CLINICAL EVIDENCE FOR THE ROLE OF TRICHOMONAS VAGINALIS IN REGULATION OF THE SECRETORY LEUKOCYTE PROTEASE INHIBITOR IN THE FEMALE GENITAL TRACT.
ABSTRACT Background. The secretory leukocyte protease inhibitor (SLPI) is responsible for regulating inflammatory damage and innate and adaptive immune responses of the vaginal mucosa. Depressed cervicovaginal SLPI levels have been correlated with both Trichomonas vaginalis (TV) and poor reproductive health outcomes.Methods. We measured levels of SLPI in 215 vaginal specimens collected from adolescent women ages 14-22. Log-transformed SLPI values were compared by ANOVA or by unpaired t test before and after adjusting for confounding effects through the propensity score method.Results. Women on hormonal contraceptives and those with abnormal vaginal pH had lower SLPI levels as compared to their peers. After propensity score adjustment for race, behavioral factors, hormonal use and other STIs, SLPI levels were lower in women with positive TV antigen test, pH>4.5, vaginal leukocytosis, recurrent compared to initial TV infection, and were lowest in those with highest TV load.Conclusions. SLPI was reduced by >50% in a TV load dependent manner. Future research should consider whether identifying and treating women with low levels of TV infection (before they become wet mount positive) would prevent the loss of SLPI and impaired vaginal immunity. SLPI could be used as a vaginal health marker to evaluate interventions and vaginal products.
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ABSTRACT: There is some evidence that the risk of HIV infection per heterosexual act is higher in low-income countries than in high-income countries. We hypothesize that variations in per sex-act transmission probability of HIV may in part be attributed to differences in the composition and function of the vaginal microbiota between different populations. This paper presents data that are in support of this hypothesis. Experimental and clinical studies have provided evidence that the normal vaginal microbiota plays a protective role against acquisition of HIV and other sexually transmitted infections. Epidemiological studies have convincingly shown that disturbances of the vaginal microbiome, namely intermediate flora and bacterial vaginosis, increase the risk of acquisition of HIV infection. A review of the literature found large differences in prevalence of bacterial vaginosis between different populations, with the highest prevalence rates found in black populations. Possible explanations for these differences are presented including data suggesting that there are ethnic differences in the composition of the normal vaginal microbiota. Lastly, interventions are discussed to restore and maintain a healthy vaginal environment.AIDS (London, England) 10/2014; 28(16):2333-44. DOI:10.1097/QAD.0000000000000432 · 6.56 Impact Factor
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ABSTRACT: The mucosal microenvironment of the female reproductive tract (FRT) is rich in secreted endogenous antimicrobials that provide the first line of defense against pathogens. This review focuses on the spectrum of secreted antimicrobials found in the FRT that have anti-HIV functions and are regulated by the natural hormonal changes in women's life cycle. Understanding the complex nature of FRT, mucosal microenvironment will enable us to better design therapeutic interventions for women against sexually transmitted pathogens.American Journal Of Reproductive Immunology 04/2014; DOI:10.1111/aji.12250 · 3.32 Impact Factor
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ABSTRACT: Human trichomonosis, infection with Trichomonas vaginalis, is the most common non-viral sexually transmitted disease in the world. The host-parasite interaction and pathophysiological processes of trichomonosis remain incompletely understood. This review focuses on the advancements reached in the area of the pathogenesis of T. vaginalis, especially in the role of the cysteine proteinases. It highlights various approaches made in this field and lists a group of trichomonad cysteine proteinases involved in diverse processes such as invasion of the mucous layer, cytoadherence, cytotoxicity, cytoskeleton disruption of red blood cells, hemolysis, and evasion of the host immune response. A better understanding of the biological roles of cysteine proteinases in the pathogenesis of this parasite could be used in the identification of new chemotherapeutic targets. An additional advantage could be the development of a vaccine in order to reduce transmission of T. vaginalis.Parasite 01/2014; 21:54. DOI:10.1051/parasite/2014054 · 0.82 Impact Factor