Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Medstar Washington Hospital Center, Washington, DC, USA.
Am J Reprod Immunol. 2018 Jun;79(6):e12846. doi: 10.1111/aji.12846. Epub 2018 Mar 13.
Adolescent girls are disproportionately affected by the HIV/AIDS pandemic, accounting for 22% of all new HIV infections globally. Yet little is known regarding the immune microenvironment of the adolescent female reproductive tract, especially regarding differences among sexually active and inactive girls, a critical parameter to evaluate HIV susceptibility associated with young age and sexual debut.
Cervico-vaginal lavage (CVL) was collected from sexually active (10) and inactive (8) girls aged 11-19 years and analyzed by ELISA for inflammation-associated biomarkers IL-6, IL-8, TNF-α, MIP-3α, IL-1α, IL-1β, matrix metalloproteinases (MMP) 1, 2, 7, 8, and 9, as well as anti-HIV mediators, Elafin, SLPI, human beta-defensin 2, and tissue inhibitor of matrix metalloproteinases (TIMP) 1 and 2. Cervical ectopy was analyzed using Volocity. Anti-HIV activity was determined by TZM-bl assay. Statistical analyses were performed using GraphPad Prism and R.
Sexually inactive girls had significantly higher levels of TNF-α (P = .029) in CVL compared to sexually active girls. In contrast, sexually active girls showed a trend toward higher levels of IL-1α (P = .051) compared to the sexually inactive girls. Heat-map correlations between cervical ectopy and immune biomarkers were also distinct between the 2 populations with significant positive associations between % ectopy and inflammation-associated biomarkers IL-6, IL-1β, IL-8, MIP-3α, MMP-8, and MMP-9 observed in the sexually inactive but not sexually active group.
Higher pro-inflammatory biomarker TNF-α, as well as a distinct inflammation-associated immune clustering in sexually inactive girls, can potentially increase risk for infections including HIV upon sexual debut. Future studies with larger sample sizes are needed to characterize the immune parameters associated with sexual activity.
少女受到艾滋病毒/艾滋病大流行的影响不成比例，占全球所有新艾滋病毒感染的 22%。然而，人们对青春期女性生殖道的免疫微环境知之甚少，特别是在活跃和不活跃的女孩之间的差异方面，这是评估与年轻和初次性行为相关的艾滋病毒易感性的关键参数。
从 11-19 岁有性行为的（10 名）和无性行为的（8 名）女孩中收集宫颈阴道灌洗液（CVL），并通过 ELISA 分析与炎症相关的生物标志物 IL-6、IL-8、TNF-α、MIP-3α、IL-1α、IL-1β、基质金属蛋白酶（MMP）1、2、7、8 和 9 以及抗 HIV 介质 Elafin、SLPI、人β-防御素 2 和基质金属蛋白酶组织抑制剂（TIMP）1 和 2。使用 Volocity 分析宫颈异位。通过 TZM-bl 测定抗 HIV 活性。使用 GraphPad Prism 和 R 进行统计分析。
与有性行为的女孩相比，无性行为的女孩的 CVL 中 TNF-α 水平明显更高（P=0.029）。相比之下，与无性行为的女孩相比，有性行为的女孩的 IL-1α 水平呈上升趋势（P=0.051）。在这两个群体中，宫颈异位与免疫生物标志物之间的热图相关性也不同，在无性行为的群体中观察到与炎症相关的生物标志物 IL-6、IL-1β、IL-8、MIP-3α、MMP-8 和 MMP-9 之间存在显著正相关，而在有性行为的群体中则没有。
较高的促炎生物标志物 TNF-α，以及无性行为女孩中明显的炎症相关免疫聚类，可能会增加初次性行为时感染包括 HIV 的风险。需要更大样本量的未来研究来描述与性行为相关的免疫参数。
