The primary function of the female reproductive tract (FRT) is to enable successful reproduction, yet the biologic mechanisms required to accomplish this, which include fluctuating sex hormones and tolerance of semen and a semi-allogeneic fetus, can leave this unique mucosal environment susceptible to pathogenic challenge. Consequently, the FRT has evolved specialized innate and adaptive immune responses tailored to protecting itself from infection without compromising reproductive success. A family of innate immune cytokines that has emerged as important regulators of these immune responses is the type I IFNs. Type I IFNs are typically rapidly produced in response to pathogenic stimulation and are capable of sculpting pleotropic biologic effects, including immunomodulation, antiproliferative effects, and inducing antiviral and bactericidal molecules. Here, we review what is currently known about type I IFN-mediated immunity in the FRT in human, primate, and murine models and explore their importance with respect to three highly relevant FRT infections: HIV, Zika, and Chlamydia.
K E Y W O R D SChlamydia, female reproductive tract, HIV, hormonal regulation, mucosal immunity, Type I IFNs,
Zika
THE FRT: A DYNAMIC IMMUNE ENVIRONMENTThe female reproductive tract (FRT) is a site of unique mucosal immune regulation; it must be capable of detecting and inducing immune responses against pathogenic infections yet maintain tolerance to commensal bacteria, semen, and the semi-allogeneic fetus. The FRT can be broadly divided into two main anatomic sites: the lower reproductive tract, which includes the vagina and ectocervix, and the upper reproductive tract, which includes the uterus, fallopian tubes, and ovaries. The structure of the lining of the FRT varies considerably between these sites and reflects their respective functional characteristics. The lining of the lower FRT comprises multilayered squamous epithelium, which represents a large barrier defense and supports high levels of commensal microbes. In contrast, the upper FRT comprises a single layer of columnar epithelium, which is remodeled in response to sex hormones to enable support of successful implantation and pregnancy. 1 Between these two sites of the FRT is the transformation zone, where the squamous epithelium of the ectocervix meets the columnar epithelium of the endocervix. FRT immunity is predominately mediated by both epithelial cells and the immune cells that underlie the epithelium in both the upper and lower reproductive tract.
REGULATION OF FRT IMMUNITY: SEX HORMONESAn important aspect of immunoregulation within the FRT is that the FRT immune cells are continuously modulated in response to fluctuating levels of the sex hormones estrogen (E2) and progesterone (P4) during the menstrual cycle. The first line of defense against pathogen infection is usually the epithelial cells that line the upper and lower FRT. Epithelial cells that line the vagina and uterus are important regulators of immunity in the mucosa, acting through specialized antigen present...