Innate immunity and vaginal microbiota in pregnant women with bacterial vaginosis in the first trimester
Dobrokhotova Yu.E., Borovkova E.I., Zaidieva Z.S., Stepanyants I.V.
Objective. To study the indicators of vaginal mucosal innate immunity in the presence of bacterial vaginosis in the first trimester of pregnancy.
Subjects and methods. This prospective study enrolled 50 pregnant women with bacterial vaginosis. There was a study group of 30 people receiving Tergynan therapy for 10 days and a control one of 20 people having Hexicon therapy for 10 days; their mean age was 31±3.1 and 28±2.4 years, respectively. The investigators conducted a study of vaginal microbiocenosis using PCR (Florocenosis + NCMT tests) and a culture assay for L. crispatus; as well as an immunological analysis of the expression of innate immunity genes, such as Toll-like receptor-9 (TLR- 9), tumor necrosis factor-α (TNF-α), and peptide human β-defensin-1 (HBD1), by real-time reverse transcription PCR, and statistical processing (Microsoft Excel 2016 and Statistica 6.1).
Results. In the study group, the total bacterial contamination exceeded 7 lg GE/ml; the Lactobacillus titer was 4 lg CFU/ml, as shown by a culture assay; there was a preponderance of L. rhamnosus (73.3%), L. jensenii (40%), and L. crispatus (10%). The microbiological signs of bacterial vaginosis persisted in 30 and 10% of patients after 10 and 30 days of treatment, respectively. Thirty days after therapy termination, there was a 10-fold increase in the titer of Lactobacillus; L. crispatus was found to grow in 60%. The culture assay revealed no Lactobacillus growth in 35% in the control group. L. rhamnosus (75%), L. jensenii (25%), L. crispatus (15%), and L. fermentum (10%) were identified according to the species composition. After 10 and 30 days of treatment, the microbiological signs of the disease persisted in 25 and 45%, respectively. Thirty days after therapy, the Lactobacillus titer reached 6.5 lg CFU/ml; L. crispatus was detected in 55%. Both groups exhibited no significant changes in TNF-α and TLR9 gene expressions. In the study group, the level of HBD1 steadily decreased by 1.7 times from the baseline values; in the control group, the decrease in defensin was short-term and increased at day 30.
Conclusion. During the course of treatment, the recurrence rate decreased, normalization of the vaginal microbiocenosis with the growth of protective types of lactobacilli and the balance in the expression of innate immunity factors were noted.
Keywords
bacterial vaginosis
pregnancy
innate immunity
microbiome
tumor necrosis factor
Toll-like receptor-9
defensin
tergynan
hexicon
References
- Hoffmann J., Akira S. Innate immunity. Curr. Opin. Immunol. 2013; 25: 1.
- Jones J.D., Vance R.E., Dangl J.L. Intracellular innate immune surveillance devices in plants and animals. Science. 2016; 354 (6316). pii: aaf6395.
- Medzhitov R. Pattern recognition theory and the launch of modern innate immunity. J. Immunol. 2013; 191(9): 4473-4.
- Spadoni I., Zagato E., Bertocchi A., Paolinelli R., Hot E., Di Sabatino A. et al. A gut-vascular barrier controls the systemic dissemination of bacteria. Science. 2015; 350(6262): 830-4.
- Doss M., White M.R., Tecle T., Hartshorn K.L. Human defensins and LL-37 in mucosal immunity. J. Leukoc. Biol. 2010; 87(1): 79-92.
- Steinstraesser L., Kraneburg U., Jacobsen F., Al-Benna S. Host defense peptides and their antimicrobial-immunomodulatory duality. Immunobiology. 2011; 216(3): 322-33.
- Ouellette A.J., Selsted M.E. Immunology. HD6 defensin nanonets. Science. 2012; 337(6093): 420-1.
- Zhang L., Wu W.K., Gallo R.L., Fang E.F., Hu W., Ling T.K. et al. Critical role of antimicrobial peptide cathelicidin for controlling Helicobacter pylori survival and infection. J. Immunol. 2016; 196(4): 1799.
- Currie S.M., Gwyer Findlay E., McFarlane A.J., Fitch P.M., Böttcher B., Colegrave N. et al. Cathelicidins have direct antiviral activity against respiratory syncytial virus in vitro and protective function in vivo in mice and humans. J. Immunol. 2016; 196(6): 2699-710.
- Chu H., Pazgier M., Jung G., Nuccio S.P., Castillo P.A., de Jong M.F. et al. Human α-defensin 6 promotes mucosal innate immunity through self-assembled peptide nanonets. Science. 2012; 337(6093): 477-81.
- Gillaux C., Méhats C., Vaiman D., Cabrol D., Breuiller-Fouché M. Functional screening of TLRs in human amniotic epithelial cells. J. Immunol. 2011; 187(5): 2766-74.
- Hinde K., Lewis Z.T. Microbiota. Mother’s littlest helpers. Science. 2015; 348(6242): 1427-8.
- Blaser M.J. The microbiome revolution. J. Clin. Invest. 2014; 124(10): 4162-5.
- Thaiss C.A., Zmora N., Levy M., Elinav E. The microbiome and innate immunity. Nature. 2016; 535(7610): 65-74.
- Torow N., Hornef M.W. The neonatal window of opportunity: setting the stage for life-long host-microbial interaction and immune homeostasis. J. Immunol. 2017; 198(2): 557-63.
- Grigg J.B., Sonnenberg G.F. Host-microbiota interactions shape local and systemic inflammatory diseases. J. Immunol. 2017; 198(2):564-71.
Received 02.09.2019
Accepted 24.09.2019
About the Authors
Yulia E. Dobrokhotova, MD, Professor, Head of Department of Obstetrics and Gynecology, Faculty of General Medicine, N.I. Pirogov Russian National Research Medical University, Moscow, Russia. Tel: +7 (495)722-6399. E-mail: pr.dobrohotova@mail.ru117997, Russia, Moscow, Ostrovitianov str.1/9.
Ekaterina I. Borovkova, MD, Associate Professor, Professor of Therapeutical Faculty, Obstetrics and Gynecology Department N.I. Pirogov Russian National Research Medical University, Moscow, Russia. Tel:+7(903)785-5793. E-mail: Katyanikitina@mail.ru 117997, Russia, Moscow, Ostrovitianov str.1/9.
Zulya S. Zaidieva, PhD, head of Consultative and Diagnostic Department, Maternity Hospital, City Clinical Hospital №40, Moscow Healthcare Department, Moscow, Russia. Tel.: +7 (903)788-39-95. E-mail: dr.zaydieva@mail.ru 129301 Russia, Moscow, ul. Taimyrskaya, d.6.
Irina V. Stepanyants, gynecologist obstetrician, Consultative and Diagnostic Department, Maternity Hospital, City Clinical Hospital №40, Moscow Healthcare Department, Moscow, Russia. Tel.: +7 (495)683-1570. E-mail: apoplexia@rambler.ru 129301 Russia, Moscow, ul. Taimyrskaya, d.6.
For citation: Dobrokhotova Yu.E., Borovkova E.I., Zaidieva Z.S., Stepanyants I.V. Innate immunity and vaginal microbiota in pregnant women with bacterial vaginosis in the first trimester.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 9:126-34 (In Russian).
https://dx.doi.org/10.18565/aig.2019.9.126-134.
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