title: Relationship between female genital tract infections, mucosal interleukin-17 production and local T helper type 17 cells.
abstract: T helper type 17 (Th17) cells play an important role in immunity to fungal and bacterial pathogens, although their role in the female genital tract, where exposure to these pathogens is common, is not well understood. We investigated the relationship between female genital tract infections, cervicovaginal interleukin-17 (IL-17) concentrations and Th17 cell frequencies. Forty-two cytokines were measured in cervicovaginal lavages from HIV-uninfected and HIV-infected women. Frequencies of Th17 cells (CD3(+) CD4(+) IL-17a(+)) were evaluated in cervical cytobrushes and blood by flow cytometry. Women were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and herpes simplex virus 2 by PCR, and candidal infections and bacterial vaginosis by Gram stain. Women with bacterial sexually transmitted infections (STIs), specifically chlamydia and gonorrhoea, had higher genital IL-17 concentrations than women with no STI, whereas women with candidal pseudohyphae/spores had lower IL-17 concentrations compared with women without candidal infections. Viral STIs (herpes simplex virus 2 and HIV) were not associated with significant changes in genital IL-17 concentrations. Genital IL-17 concentrations correlated strongly with other inflammatory cytokines and growth factors. Although Th17 cells were depleted from blood during HIV infection, cervical Th17 cell frequencies were similar in HIV-uninfected and HIV-infected women. Cervical Th17 cell frequencies were also not associated with STIs or candida, although few women had a STI. These findings suggest that IL-17 production in the female genital tract is induced in response to bacterial but not viral STIs. Decreased IL-17 associated with candidal infections suggests that candida may actively suppress IL-17 production or women with dampened IL-17 responses may be more susceptible to candidal outgrowth.
authors: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town Medical School, Cape Town, South Africa.|Centre for the AIDS Programme of Research in South Africa, University of KwaZulu Natal, Durban, South Africa.
authors: Lindi
authors: L
authors: Masson
authors: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town Medical School, Cape Town, South Africa.
authors: Amy L
authors: AL
authors: Salkinder
authors: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town Medical School, Cape Town, South Africa.
authors: Abraham Jacobus
authors: AJ
authors: Olivier
authors: Centre for the AIDS Programme of Research in South Africa, University of KwaZulu Natal, Durban, South Africa.
authors: Lyle R
authors: LR
authors: McKinnon
authors: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town Medical School, Cape Town, South Africa.
authors: Hoyam
authors: H
authors: Gamieldien
authors: Centre for the AIDS Programme of Research in South Africa, University of KwaZulu Natal, Durban, South Africa.|School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa.|National Health Laboratory Services, Cape Town, South Africa.
authors: Koleka
authors: K
authors: Mlisana
authors: South African Tuberculosis Vaccine Initiative, University of Cape Town, Cape Town, South Africa.
authors: Thomas J
authors: TJ
authors: Scriba
authors: Western Sydney Sexual Health Centre, Parramatta, Sydney, NSW, Australia.|Centre for Infectious Diseases and Microbiology & Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Clinical School, University of Sydney, Sydney, NSW, Australia.|National Institute for Communicable Diseases, Sandringham, Johannesburg, South Africa.
authors: David A
authors: DA
authors: Lewis
authors: Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa.
authors: Francesca
authors: F
authors: Little
authors: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town Medical School, Cape Town, South Africa.|Seattle Children's Research Institute, Seattle, WA, USA.
authors: Heather B
authors: HB
authors: Jaspan
authors: SA MRC Centre for TB Research, NRF/DST Centre of Excellence for Biomedical TB Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa.
authors: Katharina
authors: K
authors: Ronacher
authors: Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa.
authors: Lynette
authors: L
authors: Denny
authors: Centre for the AIDS Programme of Research in South Africa, University of KwaZulu Natal, Durban, South Africa.|Columbia University, New York, NY, USA.
authors: Salim S
authors: SS
authors: Abdool Karim
authors: Institute of Infectious Diseases and Molecular Medicine, University of Cape Town Medical School, Cape Town, South Africa.|Centre for the AIDS Programme of Research in South Africa, University of KwaZulu Natal, Durban, South Africa.|National Health Laboratory Services, Cape Town, South Africa.
authors: Jo-Ann S
authors: JA
authors: Passmore
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000276:immunology / Q000378:metabolism / Q000382:microbiology; D018791:CD4 Lymphocyte Count; D002177:Candidiasis / Q000276:immunology / Q000378:metabolism / Q000382:microbiology; D002584:Cervix Uteri; D016207:Cytokines / Q000096:biosynthesis; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000096:biosynthesis* / Q000097:blood; D009092:Mucous Membrane / Q000276:immunology* / Q000378:metabolism* / Q000382:microbiology; D060737:Reproductive Tract Infections / Q000276:immunology* / Q000378:metabolism* / Q000382:microbiology; D012749:Sexually Transmitted Diseases / Q000276:immunology / Q000378:metabolism / Q000382:microbiology / Q000821:virology; D058504:Th17 Cells / Q000276:immunology* / Q000378:metabolism*; D014621:Vagina; D055815:Young Adult
chemical_list: D016207:Cytokines; D020381:Interleukin-17
keywords: Female genital tract; T helper type 17; interleukin-17; sexually transmitted infection candidiasis