Relatedness of Escherichia coli colonizing women longitudinally.

PURPOSE: The longitudinal colonization patterns by Escherichia coli of the vaginal introitus and urinary tract were investigated. MATERIALS AND METHODS: Cultures of the vaginal introitus and midstream urine were collected once a week for 12 consecutive weeks from five women with (patients) and five without (controls) a history of urinary tract infection (UTI). RESULTS: A total of 63 E. coli isolates was obtained from the 10 women, 26 from controls and 37 from patients. The bacterial counts of E. coli present in control individuals were uniformly low, < or = 200 E. coli/mL. The numbers in patients were higher and more variable, reaching > 10(5)/mL in urine and vaginal specimens. In 16 instances, E. coli was present in the urine and the vaginal introitus concurrently (matched isolates). Random amplified polymorphic DNA (RAPD) fingerprinting was used to characterize all matched E. coli isolates. Concurrent vaginal and urinary tract colonization was more common in the patient population, and usually, the same E. coli strain was present at both sites; only 15% of the matched isolates represented different strains. The RAPD fingerprinting was also carried out on selected isolates recovered from four patients and three control individuals over the 12-week study period. Colonization of the vaginal introitus and urinary tract in these individuals varied over time. Generally, however, a predominant E. coli strain was present in the vaginal milieu, urinary tract, or both, either continuously (for as long as 9 consecutive weeks in one patient) or intermittently. CONCLUSION: The results support the concept that the vaginal mucosa acts as reservoir of E. coli which may enter the urinary tract.

Effect of vaginal fluid on adherence of type 1 piliated Escherichia coli to epithelial cells.

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.

Binding of type 1-piliated Escherichia coli to vaginal mucus.

To better understand the interactions involved in bacterial adherence and the role of mucus in the pathogenesis of urinary tract infections, we developed a system to study the binding of a recombinant Escherichia coli strain, HB101/pWRS1-17, expressing type 1 pili, to vaginal mucus collected from 28 women. Bacteria bound to differing extents to all specimens examined, and preincubation of bacteria with mannose inhibited binding by 50 to 89%. Additionally, all mucus samples showed reactivity with anti-mannose antibody, and the levels of reactivity correlated with the levels of bacterial binding, suggesting that the mannose-terminal saccharides present on these glycoproteins are the receptors for the binding of type 1-piliated bacteria. Mucus specimens collected over periods of 5 days and 12 weeks exhibited significant variation in bacterial binding, indicating temporal differences in the ability of vaginal mucus to act as a receptor for type 1-piliated E. coli. The results show that vaginal mucus can bind bacteria and may thus influence the initial attachment and subsequent colonization of the vaginal and urinary tract epithelium by E. coli.

PR92 antigen in human prostate fluid: elevated levels in prostate cancer.

In this preliminary study, we report that an enzyme-linked immunofluorescence assay (EFLA) was developed for the determination of PR92 antigen in prostatic fluid, utilizing anti-PR92 monoclonal antibody. Fluid samples from 64 patients were assayed. PR92 antigen was expressed as unit per microgram (U/microgram) of prostatic fluid proteins. One hundred percent of men (7 out of 7) less than 50 years of age demonstrated concentrations less than 25 U/micrograms; 91% of men (10 out of 11) with documented carcinoma, and only 9.5% of men (2 out of 21) with benign prostatic hyperplasia, demonstrated concentrations above 230 U/micrograms. The mean concentration of PR92 antigen in prostatic fluid of a group of patients suspected of having prostate cancer (high-risk group; 227 +/- 42 U/micrograms) was significantly greater than that of those with benign prostatic hyperplasia (87 +/- 23 U/micrograms; P = 0.05). Further evaluation of this potential marker and of other antigens within the prostatic fluid is warranted.

Variation of blood group antigen expression on vaginal cells and mucus in secretor and nonsecretor women.

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.

Blood group antigen expression on vaginal cells and mucus in women with and without a history of urinary tract infections.

Adherence of bacteria to carbohydrate receptors on the surface of vaginal epithelial cells is a critical event that precedes bacterial colonization of the vaginal mucosa and subsequent urinary tract infection. Blood group antigens, carbohydrate structures bound to lipids or proteins, constitute an important component of the uroepithelial cell membrane and may affect susceptibility to urinary tract infections. To determine if the ABH and Lewis antigen expression in women with a history of urinary tract infections differed from that of women without such a history, vaginal specimens from 87 women (42 patients and 45 controls) were analyzed for the detection of these antigenic determinants using monoclonal antibodies in quantitative immunoassays. The profile of ABH antigen expression was generally consistent with the ABO phenotype of the individual and appeared to be influenced by the secretor status. Secretors expressed higher levels of A, B and H determinants than nonsecretors. In addition, Lewis antigens were detected on vaginal cells and in mucus. Samples from nonsecretors expressed higher levels of Le(a) and Le(x) antigens, whereas secretors expressed higher levels of Le(b) and Le(y) antigens. The levels of antigen expression varied widely among individuals with the same blood type and secretor status. Comparisons between patient and control groups showed no significant differences in ABH or Lewis antigen expression overall, or when controlling for ABO or secretor phenotypes, respectively. These findings confirm our previous observations on healthy women, and document the heterogeneity of blood group antigen expression on vaginal epithelial cells and mucus from women with a history of urinary tract infections.

Growth of the rat prostate gland is facilitated by the autonomic nervous system.

Many factors are implicated in the development of prostatic growth: androgens, growth factors, and stromo-epithelial interaction. This study examines the role of the sympathetic and parasympathetic branches of the autonomic nervous system control of different aspects of rat prostate growth and atrophy. Unilateral sympathectomy leads to decreases in ventral prostate weight, DNA, and protein content in the lesioned side. Unilateral parasympathectomy leads to increases in ventral prostate weight, DNA, and protein content in the intact side. The separate effects of sympathectomy and parasympathectomy are maintained across a diverse combination of neural manipulations. Significant re-innervation does not occur by 60 days after manipulation as assessed by tissue norepinephrine levels. There appears to be a differential effect of the autonomic nervous system on growth and maintenance of the ventral prostate. The mechanism of contralateral hyperplasia and ipsilateral atrophy has potential significance in understanding human abnormal prostate growth.

Blood group antigen expression on vaginal and buccal epithelial cells and mucus in secretor and nonsecretor women.

Blood group antigens on epithelial cells may influence bacterial adherence to mucosal surfaces. In the urinary tract the presence of these genetically determined carbohydrate structures may affect bacterial colonization of the vaginal mucosa and subsequent urinary tract infection. In previous studies the detection of ABH and Lewis antigen expression and distribution in tissues have made use of semiquantitative immunohistochemical staining techniques. To determine the pattern and intensity of blood group antigens on epithelial cells and in the mucus overlying them, we developed quantitative immunoassays that use monoclonal antibodies to detect changes in the expression and intensity of ABH and Lewis antigens on cells and in mucus. Vaginal and buccal cell specimens from 23 healthy women (15 secretors and 8 nonsecretors) with no history of urinary tract infections and known blood group types were analyzed for the expression of these antigenic determinants. The profile of ABH antigen expression was generally consistent with the ABO phenotype of the individual and appeared to be influenced by the secretor status; the levels of A, B and H determinants were higher for secretors than nonsecretors. Lewis antigens were detected on vaginal and buccal cells, and mucus. Le(a) and Le(x) antigen expression was greater on cells and mucus from nonsecretors, whereas the expression of Le(b) and Le(y) was greater on cells and mucus from secretors. Variability in antigen expression was observed among individuals with the same blood type and secretor status. The patterns of antigen expression were similar for the vaginal and buccal cell, and mucus samples of an individual but the amount of antigen generally differed for the various samples. These findings document the variation of blood group antigen expression on vaginal epithelial cells and mucus, which may have a significant role in susceptibility to urinary tract infections in women.