Department of Plant Pathology and Microbiology, University of California, Riverside, USA.
BMC Infect Dis. 2011 Sep 30;11:263. doi: 10.1186/1471-2334-11-263.
Pregnant women are at an increased risk for HIV infection due to unknown biological causes. Given the strong effect of sex-hormones on the expression of immunomuodulatory factors, the central role of mucosal immunity in HIV pathogenesis and the lack of previous studies, we here tested for differences in immunomuodulatory factors in cervico-vaginal secretions between pregnant and non-pregnant women.
We compared concentrations of 39 immunomodulatory factors in cervicovaginal lavages (CVL) from 21 pregnant women to those of 24 non-pregnant healthy women from the US. We used Bonferroni correction to correct for multiple testing and linear regression modeling to adjust for possible confounding by plasma cytokine concentration, cervical ectopy, total protein concentration, and other possible confounders. Cervical ectopy was determined by planimetry. Concentration of immunomodulatory factors were measured by a multiplex assay, protein concentration by the Bradford Method.
Twenty six (66%) of the 39 measured immunomodulatory factors were detectable in at least half of the CVL samples included in the study. Pregnant women had threefold lower CVL concentration of CCL22 (geometric mean: 29.6 pg/ml versus 89.7 pg/ml, p = 0.0011) than non-pregnant women. CVL CCL22 concentration additionally correlated negatively with gestational age (Spearman correlation coefficient [RS]: -0.49, p = 0.0006). These associations remained significant when corrected for multiple testing. CCL22 concentration in CVL was positively correlated with age and negatively correlated with time since last coitus and the size of cervical ectopy. However, none of these associations could explain the difference of CCL22 concentration between pregnant and non-pregnant women in this study, which remained significant in adjusted analysis.
In this study population, pregnancy is associated with reduced concentrations of CCL22 in cervicovaginal secretions. The role of CCL22 on HIV transmission should now be investigated in prospective studies.
由于未知的生物学原因，孕妇感染 HIV 的风险增加。鉴于性激素对免疫调节因子表达的强烈影响、黏膜免疫在 HIV 发病机制中的核心作用以及之前缺乏研究，我们在此测试了怀孕和非怀孕妇女的宫颈阴道分泌物中的免疫调节因子是否存在差异。
我们比较了 21 名美国孕妇和 24 名非怀孕健康女性的宫颈阴道灌洗液（CVL）中的 39 种免疫调节因子的浓度。我们使用 Bonferroni 校正来校正多重检验，并使用线性回归模型来调整血浆细胞因子浓度、宫颈异位、总蛋白浓度和其他可能的混杂因素。通过面积测定法确定宫颈异位。免疫调节因子的浓度通过多重分析测定，蛋白浓度通过 Bradford 法测定。
在所研究的 CVL 样本中，至少有一半可检测到 39 种测量的免疫调节因子中的 26 种（66%）。与非怀孕女性相比，孕妇的 CVL 中 CCL22 浓度低三倍（几何平均值：29.6pg/ml 与 89.7pg/ml，p=0.0011）。CCL22 在 CVL 中的浓度与妊娠年龄呈负相关（Spearman 相关系数[RS]：-0.49，p=0.0006）。这些关联在经过多重检验校正后仍然显著。CCL22 在 CVL 中的浓度与年龄呈正相关，与上次性交后时间和宫颈异位的大小呈负相关。然而，这些关联都无法解释本研究中怀孕和非怀孕女性之间 CCL22 浓度的差异，在调整分析中仍然显著。
在本研究人群中，怀孕与宫颈阴道分泌物中 CCL22 浓度降低有关。现在应该在前瞻性研究中调查 CCL22 在 HIV 传播中的作用。
