Altered Biomarkers of Mucosal Immunity and Reduced Vaginal Lactobacillus Concentrations in Sexually Active Female Adolescents

Abstract

BackgroundGenital secretions collected from adult women exhibit in vitro activity against herpes simplex virus (HSV) and Escherichia coli (E. coli), but prior studies have not investigated this endogenous antimicrobial activity or its mediators in adolescent females.Methodology/Principal FindingsAnti-HSV and anti-E.coli activity were quantified from cervicovaginal lavage (CVL) specimens collected from 20 sexually active adolescent females (15–18 years). Soluble immune mediators that may influence this activity were measured in CVL, and concentrations of Lactobacillus jensenii and crispatus were quantified by PCR from vaginal swabs. Results for adolescents were compared to those obtained from 54 healthy, premenopausal adult women. Relative to specimens collected from adults, CVL collected from adolescent subjects had significantly reduced activity against E. coli and diminished concentrations of protein, IgG, and IgA but significantly increased anti-HSV activity and concentrations of interleukin (IL)-1α, IL-6 and IL-1 receptor antagonist. Vaginal swabs collected from adolescent subjects had comparable concentrations of L. crispatus but significantly reduced concentrations of L. jensenii, relative to adult swabs.Conclusions/SignificanceBiomarkers of genital mucosal innate immunity may differ substantially between sexually active adolescents and adult women. These findings warrant further study and may have significant implications for prevention of sexually transmitted infections in adolescent females.

Bacterial vaginosis in pregnant adolescents: proinflammatory cytokine and bacterial sialidase profile. Cross-sectional study

“…12 Our data provide the new information that IL-6 levels are even higher in pregnant adolescents with bacterial vaginosis.…”

“…10 No change in cervicovaginal IL-8 levels has been associated with adolescence so far. 12 Thus, based on data on the literature, we suggest that the increased cervicovaginal IL-8 levels reported…”

“…8,9 In fact, pregnancy and adolescence are both conditions associated with changes to the levels of immune mediators in the lower genital tract. [10][11][12] Typically, bacterial vaginosis is associated with increased cervicovaginal levels of interleukin (IL)-1 beta, but in pregnant women the levels of IL-6 and IL-8 are also elevated in the presence of bacterial vaginosis. [13][14][15][16] There is still a lack of information in the literature regarding the immune response to bacterial vaginosis in adolescents.…”

Clinical Safety and Pharmacology Trial

“…In addition to the effect of lower genital tract infections, substantial inter-and intra-individual variability exists in antimicrobial activity likely due to covariates such as age (Madan et al 2012), endogenous hormonal milieu (Keller et al 2007;Shust et al 2010), and the presence of semen and seminal plasma (Patel et al 2007) or other temporary alterations of mucosal immunity which may occur after vaginal intercourse (Keller et al 2010). There is also a gap in the data as to how ethnicity, race, and environmental exposures such as diet or tobacco affect the normal antimicrobial properties of the lower genital tract.…”

A Perspective on Progress and Gaps in HIV Prevention Science

“…Inflammatory conditions, which include adolescence, 46 bacterial vaginosis, and other STI [47][48][49] and the response to semen [40][41][42] may not only recruit new immune cells (as noted above) but enhance susceptibility to HIV by disrupting tight junctions and facilitating viral access to submucosal immune cells and directly augmenting HIV replication through activation of the viral promoter. 50 Inflammatory responses also induce T cell activation, which impacts PK/PD, particularly in the case of tenofovir.…”