Colonization of the vaginal mucosa with uropathogens from fecal flora is an important step in ascending urinary tract infections (UTIs) in women. Colonization is influenced by interactions between uropathogens, vaginal fluid, and epithelial cells. In this study, vaginal fluid from 21 women was assessed for effects on adherence of type 1 piliated Escherichia coli to the A431 cell line. Adherence to cells was enhanced by all fluid specimens when tested at low fluid protein concentrations in an in vitro assay. At higher concentrations, certain specimens maintained enhanced binding whereas others resulted in diminished binding. Increases in adherence were associated with increased binding of E. coli to vaginal fluid in vitro and with higher vaginal fluid pH. These results demonstrate that vaginal fluid significantly alters the adherence of type 1 piliated E. coli to epithelial cells in vitro and, therefore, should be studied as a potential modifier in bacterial colonization and UTIs in vivo.
The expression of blood group antigens on the surface of urothelial cells and in mucus is controlled partly by the blood type and secretor status of the individual. To our knowledge, the possibility that the levels of these antigens vary with time has not been previously assessed. We determine if the pattern and/or intensity of blood group antigen expression on vaginal epithelial cells and mucus changed with time. Cell and mucus specimens were collected weekly for 3 months from 10 women: 5 (2 secretors and 3 nonsecretors) with and 5 (3 secretors and 2 nonsecretors) without a history of urinary tract infections. In addition, samples were collected on 5 consecutive days from 5 of these individuals. The cell and mucus samples were assayed for ABH and Lewis blood group antigens using monoclonal antibodies in cell concentration immunofluorescence and enzyme-linked fluorogenic assays, respectively. Although the pattern of antigen expression in the vaginal cell and mucus samples was consistent with the blood type and secretor status of an individual, in all women the level of antigen expression changed significantly and rapidly during the 3-month and 5-day periods. The results show a previously unrecognized phenomenon and demonstrate that the expression of blood group antigens on vaginal cells and in mucus is a dynamic process.
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