Secreted Mucosal Antimicrobials in the Female Reproductive Tract that are Important to Consider forHIVPrevention

Abstract

The mucosal microenvironment of the female reproductive tract (FRT) is rich in secreted endogenous antimicrobials that provide the first line of defense against pathogens. This review focuses on the spectrum of secreted antimicrobials found in the FRT that have anti-HIV functions and are regulated by the natural hormonal changes in women's life cycle. Understanding the complex nature of FRT, mucosal microenvironment will enable us to better design therapeutic interventions for women against sexually transmitted pathogens.

Reduced levels of genital tract immune biomarkers in postmenopausal women: implications for HIV acquisition

“…The FGT mucosal microenvironment is complex. In addition to the known cytokines and chemokines, there are at least 22 distinct endogenous antimicrobials in the FGT (Reviewed [20]). Further complexity arises as levels of immune mediators do not necessarily correlate with their bioactivity which is affected by pH, ion concentration and serum proteins, and endogenous proteases [20,[63][64][65][66][67][68][69].…”

“…Less is known regarding immune functions in the genital tract, which is critical to consider in order to prevent sexual acquisition/transmission of HIV. Further, other factors that can affect immune milieu of female reproductive tract (FRT) including protein content, presence of infections and vaginal pH, also need to be considered in determining HIV susceptibility in women [18][19][20][21][22][23][24].…”

Can procalcitonin levels indicate the need for adjunctive therapies in sepsis?

“…The first line of defence against invaders consists of physical barriers such as the skin [17,18] and the mucous membranes of the respiratory [19], gastrointestinal [20] and genitourinary [21] tracts. The second line of defence is the rapidly acting innate immune system (including the complement system, sentinel phagocytic cells and natural killer cells), which plays a modulatory role on the adaptive immune system [22].…”

Biomarkers of Cervical Inflammation and Immunity Associated with Cervical Shedding of HIV-1

“…4 Genital tract inflammation, whether from trauma or reproductive tract infections (RTIs), appears to increase the risk of shedding, possibly through a direct effect on viral replication or immune mediators that recruit and activate HIV target cells. [5][6][7] Understanding the mechanisms that affect female genital tract viral load could facilitate interventions to reduce HIV shedding and transmission.…”