Birse Kenzie D, Romas Laura M, Guthrie Brandon L, Nilsson Peter, Bosire Rose, Kiarie James, Farquhar Carey, Broliden Kristina, Burgener Adam D
National HIV and Retrovirology Labs, JC Wilt Infectious Disease Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
J Infect Dis. 2017 Feb 15;215(4):590-598. doi: 10.1093/infdis/jiw590.
Increasing evidence suggests depot medroxyprogesterone acetate (DMPA) and intravaginal practices may be associated with human immunodeficiency virus (HIV-1) infection risk; however, the mechanisms are not fully understood. This study evaluated the effect of DMPA and intravaginal practices on the genital proteome and microbiome to gain mechanistic insights.
Cervicovaginal secretions from 86 Kenyan women, including self-reported DMPA users (n = 23), nonhormonal contraceptive users (n = 63), and women who practice vaginal drying (n = 46), were analyzed using tandem-mass spectrometry.
We identified 473 human and 486 bacterial proteins from 18 different genera. Depot medroxyprogesterone acetate use associated with increased hemoglobin and immune activation (HBD, HBB, IL36G), and decreased epithelial repair proteins (TFF3, F11R). Vaginal drying associated with increased hemoglobin and decreased phagocytosis factors (AZU1, MYH9, PLAUR). Injury signatures were exacerbated in DMPA users who also practiced vaginal drying. More diverse (H index: 0.71 vs 0.45; P = .009) bacterial communities containing Gardnerella vaginalis associated with vaginal drying, whereas DMPA showed no significant association with community composition or diversity.
These findings provide new insights into the impact of DMPA and vaginal drying on mucosal barriers. Future investigations are needed to confirm their relationship with HIV risk in women.
越来越多的证据表明，醋酸甲羟孕酮长效注射剂（DMPA）和阴道内操作可能与人类免疫缺陷病毒（HIV-1）感染风险相关；然而，其机制尚未完全明确。本研究评估了DMPA和阴道内操作对生殖器蛋白质组和微生物组的影响，以深入了解其机制。
对86名肯尼亚女性的宫颈阴道分泌物进行分析，其中包括自我报告使用DMPA的女性（n = 23）、使用非激素避孕药的女性（n = 63）以及进行阴道干燥操作的女性（n = 46），采用串联质谱法进行检测。
我们从18个不同属中鉴定出473种人类蛋白和486种细菌蛋白。使用醋酸甲羟孕酮长效注射剂与血红蛋白增加和免疫激活（HBD、HBB、IL36G）相关，同时上皮修复蛋白（TFF3、F11R）减少。阴道干燥与血红蛋白增加和吞噬作用因子减少（AZU1、MYH9、PLAUR）相关。在同时进行阴道干燥操作的DMPA使用者中，损伤特征更为明显。阴道干燥与含有阴道加德纳菌的细菌群落多样性增加（H指数：0.71对0.45；P = 0.009）相关，而DMPA与群落组成或多样性无显著关联。
这些发现为DMPA和阴道干燥对黏膜屏障的影响提供了新的见解。未来需要进一步研究以证实它们与女性HIV风险的关系。
