RESUMO
OBJECTIVES: To evaluate point prevalence vaginal yeast colonisation and symptomatic vaginitis in middle adolescents and to identify relation of these yeast conditions with reproductive hormones, sexual activity, sexual behaviours, and associated local immunity. METHODS: Middle adolescent females (n = 153) were evaluated for sexually transmitted infections (STIs), asymptomatic yeast colonisation, and symptomatic vulvovaginal candidiasis (VVC) by standard criteria. Also evaluated were local parameters, including vaginal associated cytokines, chemokines, and antibodies, vaginal epithelial cell antifungal activity, and Candida specific peripheral blood lymphocyte responses. Correlations between yeast colonisation/vaginitis and local immunomodulators, reproductive hormones, douching, sexual activity, condom use, and STIs were identified. RESULTS: Rates of point prevalence asymptomatic yeast colonisation (22%) were similar to adults and similarly dominated by Candida albicans, but with uncharacteristically high vaginal yeast burden. In contrast with the high rate of STIs (18%), incidence of symptomatic VVC was low (<2%). Immunological properties included high rates of Candida specific systemic immune sensitisation, a Th2 type vaginal cytokine profile, total and Candida specific vaginal antibodies dominated by IgA, and moderate vaginal epithelial cell anti-Candida activity. Endogenous reproductive hormones were in low concentration. Sexual activity positively correlated with vaginal yeast colonisation, whereas vaginal cytokines (Th1, Th2, proinflammatory), chemokines, antibodies, contraception, douching, or condom use did not. CONCLUSION: Asymptomatic vaginal yeast colonisation in adolescents is distinct in some ways with adults, and positively correlates with sexual activity, but not with local immunomodulators or sexual behaviours. Despite several factors predictive for VVC, symptomatic VVC was low compared to STIs.
Assuntos
Candidíase Vulvovaginal/epidemiologia , Vaginite/epidemiologia , Adolescente , Anticorpos Antifúngicos/imunologia , Formação de Anticorpos , Candidíase Vulvovaginal/imunologia , Quimiocinas/metabolismo , Preservativos/estatística & dados numéricos , Citocinas/metabolismo , Feminino , Humanos , Indiana/epidemiologia , Ciclo Menstrual , Prevalência , Comportamento Sexual , Parceiros Sexuais , Ducha Vaginal , Vaginite/imunologiaRESUMO
Synthetic peptides and murine monoclonal antibodies were used to map cross-reactive chlamydial epitopes. A species-specific epitope in the central region of variable sequence region 4 abuts the amino-terminal end of a B-serogroup-specific or F/G-serogroup-specific epitope, which in turn abuts known serovar-specific epitopes. The carboxyl-terminal portion of variable sequence region 4 (residues 297 to 314) comprises a region of end-to-end B-cell epitopes in some serovars of the B and F/G serogroups.
Assuntos
Proteínas da Membrana Bacteriana Externa/imunologia , Chlamydia trachomatis/imunologia , Sequência de Aminoácidos , Animais , Anticorpos Antibacterianos , Anticorpos Monoclonais , Antígenos de Bactérias/genética , Proteínas da Membrana Bacteriana Externa/genética , Infecções por Chlamydia/imunologia , Infecções por Chlamydia/prevenção & controle , Chlamydia trachomatis/classificação , Chlamydia trachomatis/genética , Reações Cruzadas , Mapeamento de Epitopos , Epitopos/genética , Camundongos , Dados de Sequência Molecular , Sorotipagem , Especificidade da EspécieRESUMO
Chlamydia trachomatis isolates from 58 patients were immunotyped by radioimmunoassay (RIA) and fluorescent-antibody staining (FA) by using monoclonal antibodies. Unambiguous typing was observed with 55 isolates by FA and 53 isolates by RIA, although 3 isolates were typed by RIA but not FA. FA required less antigen and was more sensitive in detecting mixed infections.
