Department of Pediatrics, University of North Carolina at Chapel Hill.
Department of Microbiology and Immunology, University of North Carolina at Chapel Hill.
J Infect Dis. 2019 Jun 19;220(2):330-339. doi: 10.1093/infdis/jiz087.
Chlamydia trachomatis can cause reproductive morbidities after ascending to the upper genital tract of women, and repeated infection can lead to worse disease. Data related to protective immune responses at the cervical mucosa that could limit chlamydial infection to the cervix and/or prevent reinfection inform vaccine approaches and biomarkers of risk.
We measured 48 cytokines in cervical secretions from women having chlamydial cervical infection alone (n = 92) or both cervical and endometrial infection (n = 68). Univariable regression identified cytokines associated with differential odds of endometrial infection and reinfection risk, and multivariable stepwise regression identified cytokine ratios associated with differential risk.
Elevated interleukin (IL) 15/CXCL10 (odds ratio [OR], 0.55 [95% confidence interval {CI}, .37-.78]), IL-16/tumor necrosis factor-α (OR, 0.66 [95% CI, .45-.93]), and CXCL14/IL-17A (OR, 0.73 [95% CI, .54-.97]) cytokine ratios were significantly (P ≤ .05) associated with decreased odds of endometrial infection. A higher Flt-3L/IL-14 ratio was significantly (P = .001) associated with a decreased risk of reinfection (hazard ratio, 0.71 [95% CI, .58-.88]).
Cytokines involved in humoral, type I interferon, and T-helper (Th) 17 responses were associated with susceptibility to C. trachomatis, whereas cytokines involved in Th1 polarization, recruitment, and activation were associated with protection against ascension and reinfection.
沙眼衣原体可在上生殖道上行感染女性，引起生殖系统疾病，反复感染可导致病情加重。与宫颈黏膜保护性免疫反应相关的数据可用于指导疫苗接种策略的制定，并确定疾病风险的生物标志物。
我们检测了 92 例单纯宫颈沙眼衣原体感染和 68 例宫颈和子宫内膜均感染的女性宫颈分泌物中的 48 种细胞因子。单变量回归分析确定了与子宫内膜感染和再感染风险差异相关的细胞因子，多变量逐步回归分析确定了与风险差异相关的细胞因子比值。
白细胞介素（IL）15/CXCL10（比值比 [OR]，0.55 [95%置信区间 {CI}，0.37-0.78]）、IL-16/肿瘤坏死因子-α（OR，0.66 [95% CI，0.45-0.93]）和 CXCL14/IL-17A（OR，0.73 [95% CI，0.54-0.97]）细胞因子比值显著（P ≤ 0.05）与子宫内膜感染几率降低相关。Flt-3L/IL-14 比值升高与再感染风险降低显著相关（风险比，0.71 [95% CI，0.58-0.88]）。
参与体液、I 型干扰素和 Th17 反应的细胞因子与沙眼衣原体易感性相关，而参与 Th1 极化、募集和激活的细胞因子与防止上行感染和再感染相关。
