PRO 2000 elicits a decline in genital tract immune mediators without compromising intrinsic antimicrobial activity.
OBJECTIVE
Vaginal microbicides should protect against infection without disrupting the mucosal environment or its mediators of host defense. The objective of this study was to examine the effect of 14 daily applications of 0.5% PRO 2000 or placebo gel on mediators of mucosal immunity and intrinsic antimicrobial activity.


METHODS
A randomized, prospective, double-blind, placebo-controlled study was conducted among 24 healthy, abstinent women. Levels of cytokines, chemokines, defensins, and other protective factors and intrinsic antimicrobial activity were determined in cervicovaginal lavage samples collected on study days 0, 7, 14, and 21.


RESULTS
No increase in pro-inflammatory cytokines was observed. Rather cytokines and protective factors including interleukin (IL)-1 receptor antagonist, immunoglobulins and human beta-defensin 2 were lower in the drug compared with the placebo group. All of the mediators returned towards baseline on day 21. Women who were cycling had lower levels of most proteins on study days 7 and/or 14 compared with women on oral contraceptives; however, the magnitude of decline was greater in women who received PRO 2000 compared with placebo gel. The reduction in protective factors was not associated with a loss in the intrinsic anti-viral (HIV or herpes simplex virus) activity or anti-bacterial activity (Escherichia coli or Staphylococcus aureus).


CONCLUSIONS
In contrast to experience with nonoxynol-9, PRO 2000 did not trigger an inflammatory response in cervicovaginal secretions. There was a modest reduction in mucosal immune mediators, but this loss was not associated with a reduction in intrinsic antimicrobial activity.
Keller
Marla J
MJ
Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA.
Guzman
Esmeralda
E
Hazrati
Ehsan
E
Kasowitz
Andrea
A
Cheshenko
Natalia
N
Wallenstein
Sylvan
S
Cole
Amy L
AL
Cole
Alexander M
AM
Profy
Albert T
AT
Wira
Charles R
CR
Hogarty
Kathleen
K
Herold
Betsy C
BC
D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000494:pharmacology; D000998:Antiviral Agents / Q000008:administration & dosage / Q000494:pharmacology*; D018925:Chemokines / Q000096:biosynthesis; D016207:Cytokines / Q000096:biosynthesis; D023082:Defensins / Q000096:biosynthesis; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006558:Herpes Genitalis / Q000517:prevention & control; D006801:Humans; D018928:Immunity, Mucosal / Q000187:drug effects; D018836:Inflammation Mediators / Q000378:metabolism*; D008875:Middle Aged; D009282:Naphthalenesulfonates / Q000008:administration & dosage / Q000494:pharmacology*; D011108:Polymers / Q000008:administration & dosage / Q000494:pharmacology*; D007507:Therapeutic Irrigation; D014621:Vagina / Q000276:immunology / Q000378:metabolism; D014622:Vaginal Creams, Foams, and Jellies
D000891:Anti-Infective Agents, Local; D000998:Antiviral Agents; D018925:Chemokines; D016207:Cytokines; D023082:Defensins; D018836:Inflammation Mediators; D009282:Naphthalenesulfonates; C120231:PRO 2000; D011108:Polymers; D014622:Vaginal Creams, Foams, and Jellies