronically stressed population of adults.
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Affiliation(s)
- Mary-Frances O'Connor
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, USA.
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Ouellette AL, Li JJ, Cooper DE, Ricco AJ, Kovacs GTA. Evolving Point-of-Care Diagnostics Using Up-Converting Phosphor Bioanalytical Systems. Anal Chem 2009; 81:3216-21. [DOI: 10.1021/ac900475u] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Anderson DJ, Williams DL, Ballagh SA, Barnhart K, Creinin MD, Newman DR, Bowman FP, Politch JA, Duerr AC, Jamieson DJ. Safety analysis of the diaphragm in combination with lubricant or acidifying microbicide gels: effects on markers of inflammation and innate immunity in cervicovaginal fluid. Am J Reprod Immunol 2009; 61:121-9. [PMID: 19143675 DOI: 10.1111/j.1600-0897.2008.00670.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Diaphragms are being considered for use with vaginal microbicide gels to provide enhanced protection against sexually transmitted pathogens. The purpose of this study was to determine whether use of a diaphragm with microbicide or placebo gel causes cervicovaginal inflammation or perturbations in cervicovaginal immune defense. METHOD OF STUDY Eighty-one non-pregnant women were randomized into three groups and instructed to use Milex (CooperSurgical, Inc., Trumbull, CT, USA)diaphragms overnight for 14 days in combination with one of the two acid-buffering microbicide gels [ACIDFORM (Instead Inc., La Jolla, CA, USA) or BufferGel(trade mark) (BG; ReProtect Inc., Baltimore, Maryland)] or placebo gel (K-Y Jelly); Personal Products Inc., Raritan, NJ, USA). Cervicovaginal lavages (CVLs) were performed prior to study entry and on days 8 and 16. Nine soluble mediators of vaginal inflammation or immune defense were measured in CVLs by Bio-Plex or ELISA. RESULTS Use of diaphragms with placebo or microbicide gel was not associated with increased levels of inflammation markers. Concentrations of secretory leukocyte protease inhibitor (SLPI) were markedly reduced in the BG group. CONCLUSION Daily use of a diaphragm with placebo or acidifying microbicide gel did not cause cervicovaginal inflammation. However, diaphragm/BG use was associated with markedly reduced levels of SLPI, an important mediator of innate immune defense. Further studies are warranted to establish the safety of diaphragm/microbicide gel combinations.
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Affiliation(s)
- Deborah J Anderson
- Department of Obstetrics and Gynecology, Boston University School of Medicine, 670 Albany St., Suite 516, Boston, MA 02118, USA.
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Joshi SN, Das S, Thakar M, Sahasrabuddhe V, Kumar BK, Callahan M, Mauck C. Colposcopically observed vascular changes in the cervix in relation to the hormonal levels and menstrual cycle. J Low Genit Tract Dis 2008; 12:293-9. [PMID: 18820544 PMCID: PMC4123683 DOI: 10.1097/lgt.0b013e31817efbbd] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We assessed colposcopically observed vascular changes occurring in the cervix in relation to cyclical hormonal variation in healthy women. MATERIALS AND METHODS Thirty women with regular menstrual cycles and willing to remain sexually abstinent during a menstrual cycle were enrolled. Colposcopy was performed during the peak of the estrogen and progesterone levels. RESULTS The mean (+/-SD) diameter of the largest visible blood vessel differed significantly between the estrogenic phase (0.38 +/- 0.14 mm) as compared with the progestogenic phase (0.47 +/- 0.12 mm; p <.01). The blood vessels were more prominent and dense and had a well-defined outline during the progestogenic phase than the estrogenic phase; however, these differences were not statistically significant. There was borderline increase in the interleukin 8 level during the estrogenic phase. CONCLUSIONS Physiological changes of increased vascularity of the cervix observed colposcopically during the progestogenic phase are normal. If such changes do not correspond to the menstrual cycle phase in women using vaginal microbicides in early-phase clinical trials, presence of inflammatory markers should be evaluated. Elevated interleukin 8 during the estrogenic phase needs further evaluation.
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Systemic and mucosal immunological responses during repeated mucosal SHIV162P3 challenges prior to and following infection in pigtailed macaques. Virology 2008; 375:492-503. [DOI: 10.1016/j.virol.2008.01.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 12/23/2007] [Accepted: 01/28/2008] [Indexed: 11/18/2022]
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Effect of recombinant human TNF–binding protein-1 and GnRH antagonist on mRNA expression of inflammatory cytokines and adhesion and growth factors in endometrium and endometriosis tissues in baboons. Fertil Steril 2008; 89:1306-13. [DOI: 10.1016/j.fertnstert.2006.11.205] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Revised: 11/21/2006] [Accepted: 11/27/2006] [Indexed: 11/15/2022]
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Ostanin AA, Aizikovich BI, Aizikovich IV, Kozhin AY, Chernykh ER. Role of cytokines in the regulation of reproductive function. Bull Exp Biol Med 2007; 143:75-9. [PMID: 18019018 DOI: 10.1007/s10517-007-0021-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The levels of 17 cytokines in the follicular fluid were measured by multiplex proteome analysis at the peak of stimulated ovulation during the in vitro fertilization cycle. In patients with ineffective folliculogenesis, the concentrations of IL-2, IL-4, IL-7, and granulocytic CSF in the follicular fluid were significantly lower than in women with greater mean number of collected oocytes. It was shown that multicomponent cytokine deficit was associated with lower production of high quality oocytes and lower efficiency of fertilization of the resultant oocytes in vitro. The absence of pregnancy after in vitro fertilization cycle is associated with lower levels of IL-2, IL-4, IL-7, granulocytic CSF, and macrophagic inflammatory protein 1b in combination with elevated contents of IL-8 and IL-13. The results attest to an important role of cytokines in the regulation of oogenesis and in preparation of the endometrium to implantation of the embryo.
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Affiliation(s)
- A A Ostanin
- Institute of Clinical Immunology, Siberian Division of Russian Academy of Medical Sciences, Novosibirsk.
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Passmore JAS, Morroni C, Shapiro S, Williamson AL, Hoffman M. Papanicolaou smears and cervical inflammatory cytokine responses. JOURNAL OF INFLAMMATION-LONDON 2007; 4:8. [PMID: 17456234 PMCID: PMC1868022 DOI: 10.1186/1476-9255-4-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 04/24/2007] [Indexed: 11/23/2022]
Abstract
In a case-control study among 2064 South African women to investigate the risk of clinically invasive cancer of the cervix, we found a marked reduction in the risk of cervical cancer among women who gave a history of ever having undergone even a single Pap smear, and a statistically significant decline in the HPV positivity rate correlated with the lifetime number of Pap smears received. HPV infections and their associated low-grade lesions commonly regress, indicating that most often there is an effective host immune response against HPV infection. We hypothesized that act of performing a Pap smear is associated with inflammatory responses at the site of trauma, the cervix, and that this inflammatory signalling may be an immunological factor initiating these productive anti-HPV responses. In the present study, a randomized controlled trial, we enrolled 80 healthy young women to investigate the impact of performing a Pap smear on cervical inflammation. Forty one women, in the intervention group, received a Pap smear at enrollment and cervicovaginal lavages (CVLs) were collected at baseline and 2 weeks later. Thirty nine women received no intervention at enrollment (control group) but CVLs were collected at enrolment and 2 weeks later. We assessed various markers of inflammation including IL-12 p70, TNF-α, IL-8, IL-6, IL-10, and IL-1β in CVL specimens. While CVL levels of IL-8, IL-1β and IL-6 remained unchanged following a Pap smear, markers of cell mediated immunity (IL-12 p70 and TNF-α) and T cell regulation (IL-10) were significantly elevated.
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Affiliation(s)
- Jo-Ann S Passmore
- Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Chelsea Morroni
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Samual Shapiro
- Department Of Epidemiology, Mailman School of Public Health, New York, USA
| | - Anna-Lise Williamson
- Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Margaret Hoffman
- Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Mandhane PJ, Greene JM, Sears MR. Interactions between breast-feeding, specific parental atopy, and sex on development of asthma and atopy. J Allergy Clin Immunol 2007; 119:1359-66. [PMID: 17353035 DOI: 10.1016/j.jaci.2007.01.043] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 01/15/2007] [Accepted: 01/25/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND The influence of breast-feeding on the risk of developing atopy and asthma remains controversial. OBJECTIVE To examine asthma and atopy outcomes by sex, reported specific parental history of atopy, and breast-feeding. METHODS In a birth cohort, we examined childhood asthma and atopy (positive skin prick tests) by sex and breast-feeding in relation to maternal and paternal atopy. Interactions were explored in logistic regression models. RESULTS For boys, breast-feeding (odds ratio [OR], 1.63; 95% CI, 0.93-2.87; P = .09) and maternal atopy (OR, 1.95; 95% CI, 0.93-4.08; P = .08) were each associated with atopy at age 13 years. Breast-feeding increased the risk for atopy among boys with paternal atopy (OR, 7.39; 95% CI, 2.21-24.66) compared with non-breast-fed boys with paternal atopy, but did not significantly further increase risk among subjects with maternal atopy. For girls, breast-feeding (OR, 0.74; 95% CI, 0.41-1.31) and maternal and paternal atopy were not independent risk factors for atopy at age 13 years. However, breast-feeding increased the risk for atopy in girls with maternal atopy (OR, 3.13; 95% CI, 1.20-8.14) compared with non-breast-fed girls with maternal atopy. There was no such effect among subjects with paternal atopy. Results for the outcome of asthma followed a similar pattern. CONCLUSION The influence of breast-feeding on development of atopy and asthma differs by sex and by maternal and paternal atopy, and is most significant among subjects at lower baseline risk. CLINICAL IMPLICATIONS Analyses of environmental risk factors for asthma and atopy should be stratified by specific parental atopy and sex.
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Affiliation(s)
- Piush J Mandhane
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, and Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Gosman GG, Katcher HI, Legro RS. Obesity and the role of gut and adipose hormones in female reproduction. Hum Reprod Update 2006; 12:585-601. [PMID: 16775192 DOI: 10.1093/humupd/dml024] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Reproductive function declines at both extremes of human energy balance. The relationship between obesity and reproductive function is complex and incompletely understood. The literature has established the negative impact of excess energy stores on ovulatory function and investigated the mechanisms whereby this occurs. Furthermore, weight loss in obese anovulatory women increases ovulation and conception. Obesity and anti-obesity therapy effects on the endometrium, implantation and early fetal development have received less attention. The discovery of adipokines and enterokines greatly expands the ability to investigate the relationship between obesity, therapies to produce weight loss and reproductive function. In this review, we discuss select adipose and enteric signals. We focus on in vitro, animal and human data that lend biological plausibility to adipokines and enterokines as mediators of obesity and reproduction. Very little published work exists that directly addresses adipocyte and enteric signals in this specific role; therefore, much of this review is on the basis of a synthesis of the literature in three areas: (i) in vitro and in vivo evidence regarding the reproductive effects of these signals; (ii) adipokine and enterokine changes that occur with weight-loss therapies, focusing on hypocaloric diets, bariatric surgery and drugs that target adipocyte or enteric signals and (iii) reproductive changes produced by these weight-loss therapies.
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Affiliation(s)
- Gabriella G Gosman
- Department of Obstetrics and Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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Mitsukawa K, Otsuki K, Yanaihara A, Sawada M, Iwasaki S, Okai T. Concentration of lactoferrin and interleukin-6 in cervical mucus from patients being treated for infertility. Reprod Med Biol 2006. [PMID: 29699242 DOI: 10.1111/j.1447-0578.2006.00131.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: The concentrations of the iron-binding protein lactoferrin (LF) and interleukin-6 (IL-6) were measured in the cervical mucus of patients being treated for infertility throughout the menstrual cycle. Methods: A total of 251 cervical mucus samples were obtained from the patients throughout the menstrual cycle. One hundred and fifty samples were from primary infertility patients with unexplained infertility and 101 samples were from secondary infertility patients as a control. The concentrations of LF and IL-6 were measured by enzyme immunoassays. The standard curve of LF concentrations ranged from 1.6 to 50 ng/mL. Results: The mean LF and IL-6 concentrations in the cervical mucus of primary infertility patients were higher than that of the control patients (P= 0.04, P= 0.032, respectively) The LF and IL-6 concentrations were highly correlated (P < 0.0001). Conclusion: Elevated levels of IL-6 and LF in the cervical mucus were obtained from primary infertility patients. We speculate that LF might also be one of the causes of infertility and might play an important role in reproductive processes in the cervix. (Reprod Med Biol 2006; 5: 105-109).
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Affiliation(s)
- Kaori Mitsukawa
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Katsufumi Otsuki
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Atsushi Yanaihara
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Maki Sawada
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Shinji Iwasaki
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Takashi Okai
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
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Mitsukawa K, Otsuki K, Yanaihara A, Sawada M, Iwasaki S, Okai T. Concentration of lactoferrin and interleukin-6 in cervical mucus from patients being treated for infertility. Reprod Med Biol 2006; 5:105-109. [PMID: 29699242 DOI: 10.1007/bf03016146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: The concentrations of the iron-binding protein lactoferrin (LF) and interleukin-6 (IL-6) were measured in the cervical mucus of patients being treated for infertility throughout the menstrual cycle. Methods: A total of 251 cervical mucus samples were obtained from the patients throughout the menstrual cycle. One hundred and fifty samples were from primary infertility patients with unexplained infertility and 101 samples were from secondary infertility patients as a control. The concentrations of LF and IL-6 were measured by enzyme immunoassays. The standard curve of LF concentrations ranged from 1.6 to 50 ng/mL. Results: The mean LF and IL-6 concentrations in the cervical mucus of primary infertility patients were higher than that of the control patients (P= 0.04, P= 0.032, respectively) The LF and IL-6 concentrations were highly correlated (P < 0.0001). Conclusion: Elevated levels of IL-6 and LF in the cervical mucus were obtained from primary infertility patients. We speculate that LF might also be one of the causes of infertility and might play an important role in reproductive processes in the cervix. (Reprod Med Biol 2006; 5: 105-109).
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Affiliation(s)
- Kaori Mitsukawa
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Katsufumi Otsuki
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Atsushi Yanaihara
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Maki Sawada
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Shinji Iwasaki
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Takashi Okai
- Department of Obstetrics and Gynecology, Showa University school of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
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Spear GT, Alves MEAF, Cohen MH, Bremer J, Landay AL. Relationship of HIV RNA and cytokines in saliva from HIV-infected individuals. ACTA ACUST UNITED AC 2005; 45:129-36. [PMID: 16051064 DOI: 10.1016/j.femsim.2005.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2004] [Revised: 11/04/2004] [Accepted: 03/06/2005] [Indexed: 11/26/2022]
Abstract
We measured levels of six cytokines and human immunodeficiency virus (HIV) RNA in saliva from HIV-seropositive individuals and compared salivary cytokine levels in HIV-seropositives and seronegatives. All of the six tested cytokines were detected in saliva although interleukin-1beta, interferon-gamma and interleukin-10 were detected more frequently (90%, 68% and 61% of samples, respectively) than interleukin-6, tumor necrosis factor-alpha and tumor necrosis factor-alpha receptor II (2-17%). There was no significant association between cytokine levels in saliva and plasma suggesting that cytokines were produced locally. Interferon-gamma levels were significantly higher in saliva from HIV-seropositives when compared to seronegatives while interleukin-10 levels were lower in seropositive saliva. Interleukin-10 levels were higher in individuals with low CD4 counts in the seropositive group. HIV RNA was detected in 29% of saliva samples from seropositives and there was a significant correlation between saliva and plasma HIV RNA levels. However, HIV RNA levels in saliva were not significantly associated with any of the saliva or plasma cytokine levels or with CD4 cell numbers. This study shows no association between inflammatory cytokine levels and HIV levels in saliva and suggests that saliva HIV levels are more influenced by blood HIV RNA levels than oral inflammation.
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Affiliation(s)
- Gregory T Spear
- Department of Immunology/Microbiology, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612, USA.
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Morin M, Bellehumeur C, Therriault MJ, Metz C, Maheux R, Akoum A. Elevated levels of macrophage migration inhibitory factor in the peripheral blood of women with endometriosis. Fertil Steril 2005; 83:865-72. [PMID: 15820792 DOI: 10.1016/j.fertnstert.2004.10.039] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2004] [Revised: 10/08/2004] [Accepted: 10/08/2004] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the concentrations of macrophage migration inhibitory factor (MIF) in the peripheral blood of normal women and patients with endometriosis. DESIGN Retrospective study using ELISA to measure peripheral blood MIF. SETTING Gynecology clinic and human reproduction research laboratory. PATIENT(S) Thirty-eight normal women and 55 women with endometriosis. INTERVENTION(S) Peripheral blood samples were obtained a few days before laparoscopy. MAIN OUTCOME MEASURE(S) The MIF concentrations in blood serum. RESULT(S) This current study showed a 364% increase in MIF concentrations in women with endometriosis as compared to normal women. A significant increase was seen in endometriosis stages I-II, but a more marked increase was observed in the more advanced stages of the disease (III-IV). Both fertile and infertile women with endometriosis had higher levels of MIF than normal controls, but the difference was more significant in infertile women with endometriosis. Women with endometriosis with no pelvic pain had higher levels of MIF than normal controls, but a more significant increase in MIF levels was observed in women with endometriosis reporting pelvic pain. CONCLUSION(S) This study showed a marked increase in MIF concentrations in the peripheral blood of women with endometriosis and a relationship with disease progress, and suggests that MIF may be involved in endometriosis-related pain and infertility.
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Affiliation(s)
- Mathieu Morin
- Laboratoire d'Endocrinologie de la Reproduction, Centre de Recherche, Hôpital Saint-François d'Assise, Centre Hospitalier Universitaire de Québec (CHUQ), Faculté de Médecine, Université Laval, 10 rue de l'Espinay, Québec, PQ, Canada G1L 3L5
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Abstract
In addition to their effects on sexual differentiation and reproduction, sex hormones appear to influence the immune system. This results in a sexual dimorphism in the immune response in humans: for instance, females produce more vigorous cellular and more vigorous humoral immune reactions, are more resistant to certain infections, and suffer a higher incidence of autoimmune diseases. Disease expression is also affected by the reproductive status of the female. As sex steroids--estrogens, progesterone and testosterone--differ between gender and within different reproductive stages, a lot of research has focussed on the effects of sex hormones on immune responses. Although there is also a vast literature on the effects of sex hormones on immune responses in animals, in this review we will focus on the most intriguing effects and mechanisms by which sex hormones affect different components of the immune system in humans.
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Affiliation(s)
- Annechien Bouman
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, The Netherlands
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Cummins JM, Krakowka GS, Thompson CG. Systemic effects of interferons after oral administration in animals and humans. Am J Vet Res 2005; 66:164-76. [PMID: 15691053 DOI: 10.2460/ajvr.2005.66.164] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Joseph M Cummins
- Amarillo Biosciences Inc, 4134 Business Park Dr, Amarillo, TX 79110, USA
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Rzymski P, Opala T, Wilczak M, Woźniak J, Sajdak S. Serum tumor necrosis factor alpha receptors p55/p75 ratio and ovarian cancer detection. Int J Gynaecol Obstet 2005; 88:292-8. [PMID: 15733884 DOI: 10.1016/j.ijgo.2004.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2004] [Revised: 12/09/2004] [Accepted: 12/22/2004] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Early ovarian cancer detection is still very difficult and patients are mostly in advanced stages, with obvious influence on poor prognosis. METHOD Fifty-one ovarian cancer patients and 16 healthy controls had the serum concentrations of TNF alpha receptor p55, p75 and CA-125 measured prospectively and preoperatively. RESULT Mean concentrations of TNF alpha receptor p55, p75 and CA-125 in patients with ovarian cancer were higher than in controls. The ratios of p55 and p75 receptor in ovarian cancer and controls were 0.73+/-0.38 and 0.55+/-0.06 respectively. The areas under ROC curve in detecting malignancy (all FIGO stages) were 0.73, 0.65, 0.88 and 0.85 for p55, p75, p55/p75 ratio and CA-125 respectively. The areas under ROC curve in detecting stage I of ovarian cancer were 0.52, 0.60, 0.84 and 0.66 for p55, p75, p55/p75 ratio and CA-125 respectively. CONCLUSION Serum TNF alpha p55/p75 ratio showed promising value in ovarian cancer detection.
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Affiliation(s)
- P Rzymski
- Department of Mother's and Child's Health, Karol-Marcinkowski University of Medical Sciences, Polna St 33, 60-535 Poznan, Poland.
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