Defining genital tract cytokine signatures of sexually transmitted infections and bacterial vaginosis in women at high risk of HIV infection: a cross-sectional study

被引：149

作者：

Masson, Lindi ^{[1
,2
]}

Mlisana, Koleka ^{[2
,3
,4
]}

Little, Francesca ^{[5
]}

Werner, Lise ^{[2
]}

Mkhize, Nonhlanhla N. ^{[1
,6
]}

Ronacher, Katharina ^{[7
,8
]}

Gamieldien, Hoyam ^{[1
]}

Williamson, Carolyn ^{[1
,2
]}

Mckinnon, Lyle R. ^{[2
]}

Walzl, Gerhard

Karim, Quarraisha Abdool ^{[2
,9
]}

Karim, Salim S. Abdool ^{[2
,9
]}

Passmore, Jo-Ann S. ^{[1
,2
,4
]}

机构：

[1] Univ Cape Town, Inst Infect Dis & Mol Med, Div Med Virol, Sch Med, ZA-7925 Cape Town, South Africa

[2] Univ KwaZulu Natal, Ctr AIDS Programme Res South Africa CAPRISA, Durban, South Africa

[3] Univ KwaZulu Natal, Dept Med Microbiol, Durban, South Africa

[4] Natl Hlth Lab Serv, Johannesburg, South Africa

[5] Univ Cape Town, Dept Stat Sci, ZA-7925 Cape Town, South Africa

[6] Natl Inst Communicable Dis, Johannesburg, South Africa

[7] Univ Stellenbosch, Div Mol Biol & Human Genet, DST NRF Ctr Excellence Biomed TB Res, Fac Med & Hlth Sci, Cape Town, South Africa

[8] Univ Stellenbosch, MRC Ctr Mol & Cellular Biol, Cape Town, South Africa

[9] Columbia Univ, New York, NY USA

来源：

SEXUALLY TRANSMITTED INFECTIONS | 2014年 / 90卷 / 08期

基金：

英国惠康基金; 英国医学研究理事会; 美国国家卫生研究院; 新加坡国家研究基金会;

关键词：

HUMAN-IMMUNODEFICIENCY-VIRUS; NECROSIS-FACTOR-ALPHA; CHLAMYDIA-TRACHOMATIS; EPITHELIAL-CELLS; VAGINAL FLORA; RESPONSES; INCREASE; DISEASES; INNATE;

D O I：

10.1136/sextrans-2014-051601

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives Sexually transmitted infections (STI) and bacterial vaginosis (BV) cause female genital tract inflammation. This inflammation, which is often present in the absence of symptoms, is associated with increased susceptibility to HIV infection. We aimed to evaluate genital cytokine profiles and the degree of inflammation associated with common STIs and BV. Methods HIV-uninfected women (n=227) were screened for BV, Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus type 2 (HSV-2), and Trichomonas vaginalis. Concentrations of 42 cytokines in cervicovaginal lavages and 13 cytokines in plasma were measured using Luminex. Changes in cytokine profiles were evaluated using Mann-Whitney U test, logistic regression and factor analysis. p Values were adjusted for multiple comparisons using a false discovery rate step-down procedure. Results Women with chlamydia or gonorrhoea had the highest genital cytokine concentrations, with 17/42 and 14/42 cytokines upregulated compared with women with no infection, respectively. BV was associated with elevated proinflammatory cytokine concentrations, but lower chemokine and haematopoietic cytokine concentrations. HSV-2 reactivation was associated with lower levels of inflammation, while trichomoniasis did not cause significant differences in genital cytokine concentrations. Genital infections did not influence plasma cytokine concentrations. Although certain STIs, in particular chlamydia and gonorrhoea, were associated with high genital cytokine concentrations, only 19% of women with an STI/BV had clinical signs. Conclusions Chlamydia was associated with the highest genital cytokine levels, followed by gonorrhoea, HSV-2, trichomoniasis, and BV. In regions where HIV is prevalent and STIs are managed syndromically, better STI/BV screening is urgently needed, as certain infections were found to be highly inflammatory.

引用

页码：580 / U21

页数：8

共 30 条

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