Thurman Andrea, Jacot Terry, Melendez Johan, Kimble Thomas, Snead Margaret, Jamshidi Roxanne, Wheeless Angie, Archer David F, Doncel Gustavo F, Mauck Christine
Eastern Virginia Medical School, 601 Colley Avenue, Room 235, Norfolk, VA 23507, USA.
Eastern Virginia Medical School, 601 Colley Avenue, Room 235, Norfolk, VA 23507, USA.
Contraception. 2016 Nov;94(5):512-520. doi: 10.1016/j.contraception.2016.05.012. Epub 2016 May 31.
The primary objective of this pilot study is to determine and compare the residence time in the vagina of biomarkers of semen exposure for up to 15 days post exposure. The biomarkers are prostate-specific antigen (PSA), Y chromosome DNA, the sex determining region of the Y chromosome (SRY) and testis-specific protein Y-encoded 4 (TSPY4). The secondary objectives are to determine if biomarker concentrations differed between intercourse and inoculation groups, to establish whether the sampling frequency post exposure affected biomarker concentrations and decay profile and to determine if biomarker concentrations in vaginal swabs obtained by the participant at home were similar to swabs obtained by the nurse in the clinic.
We randomized healthy women to unprotected intercourse (n=17) versus vaginal inoculation with the male partner's semen in the clinic (n=16). Women were then further randomized to have vaginal swabs obtained at either 7 or 4 time points after semen exposure, up to 15 days post exposure, either obtained at home by the participant or in the clinic by the research nurse.
PSA and SRY were markers of recent semen exposure. TSPY4 was detectable in approximately 50% of participants at 15 days post exposure. Unprotected intercourse resulted in significantly higher concentrations of select biomarkers. Sampling frequency and home versus clinic sampling had no significant effect on biomarker concentrations.
Objective biomarkers of recent or distant semen exposure may have great utility for verifying protocol compliance in a variety of clinical trials.
本初步研究的主要目的是确定并比较暴露后长达15天内精液暴露生物标志物在阴道内的停留时间。这些生物标志物包括前列腺特异性抗原(PSA)、Y染色体DNA、Y染色体性别决定区(SRY)和睾丸特异性蛋白Y编码4(TSPY4)。次要目的是确定性交组和接种组之间生物标志物浓度是否存在差异,确定暴露后采样频率是否会影响生物标志物浓度和衰减曲线,并确定参与者在家中采集的阴道拭子中的生物标志物浓度是否与诊所护士采集的拭子相似。
我们将健康女性随机分为无保护性交组(n = 17)和在诊所接受男性伴侣精液阴道接种组(n = 16)。然后,将女性进一步随机分为在精液暴露后7个或4个时间点采集阴道拭子,暴露后长达15天,拭子由参与者在家中或研究护士在诊所采集。
PSA和SRY是近期精液暴露的标志物。暴露后15天,约50%的参与者可检测到TSPY4。无保护性交导致某些生物标志物的浓度显著更高。采样频率以及在家采样与在诊所采样对生物标志物浓度没有显著影响。
近期或远期精液暴露的客观生物标志物在验证各种临床试验中的方案依从性方面可能具有很大用途。