Article

Host immune consequences of asymptomatic Trichomonas vaginalis infection in pregnancy

Division of Maternal-Fetal Medicine, Magee-Womens Research Institute, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
American journal of obstetrics and gynecology (Impact Factor: 3.97). 02/2007; 196(1):59.e1-5. DOI: 10.1016/j.ajog.2006.08.035
Source: PubMed

ABSTRACT The purpose of this study was to define the impact of asymptomatic trichomoniasis on lower genital tract neutrophil activation in pregnancy.
In this nested cohort study, pelvic examination was performed on 65 asymptomatic pregnant women between 7 and 22 weeks' with vaginal pH > 4.4. Concentrations of cervical interleukin-8 and alpha-defensin were determined using enzyme-linked immunosorbent assay (ELISA). Trichomonas vaginalis was detected by culture.
Median concentrations of vaginal fluid neutrophil defensins and cervical interleukin-8 were significantly greater among women with asymptomatic trichomoniasis (median defensins 18,622 ng/mL, median IL-8 9244 pg/mL) than their uninfected counterparts (median defensins 5144 ng/mL, median IL-8 2044 pg/mL) (P < .001). All women with asymptomatic trichomoniasis had detectable defensin and interleukin-8 concentrations.
Asymptomatic trichomoniasis in pregnancy is accompanied by a state of neutrophil activation.

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    • "Cationic peptides including defensins are required for anti-HIV activity of vaginal fluid from healthy women (Venkataraman et al., 2005). While it is well established that sexual transmitted infections (STIs) significantly increase the likelihood of HIV transmission (Chesson and Pinkerton, 2000; Cohen et al., 1997; Galvin and Cohen, 2004; Mabey, 2000; Plummer, 1998) and that levels of defensins including HNPs, HBDs and HD5 in genital fluid, are elevated in patients with STIs (Porter et al., 2005; Simhan et al., 2007; Valore et al., 2006; Wiesenfeld et al., 2002), the role of defensins in HIV transmission seems to be complex. "
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    • "At the same time in symptomatic women, antiinflammatory mediators such as the soluble leukocyte protease inhibitor (SLPI) were lower (possibly due to digestion by trichomonas cysteine proteases) and reactive nitrogen intermediates were higher (Al-Mohammed and Hussein, 2006; Draper et al., 1998). The presence of increased C-reactive protein in the sera of T. vaginalis-infected pregnant women suggests that the impact of the immunoinflammatory reaction to the parasite exceeds the boundaries of the reproductive tract mucosa (Simhan et al., 2007). Mechanisms of pregnancy complications linked to T. vaginalis remain elusive. "
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Marijane A Krohn