阿奇霉素对沙眼衣原体感染后生殖道黏膜免疫反应的影响

目的 研究阿奇霉素治疗生殖道沙眼衣原体感染过程中对局部黏膜免疫反应的影响,为其临床应用提供新的实验依据.方法 构建小鼠生殖道沙眼衣原体感染模型,随机分为生理盐水组和阿奇霉素组.阿奇霉素组一次性给予阿奇霉素（80mg/kg）,生理盐水组给予等量生理盐水.给药当天、给药第7天、给药第14天和给药第21天,阴道拭子取宫颈脱落细胞,分离沙眼衣原体.给药21天,处死动物.收集血清,ELISA测定血清IL-6和TNF-α水平,同时进行阴道、宫颈黏膜常规HE染色和肥大细胞甲苯胺蓝染色、树突状细胞免疫组织化学分析.结果 1.阿奇霉素组沙眼衣原体感染率明显低于生理盐水组,且未出现上行感染（P〈0.05）.2.阿奇霉素组生殖道黏膜内树突状细胞数量增加（P〈0.05）,肥大细胞数量无明显变化（P〈0.05）.3.阿奇霉素组血清内IL-6和TNF-α的水平,均高于对照组和生理盐水组（P〈0.05）.结论 阿奇霉素除了有效清除生殖道沙眼衣原体感染,亦可以调节生殖道黏膜的免疫反应,减轻免疫病理损伤,使沙眼衣原体感染有较好的预后.

The influence of azithromycin on genital mucosal immunity in chlamydial trachomatis infection

Objective To investigate the influence of azithromycin used to treat the genttal chlamydia trachomatis infection on the local mucosal immune response, and to provide proofs for its new clinical applications. Methods We established the mouse model of genital ehlamydia trachomatis infection. The model mice were randomly divided into the azithromycin group and the saline group. The former was given azithromycin （80 mg/kg） by intragastric infusion while the latter was given the same volume of saline. Vaginal swabs were used to collect cervical exfoliated ceils for the isolation of chlamydia trachomatis in the dose day, 7th day, 14th day and 21st day. At the 21th clay, the animals were sacrificed. The serum IL-6 and TNF alpha concentrations were determined by ELISA. Simultaneously, the mast cells and dentritic cells in the mucosa of the genital tract were stained by toluidine blue and analyzed by immunohistochemis- try. Results I. The ratio of infection in the azithromyein group decreased significantly compared with that of the saline group （P〈0.05）. 2. The amount of genital mucosal dendritic cells in the azithromycin group increased significantly than that in the control and saline groups respectively （P〈0.05）. There was no significant difference between the azithromycin group and the control group in the amount of mucosal mast cells. 3. The serum IL-6 and TNF alpha concentrations in the azithromycin group was significantly higher than those in saline and control groups （P 〈0. 05）. Conclusion Azithromycin can effectively remove chlamydia trachomatis infection in the genital tract. Moreover, it can ameliorate the genital tract mucosa damaged caused by chlamydia trachomatis infection and regulate the local mucosal immunity.