Elafin (SKALP/Trappin-2/proteinase inhibitor-3) Is Produced by the Cervix in Pregnancy and Cervicovaginal Levels Are Diminished in Bacterial Vaginosis

Abstract

Elafin is a component of cervicovaginal secretions in pregnancy, and levels are diminished in bacterial vaginosis. It may be an important component of innate immunity in the lower genital tract.

Cross-Sectional Analysis of Selected Genital Tract Immunological Markers and Molecular Vaginal Microbiota in Sub-Saharan African Women, with Relevance to HIV Risk and Prevention

“…Kenyan pregnant women in our study showed lower levels of elafin. Elafin has been shown to be expressed in the genital tract of pregnant women (20), and its anti-HIV activity was previously described (21,22), making it a probable correlate of immunity against HIV infection. In another relatively small study of predominantly white U.S. women (23), the levels of IL-1␣ and IL-1RA were relatively higher in the CVL samples of pregnant women with a mean gestational age of 23.5 weeks.…”

Molecular Definition of Vaginal Microbiota in East African Commercial Sex Workers

“…Despite the lack of a classic inflammatory response in BV (3), possibly abrogated by antibody-and cytokine-cleaving proteases of BV organisms (13), BV is strongly associated with increased levels of proinflammatory cytokines such as interleukin-1␤ (IL-1␤), IL-6, and IL-8 (40) and decreased mucosal defense factors such as elafin (52). In contrast, vaginal lacto-bacilli metabolize epithelial glycogen and produce lactic acid and reactive oxygen species such as hydrogen peroxide (H 2 O 2 ), widely believed to protect the reproductive tract from exogenous pathogens (7,9,28).…”

Host Defense Peptide Expression in Human Cervical Cells and Regulation by 1,25-Dihydroxyvitamin D3 in the Presence of Cytokines and Bacterial Endotoxin

“…Moreover, there is emerging evidence that suggests that the reproductive tract production of elafin is altered in bacterial vaginosis (BV) 7 , chorioamnionitis 9 and in women at high risk of preterm labour 8 .…”

“…There is growing literature demonstrating the expression of host defence peptides (HDPs) in the human female reproductive tract, including the cervical mucus plug, [6][7][8] . Moreover, there is emerging evidence that suggests that the reproductive tract production of elafin is altered in bacterial vaginosis (BV) 7 , chorioamnionitis 9 and in women at high risk of preterm labour 8 .…”