title: Levels of vaginal secretory leukocyte protease inhibitor are decreased in women with lower reproductive tract infections.
abstract: OBJECTIVE
  Secretory leukocyte protease inhibitor contributes resistance to primary human immunodeficiency virus infection in the oral cavity. However, the levels of this inhibitor in the genital tract of women with sexually transmitted diseases or vaginitis are not well described. The objective was to determine vaginal inhibitor levels in women with symptomatic and asymptomatic genital infections.
  
  
  METHODS
  We tested 207 nonpregnant women for Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, Candida species, and bacterial vaginosis by standard methods. A second group of symptom-free pregnant women (N = 231) was also studied. Secretory leukocyte protease inhibitor was measured by enzyme-linked immunosorbent assay, and results were compared by nonparametric methods.
  
  
  RESULTS
  Vaginal levels of secretory leukocyte protease inhibitor in both groups were significantly lower in women with any sexually transmitted disease than in those without infection (P<.0001). Patients with bacterial vaginosis and those with bacterial vaginosis with yeast vaginitis also had decreased levels (P<.025).
  
  
  CONCLUSIONS
  Levels of secretory leukocyte protease inhibitor in vaginal fluid are decreased in women with lower genital tract infection. This may represent a common mechanism of increasing susceptibility to infection with human immunodeficiency virus.
authors.affiliation: Magee-Womens Research Institute, Pittsburgh, PA 15213, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Draper
authors.forename: D V
authors.initials: DV
authors.lastname: Landers
authors.forename: M A
authors.initials: MA
authors.lastname: Krohn
authors.forename: S L
authors.initials: SL
authors.lastname: Hillier
authors.forename: H C
authors.initials: HC
authors.lastname: Wiesenfeld
authors.forename: R P
authors.initials: RP
authors.lastname: Heine
mesh_terms: D005260:Female; D005831:Genital Diseases, Female / Q000378:metabolism*; D006801:Humans; D007239:Infections / Q000378:metabolism*; D009181:Mycoses / Q000378:metabolism; D011247:Pregnancy; D053491:Proteinase Inhibitory Proteins, Secretory; D011506:Proteins / Q000378:metabolism*; D012749:Sexually Transmitted Diseases / Q000378:metabolism; D014621:Vagina / Q000378:metabolism*; D014627:Vaginitis / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000378:metabolism
chemical_list: D053491:Proteinase Inhibitory Proteins, Secretory; D011506:Proteins