title: Use of porcine vaginal tissue ex-vivo to model environmental effects on vaginal mucosa to toxic shock syndrome toxin-1.
abstract: Menstrual toxic shock syndrome (mTSS) is a rare, recognizable, and treatable disease that has been associated with tampon use epidemiologically. It involves a confluence of microbial risk factors (Staphylococcus aureus strains that produce the superantigen-TSST-1), as well as environmental characteristics of the vaginal ecosystem during menstruation and host susceptibility factors. This paper describes a series of experiments using the well-characterized model of porcine vaginal mucosa ex-vivo to assess the effect of these factors associated with tampon use on the permeability of the mucosa. The flux of radiolabeled TSST-1 and tritiated water ((3)H2O) through porcine vaginal mucosa was determined at various temperatures, after mechanical disruption of the epithelial surface by tape stripping, after treatment with surfactants or other compounds, and in the presence of microbial virulence factors. Elevated temperatures (42, 47 and 52°C) did not significantly increase flux of (3)H2O. Stripping of the epithelial layers significantly increased the flux of labeled toxin in a dose-dependent manner. Addition of benzalkonium chloride (0.1 and 0.5%) and glycerol (4%) significantly increased the flux of (3)H2O but sodium lauryl sulfate at any concentration tested did not. The flux of the labeled toxin was significantly increased in the presence of benzalkonium chloride but not Pluronic® L92 and Tween 20 and significantly increased with addition of α-hemolysin but not endotoxin. These results show that the permeability of porcine vagina ex-vivo to labeled toxin or water can be used to evaluate changes to the vaginal environment and modifications in tampon materials, and thus aid in risk assessment.
authors: Feminine Care Global Product Stewardship, 6110 Center Hill Road, The Procter & Gamble Company, Cincinnati, OH 45224, USA.
authors: Catherine C
authors: CC
authors: Davis
authors: Feminine Care Global Product Stewardship, 6110 Center Hill Road, The Procter & Gamble Company, Cincinnati, OH 45224, USA.
authors: Mekhine
authors: M
authors: Baccam
authors: Dows Institute for Dental Research, The University of Iowa, Iowa City, IA 52242, USA.
authors: Mary J
authors: MJ
authors: Mantz
authors: Feminine Care Product Development, 6110 Center Hill Road, The Procter & Gamble Company, Cincinnati, OH 45224, USA.
authors: Thomas W
authors: TW
authors: Osborn
authors: Feminine Care Product Development, 6110 Center Hill Road, The Procter & Gamble Company, Cincinnati, OH 45224, USA.
authors: Donna R
authors: DR
authors: Hill
authors: Dows Institute for Dental Research, The University of Iowa, Iowa City, IA 52242, USA.
authors: Christopher A
authors: CA
authors: Squier
mesh_terms: D000818:Animals; D001427:Bacterial Toxins / Q000633:toxicity*; D002463:Cell Membrane Permeability / Q000187:drug effects; D004768:Enterotoxins / Q000633:toxicity*; D004847:Epithelial Cells / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006460:Hemolysin Proteins / Q000633:toxicity; D066298:In Vitro Techniques; D008070:Lipopolysaccharides / Q000302:isolation & purification / Q000378:metabolism; D009092:Mucous Membrane / Q000187:drug effects* / Q000473:pathology; D012307:Risk Factors; D012486:Salmonella typhimurium / Q000378:metabolism; D012772:Shock, Septic / Q000382:microbiology / Q000473:pathology; D013211:Staphylococcus aureus; D018089:Superantigens / Q000633:toxicity*; D013501:Surface-Active Agents / Q000494:pharmacology; D013552:Swine; D013696:Temperature; D014621:Vagina / Q000187:drug effects* / Q000473:pathology; D037521:Virulence Factors / Q000633:toxicity
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D006460:Hemolysin Proteins; D008070:Lipopolysaccharides; D018089:Superantigens; D013501:Surface-Active Agents; D037521:Virulence Factors; C030107:enterotoxin F, Staphylococcal; C021091:staphylococcal alpha-toxin
keywords: Endotoxin; Permeability; Surfactant; Temperature; Toxic shock syndrome toxin-1 (TSST-1); Vagina