Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Department of Medical Microbiology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Front Immunol. 2021 Jun 9;12:695201. doi: 10.3389/fimmu.2021.695201. eCollection 2021.
The presence of semen in the vagina from unprotected sex may influence the immune and microbial environment of the female genital tract. Inflammatory cytokine concentrations and BV-associated bacteria in female genital secretions may influence HIV risk, although the effect of recent sexual intercourse on incident BV and the cytokine milieu of cervicovaginal secretions has rarely been measured in previous studies. Here, we investigated the extent to which partner semen impacts the cytokine response and incident BV.
At baseline, we assessed the recency of semen exposure in menstrual cup supernatants by quantifying prostate specific antigen (PSA) levels using ELISA in 248 HIV-uninfected women at high risk for HIV infection. Luminex was used to measure 48 cytokines in menstrual cup supernatants and vaginal swabs to diagnose BV by Nugent score. Point-of-care screening for and was conducted using GeneXpert while OSOM was used for detection. Multivariable models, adjusted for age, sexually transmitted infections, BV, current contraception use and condom use, were used to assess the impact of semen exposure on biomarkers of inflammation and BV.
Presence of PSA, indicating recent semen exposure within 48 hours prior to sampling, was observed in menstrual cup supernatants of 17% (43/248) of women. Of these women, 70% (30/43) had self-reported condom use at their last sex act and 84% (36/43) had BV (Nugent score >7). PSA presence was significantly associated with prevalent BV (Relative Risk (RR), 2.609; 95% Confidence Interval (CI), 1.104 - 6.165; p = 0.029). Furthermore, women with detectable PSA had high median concentrations of macrophage inflammatory protein- beta (MIP-1α, p=0.047) and low median concentration of the stem cell growth factor beta (SCGF-β, p=0.038) compared to those without PSA.
A degree of discordance between self-reports of consistent condom use and PSA positivity was observed. There was also evidence of a relationship between recent semen exposure, BV prevalence and altered cytokine concentrations. These findings suggest that PSA, as a semen biomarker, should be taken into consideration when investigating biological markers in the female genital tract and self-reported condom use in studies on reproductive and sexual health.
无保护性行为中精液进入阴道可能会影响女性生殖道的免疫和微生物环境。生殖道分泌物中炎症细胞因子浓度和细菌性阴道病（BV）相关细菌可能会影响 HIV 风险，但之前的研究很少测量最近的性行为对新发 BV 和宫颈阴道分泌物细胞因子环境的影响。在这里，我们研究了精液对细胞因子反应和新发 BV 的影响程度。
在基线时，我们通过 ELISA 定量检测 248 名 HIV 未感染、HIV 感染风险较高的女性月经杯上清液中的前列腺特异性抗原 (PSA) 水平，评估了最近精液暴露的情况。我们使用 Luminex 测量了月经杯上清液和阴道拭子中的 48 种细胞因子，并通过 Nugent 评分诊断 BV。使用 GeneXpert 进行即时检测筛查 和 ，使用 OSOM 进行 检测。我们使用多变量模型，调整了年龄、性传播感染、BV、当前避孕方法和避孕套使用情况，以评估精液暴露对炎症和 BV 生物标志物的影响。
在 248 名女性的月经杯上清液中，有 17%（43/248）的女性检测到 PSA，表明在采样前 48 小时内有最近的精液暴露。在这些女性中，70%（30/43）报告在最近一次性行为中使用了避孕套，84%（36/43）患有 BV（Nugent 评分>7）。PSA 阳性与 BV 患病率显著相关（RR，2.609；95%CI，1.104-6.165；p=0.029）。此外，与没有 PSA 的女性相比，有 PSA 可检测的女性巨噬细胞炎症蛋白-β（MIP-1α，p=0.047）的中位数浓度较高，而干细胞生长因子-β（SCGF-β，p=0.038）的中位数浓度较低。
在一致使用避孕套的自我报告和 PSA 阳性之间观察到一定程度的不相符。最近的精液暴露、BV 患病率和细胞因子浓度变化之间也存在关系。这些发现表明，PSA 作为精液生物标志物，在研究女性生殖道的生物标志物和生殖健康与性行为的自我报告的避孕套使用时应予以考虑。
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