女性性传播病毒感染患病率上升:女性性激素在调节易感性和免疫反应中的作用。

Increased prevalence of sexually transmitted viral infections in women: the role of female sex hormones in regulating susceptibility and immune responses.

机构信息

Department of Pathology and Molecular Medicine, Michael DeGroote Center for Learning and Discovery, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Reprod Immunol. 2011 Mar;88(2):204-9. doi: 10.1016/j.jri.2010.12.004. Epub 2011 Feb 5.

Abstract

Sexually transmitted infections (STIs) caused by viruses, including HSV-2, HIV-1, HPV, are among the most prevalent infectious diseases worldwide and a major cause of morbidity and mortality. Despite decades of effort, the attempts to develop efficacious vaccines against viral STIs have failed repeatedly, with the exception of the recent HPV vaccine. Given the higher prevalence rates of STIs in women, it is becoming clear that a better understanding of gender-specific differences in STIs may be critical for the development of preventative strategies for these diseases. In order to gain this insight, it is important to examine the distinct microenvironment of the female reproductive tract, the site of primary infection, since it can significantly influence the outcome of infection. An important biological factor in the female reproductive tract is the presence of female sex hormones, estrogen and progesterone, which are produced endogenously primarily by the ovaries and commonly provided exogenously via the use of hormonal contraceptives. Here we review our current knowledge of the role played by the female sex hormones in regulating susceptibility and immune responses to viral sexually transmitted infections and whether this could contribute to higher prevalence of STIs in women. Manipulating the microenvironment of the female genital tract with sex hormones may contribute to the development of improved immunization strategies against sexually transmitted infections.

摘要

性传播感染(STIs)由病毒引起,包括单纯疱疹病毒 2 型(HSV-2)、人类免疫缺陷病毒 1 型(HIV-1)和人乳头瘤病毒(HPV),是全球最普遍的传染病之一,也是发病率和死亡率的主要原因。尽管经过几十年的努力,针对病毒性 STIs 的有效疫苗的尝试一再失败,除了最近的 HPV 疫苗。鉴于 STIs 在女性中的更高流行率,越来越明显的是,更好地了解 STIs 中的性别特异性差异可能对于这些疾病的预防策略的发展至关重要。为了获得这种见解,重要的是要检查女性生殖道的独特微环境,即原发感染部位,因为它会显著影响感染的结果。女性生殖道中的一个重要生物学因素是女性性激素雌激素和孕激素的存在,它们主要由卵巢内源性产生,通常通过使用激素避孕药外源性提供。在这里,我们回顾了我们目前对女性性激素在调节对病毒性性传播感染的易感性和免疫反应中的作用的了解,以及这是否可能导致女性中 STIs 的更高流行率。用性激素操纵女性生殖道的微环境可能有助于开发针对性传播感染的改进免疫策略。

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