title: Bacterial Vaginosis Is Associated with Loss of Gamma Delta T Cells in the Female Reproductive Tract in Women in the Miami Women Interagency HIV Study (WIHS): A Cross Sectional Study.
abstract: Bacterial vaginosis (BV) is the most common female reproductive tract infection and is associated with an increased risk of acquiring and transmitting HIV by a mechanism that is not well understood. Gamma delta (GD) T cells are essential components of the adaptive and innate immune system, are present in the female reproductive tract, and play an important role in epithelial barrier protection. GD1 cells predominate in the mucosal tissue and are important in maintaining mucosal integrity. GD2 cells predominate in peripheral blood and play a role in humoral immunity and in the immune response to pathogens. HIV infection is associated with changes in GD T cells frequencies in the periphery and in the female reproductive tract. The objective of this study is to evaluate if changes in vaginal flora occurring with BV are associated with changes in endocervical GD T cell responses, which could account for increased susceptibility to HIV. Seventeen HIV-infected (HIV+) and 17 HIV-uninfected (HIV-) pre-menopausal women underwent collection of vaginal swabs and endocervical cytobrushes. Vaginal flora was assessed using the Nugent score. GD T cells were assessed in cytobrush samples by flow cytometry. Median Nugent score was 5.0 and 41% of women had abnormal vaginal flora. In HIV uninfected women there was a negative correlation between Nugent score and cervical GD1 T cells (b for interaction = - 0.176, p<0.01); cervical GD1 T cells were higher in women with normal vaginal flora than in those with abnormal flora (45.00% vs 9.95%, p = 0.005); and cervical GD2 T cells were higher in women with abnormal flora than in those with normal flora (1.70% vs 0.35%, p = 0.023). GD T cells in the genital tract are protective (GD1) and are targets for HIV entry (GD2). The decrease in cervical GD1 and increase in GD2 T cells among women with abnormal vaginal flora predisposes women with BV to HIV acquisition. We propose to use GD T cell as markers of female genital tract vulnerability to HIV.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Alcaide
authors.affiliation: Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Natasa
authors.initials: N
authors.lastname: Strbo
authors.affiliation: Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Laura
authors.initials: L
authors.lastname: Romero
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Jones
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Violeta J
authors.initials: VJ
authors.lastname: Rodriguez
authors.affiliation: Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Kristopher
authors.initials: K
authors.lastname: Arheart
authors.affiliation: Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America, Hector Bolivar, Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Octavio
authors.initials: O
authors.lastname: Martinez
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Hector
authors.initials: H
authors.lastname: Bolivar
authors.affiliation: Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Eckhard R
authors.initials: ER
authors.lastname: Podack
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, 33136, United States of America.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Fischl
mesh_terms: D000328:Adult; D001419:Bacteria / Q000145:classification / Q000254:growth & development / Q000276:immunology; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000276:immunology / Q000382:microbiology; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility / Q000276:immunology; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000276:immunology / Q000821:virology; D054884:Host-Pathogen Interactions / Q000276:immunology; D006801:Humans; D064307:Microbiota / Q000276:immunology / Q000502:physiology; D011157:Population Dynamics; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000276:immunology* / Q000378:metabolism; D060737:Reproductive Tract Infections / Q000276:immunology* / Q000382:microbiology; D012307:Risk Factors; D016176:T-Lymphocyte Subsets / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000276:immunology* / Q000382:microbiology
chemical_list: D016692:Receptors, Antigen, T-Cell, gamma-delta