“…Many of the T. vaginalis cysteine proteases have been identified in vaginal secretions from infected women 84, 85. The cytotoxic effects of cysteine proteases include degradation of mucus, complement and immunoglobulin, and destruction of extracellular matrix (fibronectin, several types of collagen, and laminin) 43, 72, 73, 84, 86, 87. Cysteine proteases therefore can function as epithelial cell detaching factors and can mediate direct cytotoxic effects on vaginal and uterine epithelial cells by induction of apoptosis72, 73, 84, 88, 89, 90 (Fig 1D).…”