Local immunity factors in the reproductive system of women with Chlamydia infection

A total of 50 healthy women and 184 women of reproductive age with Chlamidia infection, complicated by candidiasis, mycoplasmosis and bacterial vaginosis were under examination. The local infectious immunity indices of cervical mucous were detected. The investigation of cell-mediated and humoral factors of cervical secretions revealed the dysfunction of local infectious protection in women with Chlamydia infection.     

Experimental study of the immunological activity of a preparation made from the antigenic complexes of opportunistic microorganisms administered by different routes

The data obtained in the experimental study of the humoral factors of local and systemic immunity, as well as the morphofunctional changes of internal organs, after multiple subcutaneous and aerosol immunization with the combined preparation of Proteus, Staphylococcus, Klebsiella pneumoniae and Escherichia coli antigens (preparation nC-4) are presented. The subcutaneous and aerosol administration of preparation nC-4 has been found to induce an increase in the levels of antibodies to all components of the preparation in the blood serum and in respiratory tract secretions. The introduction of the preparation through the respiratory tract resulted in an earlier intensive accumulation of specific antibodies and IgA in respiratory tract secretions. The results of the quantitative cytological study of respiratory tract secretions and the morphofunctional changes of the lymphoid tissue associated with the lungs are indicative of an important role played by cell-mediated immunity factors in the formation of local postvaccinal immunity.     

Anti-inflammatory cytokines of cervical secretions and the blood serum in women with genital infections

In cervical secretions of healthy non-pregnant women of the reproductive age high concentrations of ant-inflammatory cytokines, greatly exceeding those in blood serum, were detected. During pregnancy the level of TNF-alpha in cervical secretions dropped. The inflammation of the uterus neck was accompanied by a drop in the levels of IL-alpha and IL-1beta and a rise in the level of IL-8 in cervical secretions in pregnant and non-pregnant women. Similar changes in the cytokine profile occurred also in the blood serum, but they were less pronounced and could be observed only in non-pregnant women. The threat of the interruption of pregnancy, developing simultaneously with cervicitis, was accompanied not only by changes in the levels of cytokines in cervical secretions, but also by a perceptible increase in the content of IL-1alpha in the blood serum.     

The evaluation of prevalence and the impact of pathological microflora of the lower genital tract among women at early pregnancy on the risk of preterm delivery

The main aim of this prospective study was to determine the prevalence and an association between pathological microflora of the lower genital tract diagnosed at early pregnancy and the risk of preterm delivery. The study group comprised 179 randomly selected pregnant women from Lodz region, between 8 and 16 week of pregnancy. For the qualitative and quantitative assessment of biocenosis of the lower genital tract vaginal and cervical swabs were collected from the pregnant women under study. The C. trachomatis antigen was detected by direct immunofluorescence assay. The vaginal swabs were tested for aerobic and anaerobic bacteria. Bacterial vaginosis was diagnosed by Gram stain according to Spiegel's criteria. To evaluate the risk factors odds ratios were calculated using EPI INFO software. 21 (11.7%) women delivered before 37th week of pregnancy. Bacterial vaginosis was diagnosed among 51 (28.5%) pregnant women while intermediate microflora was diagnosed by Gram stain in 62 (34.6%) women. The shortest mean gestational age at delivery was noted among women with BV. The rate of preterm delivery in BV group was 15.7% comparing to 9.1% among women with normal microflora. Among women with preterm delivery BV was diagnosed in 38.1% (OR = 1.86). Based on culture results only 84 (46.9%) women had normal microflora at early pregnancy. The pathological culture was associated with slightly increased preterm delivery rate (12.6%) as compare to 10.7% in control group. Positive culture for Bacteroides and Mobiluncus was connected with nonstatistical rise in the risk of preterm delivery. No association between C. trachomatis infection at early pregnancy and elevated risk of preterm delivery was found. Early pregnancy diagnosis of bacterial vaginosis and its treatment should lower the rate of prematurity in Poland.     

Immune responses to vaginal or systemic infection of BALB/c mice with herpes simplex virus type 2.

The temporal relationships among the humoral and cellular immune responses were defined in BALB/c mice after vaginal or systemic infection with herpes simplex virus type 2 (HSV-2). After vaginal infection, mice showed evidence of clinical vaginitis on days 4 to 6 and HSV-2 replication was detected locally in the vaginal secretions, cervix, vagina, and uterus before the virus subsequently spread to the central nervous system. Death from encephalitis occurred between 7 and 10 days after infection. Vaginal infection was associated with significant delayed type hypersensitivity and splenic proliferative cell-mediated immune responses which appeared during the acute infection and waned by 3 weeks. There was almost no evidence of a systemic neutralizing antibody response at any time after vaginal infection. In contrast to the local vaginal infection, systemic i.v. HSV-2 infection induced a humoral response as well as the two cellular immune responses. Although both cellular immune responses appeared during the acute infection (days 6 to 14) and persisted for approximately 5 weeks, the humoral response appeared in surviving animals and persisted for at least 4 months. Thus, vaginal HSV-2 infection was associated primarily with transient cellular immune responses, whereas i.v. HSV-2 infection induced prolonged systemic humoral and cellular immune responses.     

34例胎膜早破孕妇妊娠晚期阴道微生态及免疫因子变化状况分析

目的：胎膜早破是一种常见但发生机制十分复杂的妊娠并发症。在所有的早产儿中,孕妇胎膜早破的比例高达33％。本研究针对胎膜早破产妇妊娠晚期阴道微生态及免疫因子的变化情况,分析阴道内茵群失调或局部免疫反应与胎膜早破的关系,为临床研究提供实验数据。方法：回顾性分析我院于2010年7月-2013年3月收治的34例胎膜早破孕妇的临床资料,同时选取于我院进行健康体检的妇女及产前检查的健康孕妇各34例作为对照。采集所有研究对象的阴道分泌物,对比分析各组样本中病原微生物的分布及免疫因子的浓度。结果：胎膜早破组乳酸杆菌的检出率要明显低于健康妇女组与健康孕妇组（79．4％VS70．6％VS34．1,X2=8．438,P〈0．05）,三组研究对象其他茵属分布的差异比较无统计学意义（P〉0．05）;胎膜早破组阴道分泌物IL-6浓度与TNF．仪浓度要显著高于健康妇女组与健康孕妇组（P〈0．05）。结论：胎膜早破产妇阴道内的菌群分布与健康女性及孕妇有所不同,阴道内茵群失调及局部的免疫反应可能会导致胎膜旱破的发生。     

Efficiency of immunocorrection using cytokines in the therapy of papillomavirus infection

The data of the immunological examination and the results of treatment of 86 patients with papillomavirus infection (PVI) are presented. The multifactor suppression of cell-mediated and humoral immunity was established. The degree of immune disturbances correlated with the spread and severity of lesions. The use of systemic injections of cytokines (leukinferon and concentrated interferon) in low doses as adjuvant therapy with laser-radiosurgery led to the normalization of most immunological characteristics and the course of PVI without relapses.     

Impairment of T cell-mediated immunity to Listeria monocytogenes in pregnant mice

In order to study pregnancy-induced changes in cell-mediated immunity to Listeria monocytogenes, acquired resistance and T cell functions in pregnant mice were compared with those in nonpregnant mice after immunization with viable listerial cells. Impaired generation of acquired resistance was evident in pregnant mice from the impaired elimination of bacteria and poor survival after secondary challenge. Delayed footpad reactivity to listerial antigen was also lower in the pregnant mice. When immune spleen cells were examined for their ability to produce macrophage activating factor in vitro, culture supernatants from pregnant-mouse spleen cells with listerial antigen showed far less ability to render macrophages cytostatic for P815 mastocytoma cells. To elucidate further the impairment of listeria-immune T cell generation in pregnant mice, a local transfer experiment was carried out. When a given number of immune spleen cells was transferred locally into the footpads of naive mice, both delayed footpad reaction and local protection were much lower in the pregnant mice. This local transferability of the reactions was abrogated after treatment of cells with anti-Thy 1 antibody plus complement. These findings indicate that pregnancy impairs the generation of specific T cells capable of contributing to acquired resistance to L. monocytogenes. Possible mechanisms for this impairment and the relationship to macrophage functions are discussed.     

Bacterial Vaginosis Is Associated with Loss of Gamma Delta T Cells in the Female Reproductive Tract in Women in the Miami Women Interagency HIV Study (WIHS): A Cross Sectional Study

Bacterial vaginosis (BV) is the most common female reproductive tract infection and is associated with an increased risk of acquiring and transmitting HIV by a mechanism that is not well understood. Gamma delta (GD) T cells are essential components of the adaptive and innate immune system, are present in the female reproductive tract, and play an important role in epithelial barrier protection. GD1 cells predominate in the mucosal tissue and are important in maintaining mucosal integrity. GD2 cells predominate in peripheral blood and play a role in humoral immunity and in the immune response to pathogens. HIV infection is associated with changes in GD T cells frequencies in the periphery and in the female reproductive tract. The objective of this study is to evaluate if changes in vaginal flora occurring with BV are associated with changes in endocervical GD T cell responses, which could account for increased susceptibility to HIV. Seventeen HIV-infected (HIV+) and 17 HIV-uninfected (HIV-) pre-menopausal women underwent collection of vaginal swabs and endocervical cytobrushes. Vaginal flora was assessed using the Nugent score. GD T cells were assessed in cytobrush samples by flow cytometry. Median Nugent score was 5.0 and 41% of women had abnormal vaginal flora. In HIV uninfected women there was a negative correlation between Nugent score and cervical GD1 T cells (b for interaction = - 0.176, p<0.01); cervical GD1 T cells were higher in women with normal vaginal flora than in those with abnormal flora (45.00% vs 9.95%, p = 0.005); and cervical GD2 T cells were higher in women with abnormal flora than in those with normal flora (1.70% vs 0.35%, p = 0.023). GD T cells in the genital tract are protective (GD1) and are targets for HIV entry (GD2). The decrease in cervical GD1 and increase in GD2 T cells among women with abnormal vaginal flora predisposes women with BV to HIV acquisition. We propose to use GD T cell as markers of female genital tract vulnerability to HIV.     

Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis.

Microorganisms associated with bacterial vaginosis are commonly recovered from the amniotic fluid and chorion-amnion of patients who deliver prematurely. Bacteria closely related to those causing bacterial vaginosis may play a role in the initiation of uterine contractions, ripening of the cervix and weakening of the fetal membranes by stimulating prostaglandin synthesis. In the present investigation, cervical mucus was collected by brush from early pregnant women with and without bacterial vaginosis. The concentrations of PGE2, PGF2 alpha and 6-keto-PGF1 alpha were determined in the mucus samples by methyl oximation and then radioimmunoassay, utilizing antibodies raised against oximated prostaglandins. It was found that the concentration of PGE2 and PGF2 alpha was significantly higher in the mucus of women with bacterial vaginosis compared with healthy women. The concentration of 6-keto-PGF1 alpha was similar in both study groups. All patients had been instructed to abstain from sexual intercourse for 24 hours before sampling. However, it may be that women with high concentrations in their mucus may have had intercourse anyway. However, it is fairly well possible that the significant differences in the PGE2 and PGF2 alpha values are causally related to the higher rate of preterm labor in women with the commonplace infection of bacterial vaginosis.     

The use of biological preparations for correction of microbial status in pregnant women

15 pregnant women with pregnancy lasting 28-32 weeks, whose medico-laboratory data (the positive result of the amino test, high pH value and the detection of "key" cells) suggested the presence of bacterial vaginosis, were placed under observation. The bacteriological study of vaginal microflora in all these women revealed pronounced disturbances simultaneously with the development of intestinal dysbacteriosis. The local application of the bacterial preparation "Zhlemik" containing freeze-dried live lactic acid bacteria of vaginal origin and the oral administration of lactic acid bifidumbacterin containing live bifidobacteria of intestinal origin permitted the successful restoration of vaginal and intestinal microbiocenosis. The capacity of biotherapeutic preparations for inducing non-specific immunostimulation led to a significant rise in the levels of IgA, IgM and IgG in vaginal secretions.     

乳杆菌活菌制剂对细菌性阴道病局部免疫的调节

目的检测正常人和细菌性阴道病(BV)患者治疗前后阴道局部细胞因子的变化,探讨乳杆菌活菌制剂对女性生殖道免疫的影响,为阴道微生态平衡与阴道黏膜免疫屏障的关系的研究提供一定的依据。方法用乳杆菌活菌制剂治疗BV,通过酶联免疫吸附试验法即ELISA法来检测BV患者治疗前后及正常健康妇女阴道局部细胞因子sIgA、IL-2、IL-13的水平。结果 sIgA、IL-13水平治疗前组较对照组明显升高(P<0.01),治疗后组较治疗前组水平下降(P<0.05),治疗后组较对照组水平升高(P>0.05);IL-2水平治疗前组较对照组明显降低,治疗后组较治疗前组明显升高(P<0.05),治疗后组较对照组下降(P<0.05)。结论 BV患者阴道局部免疫功能发生了改变;乳杆菌活菌制剂对BV患者阴道局部免疫具调节作用.     

Characteristics of the immune response to a single peroral administration of different doses of corpuscular pertussis vaccine

The effect of oral administrations of different doses of pertussis vaccine on the humoral and cell-mediated responses of systemic immunity and on the immunomorphological transformation of the mucous membrane of the small intestine was studied in (CBA X C57BL/6)F1 mice. On day 28 after the administration of all the tested doses of pertussis vaccine the animals were found to have a high degree of protection from the development of meningoencephalitis induced by the inoculation of Bordetella pertussis in the absence of specific hemagglutinins in their blood sera. At the same time the formation of spontaneous and immune rosette-forming cells and splenocytes was found to be inversely related to the administered dose. The immunomorphological transformation observed in the mucous membrane of the small intestine and in the lymphoid tissue associated with the small intestine was indicative of the stimulation of local immunity. The results thus obtained suggest that a single oral administration of pertussis vaccine to mice stimulates cell-mediated and humoral reactions of local immunity and induces the development of systemic cell-mediated immunity.     

The phenomenon of the formation of universal rosette-forming cells under superextreme loads

A combined immunological study of cell-mediated and humoral immunity factors in sportsmen at the period of important competitions was made. The effect of the maximum bearable load was found to lead to the formation of a great number of universal rosette-forming lymphocytes and neutrophils. In the control group their number did not exceed 1-4% of the total population of these cells. Simultaneously, the suppression of the phagocytic activity of neutrophils and some of the humoral factors of systemic and local immunity with the parallel development of compensating processes were recorded.     

Bacterial vaginosis: etiopathogenetic aspects

Current microbiological data on the vaginal microecology in healthy women and in patients with bacterial vaginosis are presented in the article. Problems of formation of colonization resistance of vaginal microbiocenosis were discussed. Etiologic role of certain microorganisms and their associations in the pathogenesis of bacterial vaginosis was considered. Pathophysiological processes leading to development of vaginal disbiosis, features of local immune status and molecular specificity of intercellular interactions in the development of adaptive immune response were characterized.     

Cellular and humoral IgA responses after single and multiple local injections of antigen

IgA responses in submandibular salivary glands, cervical lymph nodes, and saliva of rats were studied. Immunoglobulin-containing cells of the IgA isotype were examined by immunofluorescence of mononuclear cells isolated from the submandibular salivary glands and cervical lymph nodes after primary and multiple local injections of Streptococcus mutans. Also, salivary and serum antibodies to S. mutans were determined using an ELISA. The results support immunologic memory for the secretory (salivary) IgA system at both the cellular and humoral levels. Comparison of the dynamics of the IgAICC responses among the tissues and secretions after the injection regimes suggests that the cervical lymph nodes may provide an enriched tissue source for secretory IgA responses in the oral cavity.     

Acceptance of a connective tissue equivalent for grafting and capsuloligamentary reconstruction

A strip of a connective tissue equivalent prepared by using the patient's fibroblasts cultivated in vitro and calf skin collagen, was used for capsuloligamentary reconstruction of the knee. The study of the humoral and cell-mediated immune responses indicated that there was no cell-mediated immune reaction and only a transient humoral reaction 2 months after implantation. This first assay in human surgery gave a good functional result, and an immunological response was no longer observed 5 months after grafting.     

Endpiece: The noble profession

ObjectivesTo assess whether bacterial vaginosis or chlamydial infection before 10 weeks'' gestation is associated with miscarriage before 16 weeks.DesignProspective cohort study.Setting32 general practices and five family planning clinics in south London.Participants1216 pregnant women, mean age 31, presenting before 10 weeks'' gestation.Results121 of 1214 women (10.0%, 95% confidence interval 8.3% to 11.7%) miscarried before 16 weeks. 174 of 1201 women (14.5%, 12.5% to 16.5%) had bacterial vaginosis. Compared with women who were negative for bacterial vaginosis those who were positive had a relative risk of miscarriage before 16 weeks'' gestation of 1.2 (0.7 to 1.9). Bacterial vaginosis was, however, associated with miscarriage in the second trimester at 13-15 weeks (3.5, 1.2 to 10.3). Only 29 women (2.4%, 1.5% to 3.3%) had chlamydial infection, of whom one miscarried (0.32, 0.04 to 2.30).ConclusionBacterial vaginosis is not strongly predictive of early miscarriage but may be a predictor after 13 weeks'' gestation. The prevalence of Chlamydia was too low to assess the risk, but it is unlikely to be a major risk factor in pregnant women.

What is already known on this topic

Miscarriages are common and associated with considerable morbidity and costsBacterial vaginosis is associated with miscarriage after 16 weeks'' gestation and preterm birth but the role of chlamydial infection is uncertain

What this study adds

Bacterial vaginosis is not a strong predictor of miscarriage before 16 weeks'' gestation but may be associated with miscarriage at 13-15 weeks'' gestationThe prevalence of chlamydial infection was too low for it to be a major risk factor for miscarriage in this population of healthy pregnant womenNon-invasive screening for bacterial vaginosis and chlamydial infection by using self administered vaginal swabs is feasible in pregnant women in the community     

Circulating immune complexes in the pathogenesis of recurrent erysipelas

The dynamics of circulating immune complexes (CIC) in comparison with the level of SH-groups of serum deproteinate and other characteristics of cell-mediated and humoral immunity (the reaction of the inhibition of antibodies, the levels of T-cells and their main subpopulations) was studied in 103 erysipelas patients and in 46 persons having had the disease at the acute period of this infection and at the periods between relapses. The elevated levels of CIC and SH-groups of serum deproteinate were found to be directly correlated with the inhibition index. The study showed that, as a rule, in patients with the elevated level of CIC the frequently relapsing form of erysipelas, accompanied by the formation of relative hypersuppressor-type secondary immunodeficiency and by a decrease in the functional activity of dermal macrophages, was observed.