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Gubarkova E, Potapov A, Moiseev A, Kiseleva E, Krupinova D, Shatilova K, Karabut M, Khlopkov A, Loginova M, Radenska-Lopovok S, Gelikonov G, Grechkanev G, Gladkova N, Sirotkina M. Depth-Resolved Attenuation Mapping of the Vaginal Wall under Prolapse and after Laser Treatment Using Cross-Polarization Optical Coherence Tomography: A Pilot Study. Diagnostics (Basel) 2023; 13:3487. [PMID: 37998623 PMCID: PMC10670580 DOI: 10.3390/diagnostics13223487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Vaginal wall prolapse is the most common type of pelvic organ prolapse and is mainly associated with collagen bundle changes in the lamina propria. Neodymium (Nd:YAG) laser treatment was used as an innovative, minimally invasive and non-ablative procedure for the treatment of early-stage vaginal wall prolapse. The purpose of this pilot study was to assess connective tissue changes in the vaginal wall under prolapse without treatment and after Nd:YAG laser treatment using cross-polarization optical coherence tomography (CP OCT) with depth-resolved attenuation mapping. A total of 26 freshly excised samples of vaginal wall from 26 patients with age norm (n = 8), stage I-II prolapses without treatment (n = 8) and stage I-II prolapse 1-2 months after Nd:YAG laser treatment (n = 10) were assessed. As a result, for the first time, depth-resolved attenuation maps of the vaginal wall in the B-scan projection in the co- and cross-polarization channels were constructed. Two parameters within the lamina propria were target calculated: the median value and the percentages of high (≥4 mm-1) and low (<4 mm-1) attenuation coefficient values. A significant (p < 0.0001) decrease in the parameters in the case of vaginal wall prolapse compared to the age norm was identified. After laser treatment, a significant (p < 0.0001) increase in the parameters compared to the normal level was also observed. Notably, in the cross-channel, both parameters showed a greater difference between the groups than in the co-channel. Therefore, using the cross-channel achieved more reliable differentiation between the groups. To conclude, attenuation coefficient maps allow visualization and quantification of changes in the condition of the connective tissue of the vaginal wall. In the future, CP OCT could be used for in vivo detection of early-stage vaginal wall prolapse and for monitoring the effectiveness of treatment.
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Affiliation(s)
- Ekaterina Gubarkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Center of Photonics, Lobachevsky State University of Nizhny Novgorod, 603950 Nizhny Novgorod, Russia
| | - Arseniy Potapov
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Alexander Moiseev
- Institute of Applied Physics of the Russian Academy of Sciences, 603950 Nizhny Novgorod, Russia
| | - Elena Kiseleva
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Darya Krupinova
- Department of Obstetrics and Gynecology, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Nizhny Novgorod Regional Oncologic Hospital, 603126 Nizhny Novgorod, Russia
| | | | - Maria Karabut
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | | | - Maria Loginova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Center of Photonics, Lobachevsky State University of Nizhny Novgorod, 603950 Nizhny Novgorod, Russia
| | - Stefka Radenska-Lopovok
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Institute of Clinical Morphology and Digital Pathology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Grigory Gelikonov
- Institute of Applied Physics of the Russian Academy of Sciences, 603950 Nizhny Novgorod, Russia
| | - Gennady Grechkanev
- Department of Obstetrics and Gynecology, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Natalia Gladkova
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
| | - Marina Sirotkina
- Institute of Experimental Oncology and Biomedical Technologies, Privolzhsky Research Medical University, 603950 Nizhny Novgorod, Russia
- Center of Photonics, Lobachevsky State University of Nizhny Novgorod, 603950 Nizhny Novgorod, Russia
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Miao Y, Sudol NT, Li Y, Chen JJ, Arthur RA, Qiu S, Jiang Y, Tadir Y, Lane F, Chen Z. Optical coherence tomography evaluation of vaginal epithelial thickness during CO 2 laser treatment: A pilot study. JOURNAL OF BIOPHOTONICS 2022; 15:e202200052. [PMID: 35860856 PMCID: PMC9633389 DOI: 10.1002/jbio.202200052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/18/2022] [Accepted: 07/19/2022] [Indexed: 05/20/2023]
Abstract
Genitourinary syndrome of menopause (GSM) negatively affects more than half of postmenopausal women. Energy-based therapy has been explored as a minimally invasive treatment for GSM; however, its mechanism of action and efficacy is controversial. Here, we report on a pilot imaging study conducted on a small group of menopause patients undergoing laser treatment. Intravaginal optical coherence tomography (OCT) endoscope was used to quantitatively monitor the changes in the vaginal epithelial thickness (VET) during fractional-pixel CO2 laser treatment. Eleven patients with natural menopause and one surgically induced menopause patient were recruited in this clinical study. Following the laser treatment, 6 out of 11 natural menopause patient showed increase in both proximal and distal VET, while two natural menopause patient showed increase in VET in only one side of vaginal tract. Furthermore, the patient group that showed increased VET had thinner baseline VET compared to the patients that showed decrease in VET after laser treatment. These results demonstrate the potential utility of intravaginal OCT endoscope in evaluating the vaginal tissue integrity and tailoring vaginal laser treatment on a per-person basis, with the potential to monitor other treatment procedures.
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Affiliation(s)
- Yusi Miao
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Neha T Sudol
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, CA, USA
| | - Yan Li
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Jason J Chen
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Rebecca A. Arthur
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, CA, USA
| | - Saijun Qiu
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Yuchen Jiang
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Yona Tadir
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
| | - Felicia Lane
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, CA, USA
| | - Zhongping Chen
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
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Vincent KL, Frost PA, Motamedi M, Dick EJ, Wei J, Yang J, White R, Gauduin MC. High-Resolution Quantitative Mapping of Macaque Cervicovaginal Epithelial Thickness: Implications for Mucosal Vaccine Delivery. Front Immunol 2021; 12:660524. [PMID: 34262561 PMCID: PMC8273733 DOI: 10.3389/fimmu.2021.660524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/28/2021] [Indexed: 11/13/2022] Open
Abstract
Vaginal mucosal surfaces naturally offer some protection against sexually transmitted infections (STIs) including Human Immunodeficiency Virus-1, however topical preventative medications or vaccine designed to boost local immune responses can further enhance this protection. We previously developed a novel mucosal vaccine strategy using viral vectors integrated into mouse dermal epithelium to induce virus-specific humoral and cellular immune responses at the site of exposure. Since vaccine integration occurs at the site of cell replication (basal layer 100-400 micrometers below the surface), temporal epithelial thinning during vaccine application, confirmed with high resolution imaging, is desirable. In this study, strategies for vaginal mucosal thinning were evaluated noninvasively using optical coherence tomography (OCT) to map reproductive tract epithelial thickness (ET) in macaques to optimize basal layer access in preparation for future effective intravaginal mucosal vaccination studies. Twelve adolescent female rhesus macaques (5-7kg) were randomly assigned to interventions to induce vaginal mucosal thinning, including cytobrush mechanical abrasion, the chemical surfactant spermicide nonoxynol-9 (N9), the hormonal contraceptive depomedroxyprogesterone acetate (DMPA), or no intervention. Macaques were evaluated at baseline and after interventions using colposcopy, vaginal biopsies, and OCT imaging, which allowed for real-time in vivo visualization and measurement of ET of the mid-vagina, fornices, and cervix. P value ≤0.05 was considered significant. Colposcopy findings included pink, rugated tissue with variable degrees of white-tipped, thickened epithelium. Baseline ET of the fornices was thinner than the cervix and vagina (p<0.05), and mensing macaques had thinner ET at all sites (p<0.001). ET was decreased 1 month after DMPA (p<0.05) in all sites, immediately after mechanical abrasion (p<0.05) in the fornix and cervix, and after two doses of 4% N9 (1.25ml) applied over 14 hrs in the fornix only (p<0.001). Histological assessment of biopsied samples confirmed OCT findings. In summary, OCT imaging allowed for real time assessment of macaque vaginal ET. While varying degrees of thinning were observed after the interventions, limitations with each were noted. ET decreased naturally during menses, which may provide an ideal opportunity for accessing the targeted vaginal mucosal basal layers to achieve the optimum epithelial thickness for intravaginal mucosal vaccination.
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Affiliation(s)
- Kathleen L. Vincent
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Patrice A. Frost
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX, United States
- Southwest National Primate Research Center, San Antonio, TX, United States
| | - Massoud Motamedi
- Department of Ophthalmology and Visual Sciences, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Edward J. Dick
- Southwest National Primate Research Center, San Antonio, TX, United States
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX, United States
| | - Jingna Wei
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Jinping Yang
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Robert White
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX, United States
| | - Marie-Claire Gauduin
- Southwest National Primate Research Center, San Antonio, TX, United States
- Disease Intervention and Prevention Program, Texas Biomedical Research Institute, San Antonio, TX, United States
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Zhu Y, Saada J, Bhawana S, Lai S, Villarreal P, Pyles R, Motamedi M, Vargas G, Moench T, Vincent KL. Surrogate post-coital testing for contraceptive efficacy against human sperm activity in the ovine vaginal model†. Biol Reprod 2020; 104:317-324. [PMID: 33300559 DOI: 10.1093/biolre/ioaa221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/31/2020] [Indexed: 11/14/2022] Open
Abstract
High unintended pregnancy rates are partially due to lack of effective nonhormonal contraceptives; development of safe, effective topical vaginal methods will address this need. Preclinical product safety and efficacy assessment requires in vivo testing in appropriate models. The sheep is a good model for the evaluation of vaginally delivered products due to its close similarities to humans. The study objective was to develop an ovine model for efficacy testing of female nonhormonal contraceptives that target human sperm. Fresh human semen was pooled from male volunteers. Nonpregnant female Merino sheep were treated with control or vaginal contraceptive product (IgG antibody with action against sperm or nonoxynol-9 [N9]). Pooled semen was added to the sheep vagina and mixed with product and vaginal secretions. Microscopic assessment of samples was performed immediately and progressive motility (PM) of sperm was compared between treatments. Cytokines CXCL8 and IL1B were assessed in vaginal fluid after instillation of human semen. No adverse reactions or elevations in proinflammatory cytokines occurred in response to human semen. N9 produced signs of acute cellular toxicity while there were no cellular changes after IgG treatment. N9 and IgG had dose-related effects with the highest dose achieving complete sperm immobilization (no sperm with PM). Surrogate post-coital testing of vaginally administered contraceptives that target human semen was developed in an ovine model established for vaginal product preclinical testing. This expanded model can aid the development of much needed nonhormonal topical vaginal contraceptives, providing opportunities for rapid iterative drug development prior to costly, time-intensive human testing.
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Affiliation(s)
- Yong Zhu
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Jamal Saada
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Shrestha Bhawana
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Sam Lai
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Paula Villarreal
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Richard Pyles
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - Massoud Motamedi
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Gracie Vargas
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Kathleen L Vincent
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
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5
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Abstract
OBJECTIVE Optical coherence tomography is a noninvasive technology that visualizes tissue microstructure with high spatial resolution. We designed a novel vaginal system that demonstrates a clear distinction between vaginal tissues planes. In this study, we sought to compare vaginal tomographic images of premenopausal, perimenopausal, and postmenopausal women, demonstrate feasibility of tracking vaginal tissue changes after treatment with fractional-pixel CO2 laser therapy, and obtain a histologic correlation of these findings. METHODS Enrolled subjects underwent imaging and were divided into 3 groups based on menopausal status. Women with genitourinary syndrome of menopause who received fractional-pixel CO2 laser therapy were assessed before and after treatment. A cadaveric vagina was used to obtain tomographic and histologic images to assess for accuracy. Our primary outcome was mean vaginal epithelial thickness. Statistical analysis was performed using analysis of variance and t tests, respectively. RESULTS Among 6 women, the mean vaginal epithelial thickness decreased with menopause (P < 0.01). Although change in epithelial thickness after fractional-pixel CO2 laser treatment varied between the 2 subjects evaluated, it increased significantly for the subject who reported improvement of vaginal symptoms (P < 0.01). Using a cadaveric specimen, optical biopsy was correlated to an hematoxylin and eosin-stained biopsy of the same vaginal site. CONCLUSIONS This study establishes feasibility of optical coherence tomography in providing an optical biopsy of the vaginal epithelium and lamina propria. In addition, it demonstrates vaginal changes as women enter menopause. This report is the initial phase of a longitudinal cohort study to evaluate changes in vaginal microstructure after energy-based treatment.
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6
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O'Hanlon DE, Gajer P, Brotman RM, Ravel J. Asymptomatic Bacterial Vaginosis Is Associated With Depletion of Mature Superficial Cells Shed From the Vaginal Epithelium. Front Cell Infect Microbiol 2020; 10:106. [PMID: 32211347 PMCID: PMC7076050 DOI: 10.3389/fcimb.2020.00106] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/27/2020] [Indexed: 12/26/2022] Open
Abstract
Previous studies have described bacterial vaginosis (BV) as associated with increased cell-shedding from the cervicovaginal epithelium. Cell-shedding in excess of cell-proliferation is thought to decrease epithelial barrier function and increase susceptibility to infection. This study evaluated the number of shed cells in mid-vaginal smears from women with a diagnosis of symptomatic BV (sBV, n = 17), asymptomatic BV (aBV, n = 71), or no BV (n = 104) by Amsel criteria. The sBV smears contained significantly more shed cells (median 158/100X field) than no BV smears (median 91/100X field), p = 7.2e−9. However, we observed that aBV smears contained significantly fewer shed cells (median 35/100X field) than no BV smears, p = 22.0e−16. The sizes of cell-aggregates (cells shed in sometimes multilayered sections with intact cell-cell attachments) followed the same pattern. Cell-aggregates in sBV smears were significantly larger (median ~220,000 μm2) than those in no BV smears (median ~50,000 μm2), p = 1.8e−6, but cell-aggregates in aBV smears were significantly smaller (median ~7,000 μm2) than those in no BV smears, p = 0.0028. We also compared the superficial cell index (SCI), a measure of cervicovaginal epithelial cell maturity, in no BV and aBV smears with relatively low numbers of shed cells (≤50/100X field). The SCI of no BV smears was significantly higher (median 0.86) than that of aBV smears (median 0.35), p = 4.3e−98, suggesting a depletion of mature cells with exposure and shedding of underlying immature cells in aBV with low number of shed cells. These results indicate that aBV may contribute disproportionately to the increased susceptibility to reproductive tract infections associated with BV. Our findings remained true when considering only those smears in which the microbiota comprised a diverse set of strict and facultative anaerobic bacteria [Community State Type IV (n = 162)], thus excluding those dominated by Lactobacillus spp. This is consistent with our developing hypothesis that high-shedding sBV and low-shedding aBV could be temporally separated phases of the same condition, rather than two separate forms of BV. These findings might inform future work on clinical management of symptomatic and asymptomatic bacterial vaginosis.
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Affiliation(s)
- D Elizabeth O'Hanlon
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Pawel Gajer
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Rebecca M Brotman
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States
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Law TSM, Wu F, Xu H, Wang CC, Li TC. Endometrium imaging using real-time rotational optical coherence tomography imaging system: A pilot, prospective and ex-vivo study. Medicine (Baltimore) 2019; 98:e17738. [PMID: 31689821 PMCID: PMC6946521 DOI: 10.1097/md.0000000000017738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluate a novel real-time rotational optical coherence tomography (OCT) imaging system (OCTIS) with a fiber-optic probe to look at endometrium and to correlate the OCTIS images with standard histology. OCT could obtain real-time images resembling histological examination. With recent development of customized probes, it allows OCT to be used in the field of gynecology.This is a pilot, prospective, ex-vivo and observational study. Women underwent hysterectomy for various gynecological conditions were recruited and OCTIS images were obtained from endometrium of 15 fresh uterus specimens immediately after hysterectomy. The excised uterus was cut open and OCTIS imaging was obtained. The scanned region of endometrium was excised for histological examination and OCTIS images were precisely compared to corresponding histological images and ultrasound images. Blinded qualitative analysis on OCTIS images was performed by 2 assessors to determine inter-rating reliability on the histopathological diagnosis.Epithelium, glands, cysts, and stroma of endometrium were clearly seen by the OCTIS. Different phases of menstrual cycle of normal endometrium could be differentiated and pathological condition such as hyperplastic and dysplasic endometrium, which corresponded well with histological findings, could be identified. The inter-rater reliability between assessors on overall OCTIS endometrium and neoplastic OCTIS endometrium was moderate (Kendall τb of 0.58) and substantial (Kendall τb of 0.76), respectively.OCTIS can provide real-time, high-resolution and rotational imaging modality to view endometrial structure with high consistency with histological examination and satisfactory agreement between observers. It has a great potential to be developed in the clinical use of endometrial assessment for gynecological applications.
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Affiliation(s)
| | | | - Hui Xu
- Department of Obstetrics and Gynaecology
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology
- Li Ka Shing Institute of Health Sciences
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Çuburu N, Kim R, Guittard GC, Thompson CD, Day PM, Hamm DE, Pang YYS, Graham BS, Lowy DR, Schiller JT. A Prime-Pull-Amplify Vaccination Strategy To Maximize Induction of Circulating and Genital-Resident Intraepithelial CD8 + Memory T Cells. THE JOURNAL OF IMMUNOLOGY 2019; 202:1250-1264. [PMID: 30635393 DOI: 10.4049/jimmunol.1800219] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 12/11/2018] [Indexed: 12/12/2022]
Abstract
Recent insight into the mechanisms of induction of tissue-resident memory (TRM) CD8+ T cells (CD8+ TRM) enables the development of novel vaccine strategies against sexually transmitted infections. To maximize both systemic and genital intraepithelial CD8+ T cells against vaccine Ags, we assessed combinations of i.m. and intravaginal routes in heterologous prime-boost immunization regimens with unrelated viral vectors. Only i.m. prime followed by intravaginal boost induced concomitant strong systemic and intraepithelial genital-resident CD8+ T cell responses. Intravaginal boost with vectors expressing vaccine Ags was far superior to intravaginal instillation of CXCR3 chemokine receptor ligands or TLR 3, 7, and 9 agonists to recruit and increase the pool of cervicovaginal CD8+ TRM Transient Ag presentation increased trafficking of cognate and bystander circulating activated, but not naive, CD8+ T cells into the genital tract and induced in situ proliferation and differentiation of cognate CD8+ TRM Secondary genital CD8+ TRM were induced in the absence of CD4+ T cell help and shared a similar TCR repertoire with systemic CD8+ T cells. This prime-pull-amplify approach elicited systemic and genital CD8+ T cell responses against high-risk human papillomavirus type 16 E7 oncoprotein and conferred CD8-mediated protection to a vaccinia virus genital challenge. These results underscore the importance of the delivery route of nonreplicating vectors in prime-boost immunization to shape the tissue distribution of CD8+ T cell responses. In this context, the importance of local Ag presentation to elicit genital CD8+ TRM provides a rationale to develop novel vaccines against sexually transmitted infections and to treat human papillomavirus neoplasia.
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Affiliation(s)
- Nicolas Çuburu
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892;
| | - Rina Kim
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - Geoffrey C Guittard
- Laboratory of Cellular and Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - Cynthia D Thompson
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - Patricia M Day
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - David E Hamm
- Adaptive Biotechnologies, Seattle, WA 98102; and
| | - Yuk-Ying S Pang
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - Barney S Graham
- Viral Pathogenesis Laboratory, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Douglas R Lowy
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892
| | - John T Schiller
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892;
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9
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Li Y, Sudol NT, Miao Y, Jing JC, Zhu J, Lane F, Chen Z. 1.7 micron optical coherence tomography for vaginal tissue characterization in vivo. Lasers Surg Med 2018; 51:120-126. [PMID: 30058722 DOI: 10.1002/lsm.23003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Optical coherence tomography (OCT) can noninvasively visualize in vivo tissue microstructure with high spatial resolution that approaches the histologic level. Currently, OCT studies in gynecology are few and limited to a conventional 1.3 μm center wavelength swept light source which provides high spatial resolution but limited penetration depth. Here, we present a novel endoscopic OCT system with improved penetration depth and high resolution. METHODS A novel endoscopic OCT system was developed based on a 1.7 µm swept source laser, which is capable of deeper tissue penetration due to its longer wavelength. To evaluate the performance of system, we imaged the human vaginas in vivo with both conventional 1.3 and 1.7 μm endoscopic OCT systems. RESULTS With the 1.7 μm endoscopic OCT system, imaging depth was improved by more than 25%, allowing better visualization of the lamina propria and clear contrast of the epithelial layer from the surrounding tissues. CONCLUSION The significantly improved performance of the novel 1.7 μm OCT imaging system demonstrates its potential use as a minimally-invasive monitoring tool of vaginal health in gynecologic practice. Lasers Surg. Med. 51:120-126, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Yan Li
- Beckman Laser Institute, University of California, Irvine, California, 92617.,Department of Biomedical Engineering, University of California, Irvine, California, 92697-2700
| | - Neha T Sudol
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, California, 92617
| | - Yusi Miao
- Beckman Laser Institute, University of California, Irvine, California, 92617.,Department of Biomedical Engineering, University of California, Irvine, California, 92697-2700
| | - Joseph C Jing
- Beckman Laser Institute, University of California, Irvine, California, 92617.,Department of Biomedical Engineering, University of California, Irvine, California, 92697-2700
| | - Jiang Zhu
- Beckman Laser Institute, University of California, Irvine, California, 92617
| | - Felicia Lane
- Department of Obstetrics & Gynecology, University of California, Irvine, Medical Center, Irvine, California, 92617
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, California, 92617.,Department of Biomedical Engineering, University of California, Irvine, California, 92697-2700
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10
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Kirillin M, Motovilova T, Shakhova N. Optical coherence tomography in gynecology: a narrative review. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-9. [PMID: 29210220 DOI: 10.1117/1.jbo.22.12.121709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/14/2017] [Indexed: 06/07/2023]
Abstract
Modern gynecologic practice requires noninvasive diagnostics techniques capable of detecting morphological and functional alterations in tissues of female reproductive organs. Optical coherence tomography (OCT) is a promising tool for providing imaging of biotissues with high resolution at depths up to 2 mm. Design of the customized probes provides wide opportunities for OCT use in gynecology. This paper contains a retrospective insight into the history of OCT employment in gynecology, an overview of the existing gynecologic OCT probes, including those for combination with other diagnostic modalities, and state-of-the-art application of OCT for diagnostics of tumor and nontumor pathologies of female genitalia. Perspectives of OCT both in diagnostics and treatment planning and monitoring in gynecology are overviewed.
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Duan L, McRaven MD, Liu W, Shu X, Hu J, Sun C, Veazey RS, Hope TJ, Zhang HF. Colposcopic imaging using visible-light optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:56003. [PMID: 28492851 PMCID: PMC5421648 DOI: 10.1117/1.jbo.22.5.056003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/17/2017] [Indexed: 05/12/2023]
Abstract
High-resolution colposcopic optical coherence tomography (OCT) provides key anatomical measures, such as thickness and minor traumatic injury of vaginal epithelium, of the female reproductive tract noninvasively. This information can be helpful in both fundamental investigations in animal models and disease screenings in humans. We present a fiber-based visible-light OCT and two probe designs for colposcopic application. One probe conducts circular scanning using a DC motor, and the other probe is capable of three-dimensional imaging over a 4.6 × 4.6 - mm 2 area using a pair of galvo scanners. Using this colposcopic vis-OCT with both probes, we acquired high-resolution images from whole isolated macaque vaginal samples and identified biopsy lesions.
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Affiliation(s)
- Lian Duan
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
| | - Michael D. McRaven
- Northwestern University, Department of Cell and Molecular Biology, Chicago, Illinois, United States
| | - Wenzhong Liu
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
| | - Xiao Shu
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
| | - Jianmin Hu
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
- Wuhan University of Technology, School of Information Engineering, Wuhan, Hubei, China
| | - Cheng Sun
- Northwestern University, Department of Mechanical Engineering, Evanston, Illinois, United States
| | - Ronald S. Veazey
- Tulane University, School of Medicine, Tulane National Primate Research Center, Covington, Louisiana, United States
| | - Thomas J. Hope
- Northwestern University, Department of Cell and Molecular Biology, Chicago, Illinois, United States
| | - Hao F. Zhang
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
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Vargas G, Vincent KL, Wei J, Bourne N, Motamedi M. Topical injury evaluation of the murine colorectal mucosa using confocal endomicrosopy: a valuable method for assessing mucosal injuries associated with risk of pathogen transmission. J Microsc 2016; 264:227-237. [PMID: 27351717 DOI: 10.1111/jmi.12438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/03/2016] [Accepted: 05/30/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Concern regarding the effect of epithelial damage to the colorectal surface and possible impact on sexually transmitted infection transmission prompts the need for methods to evaluate the mucosal microscopic surface in preclinical studies examining such injury. This includes determining the effect of topical HIV prevention products on mucosal barrier integrity. In vivo imaging with high-resolution endomicroscopy could reveal defects in the mucosal barrier resulting from injury/surface trauma. METHODS Confocal endomicroscopy was investigated to assess the ability to image surface injury resulting from topical application of a chemical used in lubricants and microbial products. Mice treated with a 50 μL rectal dose of 0.2% benzalkonium chloride solution, 1% benzalkonium chloride or phosphate-buffered saline control for 20 min were imaged in vivo using confocal endomicroscopy for assessment of epithelial disruption. Following imaging, mice were sacrificed and rectal tissue evaluated by histology. Confocal images were graded based on degree of disruption to crypt and epithelial microstructure. Histology was graded based on percent of epithelial disruption observed in stained sections. Confocal image features were confirmed by high-resolution two-photon microscopy. RESULTS Based on quantitative grading of in vivo confocal endomicroscopy images, disruption at the microscopic scale was observed following treatment with benzalkonium chloride, with increased injury occurring with higher dose. Epithelial disruption at the lumen surface, evident between crypts and alteration in crypt structure on the luminal side were observed in confocal endomicroscopy and confirmed by histology. CONCLUSIONS High-resolution imaging by confocal endomicroscopy can be used as a noninvasive tool for rapid visual assessment of rectal epithelial integrity following surface injury, potentially providing valuable indication of epithelial injury or trauma.
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Affiliation(s)
- Gracie Vargas
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, Texas, U.S.A.. .,Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas, U.S.A..
| | - Kathleen Listiak Vincent
- Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas, U.S.A.,Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, U.S.A
| | - Jingna Wei
- Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas, U.S.A
| | - Nigel Bourne
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, U.S.A.,Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, Texas, U.S.A
| | - Massoud Motamedi
- Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas, U.S.A.,Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, U.S.A
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Avila C, Santorelli J, Mathai J, Ishkin S, Jabsky M, Willins J, Figueroa R, Kaplan C. Anatomy of the fetal membranes using optical coherence tomography: part 1. Placenta 2014; 35:1065-9. [PMID: 25443432 DOI: 10.1016/j.placenta.2014.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/10/2014] [Accepted: 09/14/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In vitro studies on the structure of human fetal membranes have involved light or electron microscopy with fixation, dehydration, and staining. Recently, optical coherence tomography (OCT), an imaging technology, has provided high-resolution cross-sectional images of living biological tissues, with a penetration of 2-3 mm. We evaluated the use of this technology to examine the histologic features of human fetal membranes immediately after delivery. METHODS Samples of fetal membranes of ten patients undergoing cesarean deliveries (four uncomplicated pregnancies, four with preeclampsia, and two with chorioamnionitis) and eight patients undergoing vaginal deliveries (six uncomplicated pregnancies and two with chorioamnionitis) were collected immediately after delivery. Samples were stretched across customized disks, rinsed, and analyzed using a time-domain OCT imaging system. Following OCT scanning, the samples were placed in formalin for histologic study. The OCT images were compared to histologic images of common human fetal membrane features. RESULTS We were able to delineate the layers of the fetal membranes using bench-top time-domain OCT. The system was able to image histologic features of the fetal membranes, such as microscopic chorionic pseudocysts, ghost villi, meconium stained membranes, and chorioamnionitis. The OCT images corresponded with the histologic findings. DISCUSSION This feasibility study demonstrates the potential of OCT technology for real-time assessment of human fetal membranes and may provide clinically useful information at delivery.
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Affiliation(s)
- C Avila
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - J Santorelli
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - J Mathai
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - S Ishkin
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - M Jabsky
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - J Willins
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - R Figueroa
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
| | - C Kaplan
- Department of Pathology, Stony Brook Medicine, Stony Brook University, Stony Brook, NY, USA
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Image-based noninvasive evaluation of colorectal mucosal injury in sheep after topical application of microbicides. Sex Transm Dis 2014; 40:854-9. [PMID: 24113407 DOI: 10.1097/olq.0000000000000039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Successful development of topical rectal microbicides requires preclinical evaluation in suitable large animal models. Our previous studies have demonstrated the benefits of high-resolution optical coherence tomography (OCT) to visualize subclinical microbicide toxicity in the sheep vagina. In the current study, we evaluated the potential application of colonoscopy and OCT to visualize and quantify the effects of topical products on sheep colorectal tissue, as assessed by advanced imaging techniques. METHODS Yearling virginal female sheep were treated rectally with a single 8-mL dose of 0.2% benzalkonium chloride (BZK) solution or phosphate-buffered saline control. Imaging was performed before and 30 minutes after treatment. Colonoscopy findings were evaluated based on mucosal disruption. Optical coherence tomography images were graded based on the integrity of the mucosal layer. Biopsies collected after treatment were evaluated by histology for validation of OCT scoring. RESULTS Mucosal disruption was observed by colonoscopy in BZK-treated animals, whereas none was present in controls. In contrast to colonoscopy, high-resolution in-depth OCT imaging provided visualization of the morphology of the mucosal layer and underlying muscularis, thus enabling detection of microscopic abnormalities. Noninvasive quantification of drug-induced injury after validation of the scoring system (categories 1, 2, 3) showed increased scores after treatment with BZK (P < 0.001), indicating mucosal injury. CONCLUSIONS High-resolution OCT can be used as highly sensitive tool to evaluate rectal microbicide effects. Because the sheep rectum has both gross and microscopic similarities to the human, this model is a useful addition to current methods of rectal product toxicity.
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Shalom DF, Ledford KJ, Qadir A, Lind LR, Winkler HA. Visualization of synthetic mesh utilizing optical coherence tomography. Int Urogynecol J 2013; 24:1909-14. [PMID: 23640004 DOI: 10.1007/s00192-013-2106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 03/26/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Owing to the recent upsurge in adverse events reported after mesh-augmented pelvic organ prolapse (POP) repairs, our aim was to determine whether the location and depth of synthetic mesh can be measured postoperatively within the vaginal tissue microstructure using optical coherence tomography (OCT). METHODS Seventeen patients with prior mesh-augmented repairs were recruited for participation. Patients were included if they had undergone an abdominal sacral colpopexy (ASC) or vaginal repair with mesh. Exclusion criteria were a postoperative period of <6 months, or the finding of mesh exposure on examination. OCT was used to image the vaginal wall at various POP-Q sites. If mesh was visualized, its location and depth was calculated and recorded. RESULTS Ten patients underwent ASC and 7 patients had 8 transvaginal mesh repairs. Mesh was visualized in 16 of the 17 patients using OCT. In all ASC patients, mesh was imaged centrally at the posterior apex. In patients with transvaginal mesh in the anterior and/or posterior compartments, the mesh was visualized directly anterior and/or posterior to the apex respectively. Mean depth of the mesh in the ASC, anterior, and posterior groups was 60.9, 146.7, and 125.7 μm respectively. Mesh was visualized within the vaginal epithelial layer in all 16 patients despite the route of placement. CONCLUSION In this pilot study we found that OCT can be used to visualize polypropylene mesh within the vaginal wall following mesh-augmented prolapse repair. Regardless of abdominal versus vaginal placement, the mesh was identified within the vaginal epithelial layer.
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Affiliation(s)
- Dara F Shalom
- Division of Female Pelvic Medicine and Reconstructive Surgery, North Shore University Hospital/Long Island Jewish, Manhasset, NY, USA,
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Bell BA, Vincent KL, Bourne N, Vargas G, Motamedi M. Optical coherence tomography for assessment of microbicide safety in a small animal model. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:046010. [PMID: 23588808 PMCID: PMC3626380 DOI: 10.1117/1.jbo.18.4.046010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Sensitive imaging techniques for small animals are needed to assess drug toxicity in preclinical studies. Optical coherence tomography (OCT) provides a noninvasive tool for high-resolution, depth-resolved visualization of drug-induced changes in tissue morphology. In a mouse model, we utilize OCT to assess vaginal tissue integrity following the application of topical microbicides (drugs used to prevent infection). Mice are challenged with herpes simplex virus-2 (HSV-2) to determine the correlation of tissue damage as quantified by OCT to increased susceptibility. The microbicide benzalkonium chloride (BZK) (0.02, 0.2, or 2%) or phosphate buffered saline control is administered intravaginally. In vivo OCT imaging and collection of tissue samples are performed after treatment. A quantitative OCT scoring system is applied to assess epithelial damage, and the results are compared with those of histology. A separate group of mice are treated similarly then challenged with HSV-2. Epithelial morphology quantified noninvasively by OCT and histology are dose-dependent (p<0.0001). The OCT scoring system detected a significant increase in epithelial damage with increasing BZK concentration (p<0.0001). These results paralleled an increase in HSV-2 susceptibility (p<0.005). OCT can be used as a noninvasive tool to assess topical drug toxicity in a small animal model with potential to predict increased susceptibility to vaginal infection.
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Affiliation(s)
- Brent A. Bell
- University of Texas Medical Branch, Center for Biomedical Engineering, 301 University Boulevard, Galveston, Texas 77555-1156
| | - Kathleen L. Vincent
- University of Texas Medical Branch, Department of Obstetrics and Gynecology, 301 University Boulevard, Galveston, Texas 77555-1156
| | - Nigel Bourne
- University of Texas Medical Branch, Department of Pediatrics/Sealy Center for Vaccine Development, 301 University Boulevard, Galveston, Texas 77555-0436
| | - Gracie Vargas
- University of Texas Medical Branch, Center for Biomedical Engineering, Department of Neuroscience and Cell Biology, 301 University Boulevard, Galveston, Texas 77555-1156
| | - Massoud Motamedi
- University of Texas Medical Branch, Center for Biomedical Engineering/Department of Ophthalmology, 301 University Boulevard, Galveston, Texas 77555-1156
- Address all correspondence to: Massoud Motamedi, University of Texas Medical Branch, Center for Biomedical Engineering/Department of Ophthalmology, 301 University Boulevard, Galveston, Texas 77555-1156. Tel: 409-772-8363; Fax: 409-772-0751; E-mail:
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Vincent KL, Vargas G, Wei J, Bourne N, Motamedi M. Monitoring vaginal epithelial thickness changes noninvasively in sheep using optical coherence tomography. Am J Obstet Gynecol 2013; 208:282.e1-7. [PMID: 23333551 DOI: 10.1016/j.ajog.2013.01.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 11/21/2012] [Accepted: 01/14/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE High-resolution optical coherence tomography can be used noninvasively to evaluate vaginal morphologic features, including epithelial thickness, to assess this protective barrier in transmission of sexually transmitted infections and to monitor tissue response to topical medications and hormonal fluctuations. We examined the use of optical coherence tomography to measure epithelial thickness noninvasively before and after topical treatment with a drug that causes epithelial thinning. STUDY DESIGN Twelve female sheep were treated with intravaginal placebo (n = 4) or nonoxynol-9 (n = 8). Vaginal optical coherence tomography images were obtained before and 24 hours after treatment. Four sheep in the nonoxynol-9 group were also examined on days 3 and 7. Vaginal biopsies were obtained on the last examination day. Epithelial thickness was measured in optical coherence tomography images and in hematoxylin and eosin-stained histologic sections from biopsies. Statistical analysis was performed using analyses of variance (significance P < .05). RESULTS Baseline optical coherence tomography epithelial thickness measurements were similar (85 ± 19 μm placebo, 78 ± 20 μm nonoxynol-9; P = .52). Epithelial thinning was significant after nonoxynol-9 (32 ± 22 μm) compared with placebo (80 ± 15 μm) 24 hours after treatment (P < .0001). In the 4 nonoxynol-9-treated sheep followed for 7 days, epithelial thickness returned to baseline by day 3, and increased significantly on day 7. Epithelial thickness measurements from histology were not significantly different than optical coherence tomography (P = .98 nonoxynol-9, P = .93 hydroxyethyl cellulose). CONCLUSION Drug-induced changes in the epithelium were clearly detectable using optical coherence tomography imaging. Optical coherence tomography and histology epithelial thickness measurements were similar, validating optical coherence tomography as a noninvasive method for epithelial thickness measurement, providing an important tool for quantitative and longitudinal monitoring of vaginal epithelial changes.
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Chitchian S, Vincent KL, Vargas G, Motamedi M. Automated segmentation algorithm for detection of changes in vaginal epithelial morphology using optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:116004. [PMID: 23117799 PMCID: PMC3484240 DOI: 10.1117/1.jbo.17.11.116004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 09/22/2012] [Accepted: 09/25/2012] [Indexed: 05/29/2023]
Abstract
We have explored the use of optical coherence tomography (OCT) as a noninvasive tool for assessing the toxicity of topical microbicides, products used to prevent HIV, by monitoring the integrity of the vaginal epithelium. A novel feature-based segmentation algorithm using a nearest-neighbor classifier was developed to monitor changes in the morphology of vaginal epithelium. The two-step automated algorithm yielded OCT images with a clearly defined epithelial layer, enabling differentiation of normal and damaged tissue. The algorithm was robust in that it was able to discriminate the epithelial layer from underlying stroma as well as residual microbicide product on the surface. This segmentation technique for OCT images has the potential to be readily adaptable to the clinical setting for noninvasively defining the boundaries of the epithelium, enabling quantifiable assessment of microbicide-induced damage in vaginal tissue.
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Affiliation(s)
- Shahab Chitchian
- University of Texas Medical Branch, Center for Biomedical Engineering, Galveston, Texas 77555
- University of Texas Medical Branch, Department of Ophthalmology, Galveston, Texas 77555
| | - Kathleen L. Vincent
- University of Texas Medical Branch, Center for Biomedical Engineering, Galveston, Texas 77555
- University of Texas Medical Branch, Department of Obstetrics and Gynecology, Galveston, Texas 77555
| | - Gracie Vargas
- University of Texas Medical Branch, Center for Biomedical Engineering, Galveston, Texas 77555
- University of Texas Medical Branch, Department of Neuroscience and Cell Biology, Galveston, Texas 77555
| | - Massoud Motamedi
- University of Texas Medical Branch, Center for Biomedical Engineering, Galveston, Texas 77555
- University of Texas Medical Branch, Department of Ophthalmology, Galveston, Texas 77555
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