Department of Obstetrics and Gynecology, University of Washington, Seattle, United States.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, United States.
Elife. 2022 Oct 25;11:e78565. doi: 10.7554/eLife.78565.
Adolescent girls and young women (AGYW) are at high risk of sexually transmitted infections (STIs). It is unknown whether beginning to have sexual intercourse results in changes to immune mediators in the cervicovaginal tract that contribute to this risk.
We collected cervicovaginal lavages from Kenyan AGYW in the months before and after first penile-vaginal sexual intercourse and measured the concentrations of 20 immune mediators. We compared concentrations pre- and post-first sex using mixed effect models. We additionally performed a systematic review to identify similar studies and combined them with our results by meta-analysis of individual participant data.
We included 180 samples from 95 AGYW, with 44% providing only pre-first sex samples, 35% matched pre and post, and 21% only post. We consistently detected 19/20 immune mediators, all of which increased post-first sex (p<0.05 for 13/19; Holm-Bonferroni-adjusted p<0.05 for IL-1β, IL-2, and CXCL8). Effects remained similar after excluding samples with STIs and high Nugent scores. Concentrations increased cumulatively over time after date of first sex, with an estimated doubling time of about 5 months.Our systematic review identified two eligible studies, one of 93 Belgian participants, and the other of 18 American participants. Nine immune mediators were measured in at least two-thirds of studies. Meta-analysis confirmed higher levels post-first sex for 8/9 immune mediators (p<0.05 for six mediators, most prominently IL-1α, IL-1β, and CXCL8).
Cervicovaginal immune mediator concentrations were higher in women who reported that they started sexual activity. Results were consistent across three studies conducted on three different continents.
This research was funded by R01 HD091996-01 (ACR), by P01 AI 030731-25 (Project 1) (AW), R01 AI116292 (FH), R03 AI154366 (FH) and by the Center for AIDS Research (CFAR) of the University of Washington/Fred Hutchinson Cancer Research Center AI027757.
青少年女孩和年轻女性（AGYW）感染性传播感染（STI）的风险很高。目前尚不清楚首次发生性行为是否会导致宫颈阴道道内免疫介质发生变化，从而增加这种风险。
我们从肯尼亚的 AGYW 中收集了宫颈阴道灌洗液，这些女性在首次阴茎阴道性交前和性交后几个月内提供了样本，并测量了 20 种免疫介质的浓度。我们使用混合效应模型比较了首次性行为前后的浓度。此外，我们还进行了系统评价，以确定类似的研究，并通过个体参与者数据的荟萃分析将我们的结果与这些研究相结合。
我们纳入了 180 名来自 95 名 AGYW 的样本，其中 44%的人仅提供了首次性行为前的样本，35%的人提供了首次性行为前和后的样本，21%的人仅提供了首次性行为后的样本。我们一致检测到了 20 种免疫介质中的 19 种，所有这些介质在首次性行为后都增加了（19/20；对于 13/19，经 Holm-Bonferroni 调整后，p<0.05）。在排除 STI 和高 Nugent 评分的样本后，结果仍然相似。自首次性行为以来，免疫介质的浓度随着时间的推移呈累积性增加，估计倍增时间约为 5 个月。我们的系统评价确定了两项合格的研究，一项是在 93 名比利时参与者中进行的，另一项是在 18 名美国参与者中进行的。至少有三分之二的研究测量了 9 种免疫介质。荟萃分析证实了首次性行为后 8/9 种免疫介质的水平升高（6 种介质，最明显的是 IL-1α、IL-1β 和 CXCL8，p<0.05）。
报告开始性行为的女性宫颈阴道免疫介质浓度较高。这一结果在三个在不同大洲进行的研究中是一致的。
本研究由 R01 HD091996-01（ACR）、P01 AI 030731-25（项目 1）（AW）、R01 AI116292（FH）、R03 AI154366（FH）和华盛顿大学/弗雷德哈钦森癌症研究中心艾滋病研究中心（CFAR）AI027757 资助。
Zotero 插件
