Limits...
Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage.

Archary D, Liebenberg LJ, Werner L, Tulsi S, Majola N, Naicker N, Dlamini S, Hope TJ, Samsunder N, Abdool Karim SS, Morris L, Passmore JA, Garrett NJ - PLoS ONE (2015)

Bottom Line: Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001).In MCs, 42/48 (88%) cytokines were in the detectable range in all participants compared to 27/48 (54%) in CVL (p<0.001).Concentrations of 22/41 cytokines (53.7%) were significantly higher in fluid collected by MC.

View Article: PubMed Central - PubMed

Affiliation: Centre for the AIDS Programme of Research in South Africa, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

ABSTRACT

Introduction: Optimizing methods for genital specimen collection to accurately characterize mucosal immune responses is a priority for the HIV prevention field. The menstrual cup (MC) has been proposed as an alternative to other methods including cervicovaginal lavage (CVL), but no study has yet formally compared these two methods.

Methods: Forty HIV-infected, antiretroviral therapy-naïve women from the CAPRISA 002 acute HIV infection cohort study were randomized to have genital fluid collected using the MC with subsequent CVL, or by CVL alone. Qualitative data, which assessed levels of comfort and acceptability of MC using a 5-point Likert scale, was collected. Luminex multiplex assays were used to measure HIV-specific IgG against multiple gene products and 48 cytokines.

Results: The majority (94%) of participants indicated that insertion, wearing and removal of the MC was comfortable. Nineteen MCs with 18 matching, subsequent CVLs and 20 randomized CVLs were available for analysis. Mucosal IgG responses against four HIV-antigens were detected in 99% of MCs compared to only 80% of randomized CVLs (p = 0.029). Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001). In MCs, 42/48 (88%) cytokines were in the detectable range in all participants compared to 27/48 (54%) in CVL (p<0.001). Concentrations of 22/41 cytokines (53.7%) were significantly higher in fluid collected by MC. Both total IgG (r = 0.63; p = 0.005) and cytokine concentrations (r = 0.90; p<0.001) correlated strongly between MC and corresponding post-MC CVL.

Conclusions: MC sampling improves the detection of mucosal cytokines and antibodies, particularly those present at low concentrations. MC may therefore represent an ideal tool to assess immunological parameters in genital secretions, without interfering with concurrent collection of conventional CVL samples.

No MeSH data available.


Related in: MedlinePlus

Comparison of total antibody (ng ml-1) in MCs (n = 19)- 3A, randomized CVL (n = 20) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)]- Correlation plots between total antibody in MCs and matched post MC CVLs- 3B.Correlation plots (Fig 3C–3F) of HIV specific activity in MCs (n = 18) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)] for gag p24- 3C, p66- 3D, gp41- 3E and gp120- 3F.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4492781&req=5

pone.0131906.g003: Comparison of total antibody (ng ml-1) in MCs (n = 19)- 3A, randomized CVL (n = 20) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)]- Correlation plots between total antibody in MCs and matched post MC CVLs- 3B.Correlation plots (Fig 3C–3F) of HIV specific activity in MCs (n = 18) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)] for gag p24- 3C, p66- 3D, gp41- 3E and gp120- 3F.

Mentions: Specific activity was compared between MCs and randomized CVLs in order to evaluate the differences in magnitudes for the HIV-specific binding antibodies. As shown in Fig 2A–2D, levels of p24, p66, gp41 and gp120-specific activities were significantly higher (all p<0.001) in MCs than in randomized CVL samples. Total IgG levels were also higher in MCs compared to randomized CVL samples (p<0.001) (Fig 3A). In addition, post-MC CVLs were measured for total IgG and compared to those of randomized CVLs to investigate an impact on subsequent levels of IgG secreted with prior MC sampling. Interestingly, while there was a trend towards lower levels of total IgG in post-MC CVL samples, these were not significantly different to randomized CVL levels (p = 0.096), suggesting minimal impact of prior MC sampling.


Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage.

Archary D, Liebenberg LJ, Werner L, Tulsi S, Majola N, Naicker N, Dlamini S, Hope TJ, Samsunder N, Abdool Karim SS, Morris L, Passmore JA, Garrett NJ - PLoS ONE (2015)

Comparison of total antibody (ng ml-1) in MCs (n = 19)- 3A, randomized CVL (n = 20) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)]- Correlation plots between total antibody in MCs and matched post MC CVLs- 3B.Correlation plots (Fig 3C–3F) of HIV specific activity in MCs (n = 18) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)] for gag p24- 3C, p66- 3D, gp41- 3E and gp120- 3F.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492781&req=5

pone.0131906.g003: Comparison of total antibody (ng ml-1) in MCs (n = 19)- 3A, randomized CVL (n = 20) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)]- Correlation plots between total antibody in MCs and matched post MC CVLs- 3B.Correlation plots (Fig 3C–3F) of HIV specific activity in MCs (n = 18) and matched post-MC CVLs (n = 18) [Log10 MFI*dilution factor ng ml-1 (MFI/total Ig)] for gag p24- 3C, p66- 3D, gp41- 3E and gp120- 3F.
Mentions: Specific activity was compared between MCs and randomized CVLs in order to evaluate the differences in magnitudes for the HIV-specific binding antibodies. As shown in Fig 2A–2D, levels of p24, p66, gp41 and gp120-specific activities were significantly higher (all p<0.001) in MCs than in randomized CVL samples. Total IgG levels were also higher in MCs compared to randomized CVL samples (p<0.001) (Fig 3A). In addition, post-MC CVLs were measured for total IgG and compared to those of randomized CVLs to investigate an impact on subsequent levels of IgG secreted with prior MC sampling. Interestingly, while there was a trend towards lower levels of total IgG in post-MC CVL samples, these were not significantly different to randomized CVL levels (p = 0.096), suggesting minimal impact of prior MC sampling.

Bottom Line: Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001).In MCs, 42/48 (88%) cytokines were in the detectable range in all participants compared to 27/48 (54%) in CVL (p<0.001).Concentrations of 22/41 cytokines (53.7%) were significantly higher in fluid collected by MC.

View Article: PubMed Central - PubMed

Affiliation: Centre for the AIDS Programme of Research in South Africa, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

ABSTRACT

Introduction: Optimizing methods for genital specimen collection to accurately characterize mucosal immune responses is a priority for the HIV prevention field. The menstrual cup (MC) has been proposed as an alternative to other methods including cervicovaginal lavage (CVL), but no study has yet formally compared these two methods.

Methods: Forty HIV-infected, antiretroviral therapy-naïve women from the CAPRISA 002 acute HIV infection cohort study were randomized to have genital fluid collected using the MC with subsequent CVL, or by CVL alone. Qualitative data, which assessed levels of comfort and acceptability of MC using a 5-point Likert scale, was collected. Luminex multiplex assays were used to measure HIV-specific IgG against multiple gene products and 48 cytokines.

Results: The majority (94%) of participants indicated that insertion, wearing and removal of the MC was comfortable. Nineteen MCs with 18 matching, subsequent CVLs and 20 randomized CVLs were available for analysis. Mucosal IgG responses against four HIV-antigens were detected in 99% of MCs compared to only 80% of randomized CVLs (p = 0.029). Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001). In MCs, 42/48 (88%) cytokines were in the detectable range in all participants compared to 27/48 (54%) in CVL (p<0.001). Concentrations of 22/41 cytokines (53.7%) were significantly higher in fluid collected by MC. Both total IgG (r = 0.63; p = 0.005) and cytokine concentrations (r = 0.90; p<0.001) correlated strongly between MC and corresponding post-MC CVL.

Conclusions: MC sampling improves the detection of mucosal cytokines and antibodies, particularly those present at low concentrations. MC may therefore represent an ideal tool to assess immunological parameters in genital secretions, without interfering with concurrent collection of conventional CVL samples.

No MeSH data available.


Related in: MedlinePlus