女性生殖道分泌物和精液影响着用于预防 HIV 和其他性传播感染的杀微生物剂的发展。
Female genital tract secretions and semen impact the development of microbicides for the prevention of HIV and other sexually transmitted infections.
机构信息
Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10467, USA.
出版信息
Am J Reprod Immunol. 2011 Mar;65(3):325-33. doi: 10.1111/j.1600-0897.2010.00932.x. Epub 2010 Dec 12.
Abstract
Pharmacologic strategies for the prevention of HIV include vaccines, post-exposure prophylaxis with antiretroviral therapy, and topical microbicides. Vaginal microbicides have the potential to augment innate defenses in the genital tract but may also disrupt endogenous protection and increase HIV acquisition risk, as observed in clinical trials of nonoxynol-9. The initially disappointing results of microbicide clinical trials stimulated the development of more sensitive and comprehensive pre-clinical safety studies, which include dual-chamber culture systems to model the epithelial barrier and post-coital studies to evaluate the effects of semen and sexual intercourse on microbicide efficacy. This review discusses the key factors that contribute to a healthy female genital tract environment, the impact of semen on mucosal defense, and how our understanding of these mediators informs the development of effective vaginal microbicides.
摘要
预防 HIV 的药物策略包括疫苗、暴露后用抗逆转录病毒治疗和局部杀微生物剂。阴道杀微生物剂有可能增强生殖道的先天防御能力，但也可能破坏内源性保护并增加 HIV 感染风险，正如在非诺孕醇-9 的临床试验中观察到的那样。杀微生物剂临床试验最初令人失望的结果促使人们开发了更敏感和全面的临床前安全性研究，其中包括双室培养系统来模拟上皮屏障，以及性交后研究来评估精液和性交对杀微生物剂效果的影响。这篇综述讨论了有助于女性生殖道健康的关键因素、精液对黏膜防御的影响，以及我们对这些介质的理解如何为有效的阴道杀微生物剂的开发提供信息。
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