Starting to have sexual intercourse is associated with increases in cervicovaginal immune mediators in young women: a prospective study and meta-analysis

Abstract

Background:Adolescent girls and young women (AGYW) are at high risk of sexually transmitted infections (STIs). It is unknown whether beginning to have sexual intercourse results in changes to immune mediators in the cervicovaginal tract that contribute to this risk.Methods:We collected cervicovaginal lavages from Kenyan AGYW in the months before and after first penile-vaginal sexual intercourse and measured the concentrations of 20 immune mediators. We compared concentrations pre- and post-first sex using mixed effect models. We additionally performed a systematic review to identify similar studies and combined them with our results by meta-analysis of individual participant data.Results:We included 180 samples from 95 AGYW, with 44% providing only pre-first sex samples, 35% matched pre and post, and 21% only post. We consistently detected 19/20 immune mediators, all of which increased post-first sex (p<0.05 for 13/19; Holm-Bonferroni-adjusted p<0.05 for IL-1β, IL-2, and CXCL8). Effects remained similar after excluding samples with STIs and high Nugent scores. Concentrations increased cumulatively over time after date of first sex, with an estimated doubling time of about 5 months.Our systematic review identified two eligible studies, one of 93 Belgian participants, and the other of 18 American participants. Nine immune mediators were measured in at least two-thirds of studies. Meta-analysis confirmed higher levels post-first sex for 8/9 immune mediators (p<0.05 for six mediators, most prominently IL-1α, IL-1β, and CXCL8).Conclusions:Cervicovaginal immune mediator concentrations were higher in women who reported that they started sexual activity. Results were consistent across three studies conducted on three different continents.Funding:This research was funded by R01 HD091996-01 (ACR), by P01 AI 030731-25 (Project 1) (AW), R01 AI116292 (FH), R03 AI154366 (FH) and by the Center for AIDS Research (CFAR) of the University of Washington/Fred Hutchinson Cancer Research Center AI027757.

Advances and challenges in studying the tissue‐resident T cell compartment in the human female reproductive tract

“…To uncover the reasons for this vulnerability, we examined changes in cervicovaginal immune mediators after first-time intercourse in a cohort of adolescent girls and young women in Kenya. 134 We found that all 19 immune mediators that were consistently detectable increased postfirst sex, and then rose further over the following year, with the highest statistical significance for IL-1β, IL-2, and CXCL8. Taken together, FRT immunity clearly changes within individuals over time, influenced by sex hormones, age, and behavior.…”

“…The period spanning months immediately after first‐time penile‐vaginal sexual intercourse is associated with higher incidences of STIs and bacterial vaginosis compared to later in life. To uncover the reasons for this vulnerability, we examined changes in cervicovaginal immune mediators after first‐time intercourse in a cohort of adolescent girls and young women in Kenya 134 . We found that all 19 immune mediators that were consistently detectable increased postfirst sex, and then rose further over the following year, with the highest statistical significance for IL‐1β, IL‐2, and CXCL8.…”

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

“…Excess sleep, partial sleep, insufficient sleep, and sleep deprivation, as well las frequent and infrequent napping, have all been associated with an increase in (hs)CRP concentrations [ 1067 , 1068 ]. Even if most studies have found that sex can modulate systemic inflammation, there also exist contrasting data highlighting that frequent sex can affect inflammatory markers [ 1069 ]. Apart from some previously discussed psychological conditions and cognitive decline, lower IQ levels in youth have been linked to low-grade systemic inflammation, whereas an interesting study demonstrated that daily discrimination, but not direct microaggressions based on sexual orientation, were linked to higher levels of CRP among young sexual-minority men, highlighting the immune vulnerability of the LGBT+ community [ 1070 , 1071 ].…”

Immune disorders peculiarities in girls with relapses of chronic non-specific inflammatory diseases of the genital organs

“…Для дослідження і клінічного аналізу кровігемограми -виконано забір венозної крові в пробірку об'ємом 1,0 мл з антикоагулянтом (етилендіамінтетраоцтовою кислотою -ЕДТА). Для виконання імунограми проведено забір крові в пробірку об'ємом [3][4] Зміни середньої сироваткової концентрації молекули IgA були схожими на такі в IgE (рис. 1В).…”

“…Відповідно до цього з'ясовано, що розлади функціонування імунної системи асоційовані з порушенням складу вагінального мікробіому і є важливими чинниками ризику формування НЗЗЖСО. Однак остаточно механізми зв'язку мікробіому піхви з регуляторними системами організму хазяїна досі не з'ясовані і є об'єктом активних наукових досліджень останніх років [4]. Особливу увагу серед багатьох аспектів зазначеної взаємодії надають саме імунному нагляду, з порушеннями якого пов'язують як феномен вагінального дисбіозу, так і розвиток власне НЗЗЖСО.…”