Immunological Changes in the FRT During the Menstrual Cycle

Transcription

1 Immunological Changes in the FRT During the Menstrual Cycle Charles R. Wira PhD Department of Physiology and Neurobiology Geisel School of Medicine at Dartmouth Lebanon, NH May 1, 2014

2 Anatomy and Cell Distribution Fallopian Tubes LA A Columnar Epithelial Cell Uterus Squamous Epithelial Cell Stromal Cell Endocervix Macrophage E Dendritic Cell Upper tract Lower tract Ectocervix B cell Innate immunity Humoral immunity Cellular immunity Vagina Mucus T cell NK cell

3 Hormone Regula#on of Immune Func#on in the Human Female Reproduc#ve Tract (Uterus and Vagina) SUPPRESSION of NK, DC NEUTROPHILS In UT and VAG LYMPHOID AGGREGATE FORMATION in UT Immune Cell Migra#on SUPRESSION of CTL ACTIVITY in UT Innate Cell Func#on An#microbials An#microbials Sex Hormones Suppress Some FRT Defenses CD8 T Cells Coreceptors ENHANCED DEFENSINS, SLPI increase in UT and decrease in VAG Humoral Immunity IgA and IgG increase in UT and decrease in VAG Wira and Fahey. AIDS 2008, 22: CD4, CXCR4 and CCR5 Expression Changes in UT and VAG

4 Preparation of Uterine and Vaginal Epithelial Cells, Immune Cells and Their Secretions from the Female Reproductive Tract Vaginal Cells FRT Cells Enzymatic digestion of FRT tissues to obtain epithelial & stromal cells 250 µm Epithelial Cell Sheets OH APICAL 40 µm OH BASOLATERAL Stromal Cell (Fibroblasts and Immune Cells) Magnetic bead selection Estradiol (0.1-5x10-8M) CD4+ T Cells 96-well Culture Plates

5 Estradiol Increases SLPI Secretion and HBD2 Expression by Polarized Primary Uterine Epithelial Cells SLPI (pg/ml) SLPI ** ** Fold Change (mrna expression) HBD2 ** 0 Control E P E +P 0 Control E Fahey and Wira Mucosal Immunol. 2008, 1:

6 Estradiol and Progesterone Decrease HBD2 and Elafin Secretion by Primary Vaginal Squamous Epithelial Cells HBD2 Elafin Patel et al. Am J Reprod Immunol 2013; 69:

7 Secretions from Primary Uterine and Vaginal Epithelial Cells Inhibit X4 and R5 HIV Infection of TZM Cells Uterus/Fallopian Tube Vagina 120 Virus 100 UT CM % of Virus Control ** ** 20 0 X4/T- Tropic (IIIB) R5/M- tropic (Bal) Pre- incuba`on: Incubate secre`on (1:10) with HIV IIIB and Bal 1h at 37 0 C Add virus + secre`on to TZM cells Vaginal CM Wira CR et.al. Mucosal Immunology 4: (2011) Patel et al. Am J Reprod Immunol. 2013;69(5):

8 Unique mrna Expression of CD4+Th17 Cell Markers in the Upper and Lower FRT IL-17 CCL20 Rodriguez-Garcia et al; Mucosal Immunology. Online publication 23 April doi: /mi

9 Differential Susceptibility of CD4 + T Cells from the FRT to HIV Infection Intracellular p24 (6/7) (2/8) (4/6) Rodriguez-Garcia et al; Mucosal Immunology. Online publication 23 April doi: /mi

10 Estradiol Reduces Suscep`bility of Blood CD4+ T Cells to HIV Infec`on Blood Rodriguez- Garcia M, et al. (2013). PLoS ONE.

11 Comparison of TFV-DP levels in epithelial cells, fibroblasts, CD14 + cells and CD4 + T cells from FRT tissues. Zheng et al. PLoS ONE, 2014 In Press.

12 Stimulatory Effect of E 2 and/or P4 on TFV-DP Levels in Epithelial Cells from Endometrium, Endocervix/Ectocervix Zheng et al. PLoS ONE, 2014 In Press.

13 Inhibitory Effect of Estradiol and/or Progesterone on TFV-DP Levels in CD4 + T Cells from FRT Zheng et al. PLoS ONE, 2014 In Press.

14 Antimicrobials and Chemokines in Cervico-vaginal Lavage from Women During the Menstrual Cycle 140 Protein Day 6 values 120 IL-1a Protein IL-1a IL-6 IL-8 IL-1Ra TGF-beta SLPI HBD2 HNP1-3 Lactoferrin IgG IgA 1280 ug/ml 93 pg/ml 87 pg/ml 533 pg/ml 30 ng/ml 1408 pg/ml 142 ng/ml 1608 pg/ml 131 ng/ml 378 ng/ml 4045 ng/ml 552 ng/ml % of day 6 value IL-6 IL-8 IL-1Ra TGF-beta SLPI HBD2 HNP1-3 Lactoferrin IgG IgA Menses day of cycle Based on Keller,Herold et al. AIDS 2007, 21:

15 Profile of Vaginal Secretions Recovered by Menstrual Cup from Individual Volunteers Patel et al AJRI 2014 In Press

16 Individual Profiles of Anti-HIV activity in Vaginal Secretions Patel et al AJRI 2014 In Press

17 Cytokine and Chemokine Concentrations in Lower FRT Secretions from Multiple Studies Rodriguez-Garcia et al. In: Mucosal Immunology, Chapter 108, Adapted from (Hein et al., 2002, Keller et al., 2007, Shust et al., 2010, Keller et al., 2012b, Keller et al., 2012a, Keller et al., 2011, Keller et al., 2010, Madan et al., 2012, Levinson et al., 2012, Levinson et al., 2009, Valore et al., 2002, Dezzutti et al., 2011, Kyongo et al., 2012, Anderson et al., 2012, Ghosh et al., 2010b, Walter et al., 2011).

18 Comparison of Antimicrobial Concentrations in Lower FRT Secretions from Multiple Studies Rodriguez-Garcia et al. In: Mucosal Immunology, Chapter 108, Adapted from (Hein et al., 2002, Keller et al., 2007, Shust et al., 2010, Keller et al., 2012b, Keller et al., 2012a, Keller et al., 2011, Keller et al., 2010, Madan et al., 2012, Levinson et al., 2012, Levinson et al., 2009, Valore et al., 2002, Dezzutti et al., 2011, Kyongo et al., 2012, Anderson et al., 2012, Ghosh et al., 2010b, Walter et al., 2011).

19 Differences in Cytokine and Chemokine Concentration Between Endometrial Secretions and Cervical Mucus Closed circle = cervical Open triangle = endometrial Rodriguez- Garcia et al. In: Mucosal Immunology, Chapter 108, * = significantly different. Data derived from (Boomsma et al., 2009a, Boomsma et al., 2010 Boomsma et al., 2009b).

20 Reference Ranges for Estradiol During the Menstrual Cycle Wikiversity, peer reviewed 2013

21 Reference Ranges for Progesterone During the Menstrual Cycle Wikiversity, peer reviewed 2013

22 Epithelium Immaturity as a Risk Factor for HIV Acquisition: Colposcopy Quantitative Measurement of Cervical Immaturity Cervical Transition Zone Columnar EC Squamous EC Immature = 67% of total space. Hwang et al. J Reprod. Immunol : Mature = 95% of total space.

23 Protein Levels of Cervical Vaginal Cytokine/Chemokines in Healthy Young Women with Immature and Mature Cervical Epithelium Hwang et al. J Reprod. Immunol :

24 Factors Contributing to Variability in Cytokine/Chemokine/Antimicrobials Levels, anti-hiv activity and Immune Protection in the Lower FRT 1. Hormonal balance during the menstrual cycles: anovulatory cycles. 2. Tissue environment influences HIV susceptibility of CD4+ T cells in FRT 3. Secretions in lower FRT are composed of vaginal transudate, vaginal EC secretions, cervical mucus/secretions and uterine fluid. 4. Collection procedure: CVL, menstrual cup, Dacron swab, tampon. 5. Menstrual cycle variability: Intra- and inter-individual variations. 6. Quantity of antimicrobials/cytokines in the secretions (ELISA) does not provide a complete picture of their biological activity: ie. Cathepsin D, under hormonal control, inhibits the function of CCL Some proteins inhibit and enhance HIV infection in vitro (concentration dependent): Example - RANTES, IL-8, and SDF-1a inhibit; RANTES increases HIV replication in monocytes/macrophages. IL-8 stimulates HIV replication in T cells and macrophages. 8. Cervical immaturity.

25 Acknowledgements Marta Rodriguez-Garcia John Fahey Jack Bodwell Mickey Patel Fiona Barr Sarah Crist Richard Rossoll Supported by NIH contract HHSN C, NIH grants AI102838, AI and AI (CRW)

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