Departments of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA.
Sex Transm Dis. 2012 Aug;39(8):591-7. doi: 10.1097/OLQ.0b013e318255aeef.
Clinical studies demonstrate increased prevalence of human papillomavirus (HPV)-associated disease in HIV-infected individuals and an increased risk of HIV acquisition in HPV-infected individuals. The mechanisms underlying this synergy are not defined. We hypothesize that women with cervical intraepithelial neoplasia (CIN) will exhibit changes in soluble mucosal immunity that may promote HPV persistence and facilitate HIV infection.
The concentrations of immune mediators and endogenous anti-Escherichia coli activity in genital tract secretions collected by cervicovaginal lavage were compared in HIV-negative women with high-risk HPV-positive (HRHPV+) CIN-3 (n = 37), HRHPV+ CIN-1 (n = 12), or PAP-negative control subjects (n = 57).
Compared with control subjects, women with CIN-3 or CIN-1 displayed significantly higher levels of proinflammatory cytokines including interleukin (IL)-1α, IL-1β, and IL-8 (P < 0.002) and significantly lower levels of anti-inflammatory mediators and antimicrobial peptides, including IL-1 receptor antagonist, secretory leukocyte protease inhibitor (P < 0.01), and human β defensins 2 and 3 (P < 0.02). There was no significant difference in endogenous anti-E. coli activity after controlling for age and sample storage time.
HRHPV+ CIN is characterized by changes in soluble mucosal immunity that could contribute to HPV persistence. The observed mucosal inflammation suggests a mechanism that may also contribute to the epidemiologic link between persistent HPV and HIV.
临床研究表明，HPV 相关疾病在 HIV 感染者中更为普遍，HPV 感染者感染 HIV 的风险也更高。但这种协同作用的机制尚不清楚。我们假设宫颈上皮内瘤变（CIN）患者的生殖道黏膜固有免疫会发生改变，这可能会促进 HPV 持续存在并促进 HIV 感染。
通过宫颈阴道灌洗收集生殖道分泌物，比较了 37 例高危型 HPV 阳性（HRHPV+）CIN-3、12 例 HRHPV+CIN-1 和 57 例 PAP 阴性的对照受试者的生殖道分泌物中免疫介质和内源性抗大肠埃希菌活性的浓度。
与对照组相比，CIN-3 或 CIN-1 患者的促炎细胞因子（包括白细胞介素[IL]-1α、IL-1β 和 IL-8）水平显著升高（P<0.002），抗炎介质和抗微生物肽（包括 IL-1 受体拮抗剂、分泌型白细胞蛋白酶抑制剂（P<0.01）和人β防御素 2 和 3）水平显著降低（P<0.02）。在控制年龄和样本储存时间后，内源性抗大肠埃希菌活性没有显著差异。
HRHPV+CIN 的特点是可溶性黏膜固有免疫发生改变，这可能有助于 HPV 的持续存在。观察到的黏膜炎症表明，这一机制也可能有助于 HPV 持续存在与 HIV 之间的流行病学联系。
