title: Innate immunity in the human female reproductive tract: endocrine regulation of endogenous antimicrobial protection against HIV and other sexually transmitted infections.
abstract: Mucosal surfaces of the female reproductive tract (FRT) contain a spectrum of antimicrobials that provide the first line of defense against viruses, bacteria, and fungi that enter the lower FRT. Once thought to be a sterile compartment, the upper FRT is periodically exposed to pathogens throughout the menstrual cycle. More recently, secretions from the upper FRT have been shown to contribute to downstream protection in the lower FRT. In this review, we examine the antimicrobials in FRT secretions made by immune cells and epithelial cells in the upper and lower FRT that contribute to innate protection. Because each site is hormonally regulated to maintain fertility, this review focuses on the contributions of hormone balance during the menstrual cycle to innate immune protection. As presented in this review, studies from our laboratory and others demonstrate that sex hormones regulate antimicrobials produced by innate immune cells throughout the FRT. The goal of this review is to examine the spectrum of antimicrobials in the FRT and the ways in which they are regulated to provide protection against pathogens that compromise reproductive health and threaten the lives of women.
authors.affiliation: Department of Physiology and Neurobiology, Dartmouth Medical School, Lebanon, NH 03756, USA. Charles.R.Wira@dartmouth.edu
authors.forename: Charles R
authors.initials: CR
authors.lastname: Wira
authors.forename: Mickey V
authors.initials: MV
authors.lastname: Patel
authors.forename: Mimi
authors.initials: M
authors.lastname: Ghosh
authors.forename: Lucy
authors.initials: L
authors.lastname: Mukura
authors.forename: John V
authors.initials: JV
authors.lastname: Fahey
mesh_terms: D000890:Anti-Infective Agents / Q000378:metabolism; D004702:Endocrine Glands / Q000502:physiology*; D005260:Female; D005836:Genitalia, Female / Q000276:immunology*; D012739:Gonadal Steroid Hormones / Q000502:physiology; D015658:HIV Infections / Q000276:immunology; D015497:HIV-1; D006801:Humans; D007113:Immunity, Innate; D008597:Menstrual Cycle; D012749:Sexually Transmitted Diseases / Q000276:immunology*
chemical_list: D000890:Anti-Infective Agents; D012739:Gonadal Steroid Hormones