Vaginal Stratum Corneum: Demilitarized Zone or Battlefront?

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1 Vaginal Stratum Corneum: Demilitarized Zone or Battlefront? Deborah Anderson Boston University School of Medicine Boston, MA, USA

2 Vaginal Epithelium Stratum corneum Suprabasal layer Basal layer

3 Epithelial Cells in Vaginal Stratum Corneum (Corneocytes) lumen lose nuclei and organelles glycogen-filled no tight junctions continuous turnover of apical cells

4 Vagina and Endocervix: Comparison of Apical Surfaces Vagina Endocervix

5 Stratum Corneum: Demilitarized Zone?

6 Immune Cells in the Vaginal Epithelium CD8 CD8 CD8 CD4 CD4 CD103 TIA1 CD68 CD1a TIA1 CD8 Few immune cells are present in the healthy SC Copyright 2005 Society for the Study of Reproduction Pudney J, Quayle AJ, and Anderson DJ Biol Reprod 2005;73:

7 Does the vaginal stratum corneum prevent stimulation of basal epithelial cells by products of luminal bacteria?

8 MatTek VEC culture lumen Stratum corneum Superbasal Basal lamina propria medium

9 MatTek VEC culture lumen SC Superbasal lamina propria medium Basal epithelial cells express TLRs 1/2, 3, 5 (notably they do not express TLR4, the LPS receptor)

10 Primary and immortalized cultures of vaginal basal epithelial cells produce proinflammatory cytokines and chemokines when stimulated with TLR agonists Il-6 Il-8 TNF-alpha RANTES MIP-1alpha These products recruit and activate immune

11 MatTek VEC culture lumen SC TLR agonists added to apical surface FSL Poly (I:C) Flagelin Superbasal lamina propria Basal epithelial cells express TLRs 1/2, 3, 5 medium No cytokines detected in apical or basal supernatants

12 MatTek VEC culture SC TLR agonists added to scarified surface FSL Poly (I:C) Flagelin Superbasal lamina propria Basal epithelial cells express TLRs 1/2, 3, 5 medium Cytokines detected in apical and basolateral supernatant

13 MatTek VEC culture TLR agonists added to basolateral surface SC FSL Poly (I:C) Flagelin Superbasal lamina propria Basal epithelial cells express TLRs 1/2, 3, 5 medium Cytokines detected in basolateral supernatant

14 Evidence that the healthy intact vaginal stratum corneum is a passive protective barrier Does not contain many immune cells Protects basal epithelial cells from stimulation with products from endogenous luminal bacteria

15 Stratum Corneum: Battlefront

16 Can pathogens infiltrate the stratum corneum?

17 Infiltration of Stratum Corneum by Inert Beads 0.1um (virus) 1um (bacterium)

18 HIV enters the vaginal stratum corneum where it may encounter Langerhans cells and transmit infection. Thomas Hope 2009

19 Question: How long does HIV remain viable (infectious) in the stratum corneum?

20 Assessment of HIV infectivity in the Stratum Corneum MatTek VEC culture TZM-bl (HIV indicator) cells were added to the apical surface of VEC cultures to assess infectious HIV. Stratum corneum Superbasal Basal TZM-bl cells on SC lamina propria medium

21 HIV Infection of TZM-bl cells on Vaginal Surface HIV + TZ 1 hr before addition to culture HIV +TZ HIV 1 hr before addition of TZ

22 Can HIV-infected cells infiltrate the stratum corneum from the apical side?

23 Cell-Associated HIV Transmission

24 PBMCs Adhere to Vaginal Stratum Corneum

25 Apical to basal leukocytic infiltration of the the vaginal stratum corneum surface Macrophages surface Seminal leukocytes

26 Does the vaginal stratum corneum retain soluble immunological mediators?

27 Igs in the Vaginal Stratum Corneum IgG IgA IgM Does the SC absorb Igs from the lumen? Do antibodies retain their activity in the SC? Time course of Ig retention in the SC?

28 IgG Uptake by Apical Vaginal Epithelial Cells IgG-Cy3 Negative Control

29 Evidence that Ig Uptake is not receptor mediated Absorption and retention occurs at 4ºC Absorption and retention of IgY Ig receptors not detected in stratum corneum The stratum corneum absorbs and retains other types of immune mediators - lysozyme - type-1 defensins

30 Do antibodies retain activity in the stratum corneum?

31 Retention of HSV-Cy3 mab by vaginal stratum corneum After 1 hour After 12 hours

32 Suppression of HSV-2 Infection in vitro with Anti-HSV Mab 7000 Treatment Groups: No treatment p<0.05 p<0.05 HSV DNA Copy# Anti-HSV Mab Anti-HSV Mab Preincubation/Rinse p<0.01 p< hrs 24 hrs 48 hrs Time After HSV Infection

33 VRCO1 HIV neutralizing mab blocks HIV infection of TZM-bl cells in vaginal stratum corneum

34 Vaginal Stratum Corneum Battlefront Summary Cell-free and cell-associated pathogens (eg. HIV) can enter the SC Soluble immunological mediators and leukocytes provide immune defense in the stratum corneum

35 Implications for microbicide research Assess concentrations, activity and half-life of microbicides in SC layer Design microbicides to fortify the SC -monoclonal antibodies

36 Acknowlegements Jeffrey Pudney Caitlin Blaskewicz Ryan Palapaz Seyoum Ayehunie Ken Mayer Manish Sagar Kevin Whaley Funded by grant NIH U19 AI IPCP-HTM: Monoclonal Antibody Multipurpose Microbicides

37 ICAM antibody blocked leukocyte infiltration into vaginal epithelium

38 Ig deposits in human vaginal epithelium Intracellular IgA in superbasal layer IgG in stratum corneum Intracellular IgG in superbasal layer Intercellular IgG