Mucosal integrity and inflammatory markers in the female lower genital tract as potential screening tools for vaginal microbicides.
BACKGROUND
In the female genital tract, vaginal colposcopy, endometrial mucosal integrity and inflammatory mediators are potential in vivo biomarkers of microbicide and contraceptive safety.


METHODS
A randomized, blinded crossover trial of 18 subjects comparing effects of nonoxynol-9 vaginal gel (Gynol II; putative inflammatory gel), hydroxyethyl cellulose gel (HEC; putative inert gel) and no gel exposure on endometrial and vaginal epithelial integrity and endometrial and vaginal inflammatory markers [interleukin (IL) 1β, IL-6, IL-8, MCP-1, MIP-1α, MIP-1β, RANTES, tumor necrosis factor α, IL-1RA, IL-10, SLPI).


RESULTS
Gynol II was associated with more vaginal lesions. No endometrial disruptions were observed across conditions. In the vagina, RANTES (p=.055) and IL-6 (p=.04) were higher after HEC exposure than at baseline. In the endometrium, IL-1β (p=.003) and IL-8 (p=.025) were lower after Gynol II cycles than after no gel.


CONCLUSIONS
Gynol II and HEC may modulate inflammatory markers in the vagina and endometrium. How these changes relate to infection susceptibility warrants further study.
Department of Reproductive Medicine, University of California, San Diego, CA 92130, USA. hisu@ucsd.edu
H Irene
HI
Su
Courtney A
CA
Schreiber
Courtney
C
Fay
Sam
S
Parry
Michal A
MA
Elovitz
Jian
J
Zhang
Alka
A
Shaunik
Kurt
K
Barnhart
D000282:Administration, Intravaginal; D000328:Adult; D002482:Cellulose / Q000008:administration & dosage / Q000009:adverse effects; D002584:Cervix Uteri / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D009092:Mucous Membrane / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D017137:Nonoxynol / Q000008:administration & dosage* / Q000009:adverse effects; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D016037:Single-Blind Method; D013089:Spermatocidal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014621:Vagina / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
D013089:Spermatocidal Agents; D014622:Vaginal Creams, Foams, and Jellies; D017137:Nonoxynol; D002482:Cellulose