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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 median cytokine concentrations observed in genital fluid isolated from CVL, MC and matching subsequent CVL specimens in a randomised study.Cytokine concentrations were compared in genital fluid isolated from n = 19 MC- 4A and n = 20 randomized CVL, and n = 18 matching MC and subsequently-sampled CVL specimens- 4B. The concentrations of 48 cytokines [(regulatory ○; growth factor ✚; haematopoietic ✖; adaptive ◆; inflammatory ●)] were determined in each specimen by luminex technology and the median of each cytokine concentration was compared by Spearman rank correlation. Data are depicted on Log10 scales. P-values <0.05 were considered significant.
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pone.0131906.g004: Comparison of median cytokine concentrations observed in genital fluid isolated from CVL, MC and matching subsequent CVL specimens in a randomised study.Cytokine concentrations were compared in genital fluid isolated from n = 19 MC- 4A and n = 20 randomized CVL, and n = 18 matching MC and subsequently-sampled CVL specimens- 4B. The concentrations of 48 cytokines [(regulatory ○; growth factor ✚; haematopoietic ✖; adaptive ◆; inflammatory ●)] were determined in each specimen by luminex technology and the median of each cytokine concentration was compared by Spearman rank correlation. Data are depicted on Log10 scales. P-values <0.05 were considered significant.

Mentions: The median cytokine concentrations in randomised MC specimens were similarly ranked to that isolated from randomised CVL specimens (Spearman r = 0.85, 95% CI 0.74–0.92; p<0.001; Fig 4A), indicating a similar profile of cytokines isolated from MC and CVL specimens. This trend was also observed when comparing the median cytokine concentrations in CVL sampled immediately after MC removal (n = 18) with that of matching MC specimens (Spearman r = 0.903, 95% CI 0.83–0.95, p<0.001; Fig 4B). Furthermore, comparing cytokine concentrations in CVL collected after MC sampling (n = 18) with CVLs collected from women randomised to undergo CVL sampling alone (n = 20), 47/48 cytokines measured were similar in concentration, further supporting the observation that CVL sampling immediately after MC removal does not significantly alter the cytokine profile. Only CTACK concentrations differed between groups (p<0.001), being 38% lower in CVL sampled after MC (median 26.6 pg/ml, IQR 14.5–34.4 pg/ml) compared to CVL sampled alone (42.8 pg/ml, IQR 31.7–50.2 pg/ml).


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 median cytokine concentrations observed in genital fluid isolated from CVL, MC and matching subsequent CVL specimens in a randomised study.Cytokine concentrations were compared in genital fluid isolated from n = 19 MC- 4A and n = 20 randomized CVL, and n = 18 matching MC and subsequently-sampled CVL specimens- 4B. The concentrations of 48 cytokines [(regulatory ○; growth factor ✚; haematopoietic ✖; adaptive ◆; inflammatory ●)] were determined in each specimen by luminex technology and the median of each cytokine concentration was compared by Spearman rank correlation. Data are depicted on Log10 scales. P-values <0.05 were considered significant.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0131906.g004: Comparison of median cytokine concentrations observed in genital fluid isolated from CVL, MC and matching subsequent CVL specimens in a randomised study.Cytokine concentrations were compared in genital fluid isolated from n = 19 MC- 4A and n = 20 randomized CVL, and n = 18 matching MC and subsequently-sampled CVL specimens- 4B. The concentrations of 48 cytokines [(regulatory ○; growth factor ✚; haematopoietic ✖; adaptive ◆; inflammatory ●)] were determined in each specimen by luminex technology and the median of each cytokine concentration was compared by Spearman rank correlation. Data are depicted on Log10 scales. P-values <0.05 were considered significant.
Mentions: The median cytokine concentrations in randomised MC specimens were similarly ranked to that isolated from randomised CVL specimens (Spearman r = 0.85, 95% CI 0.74–0.92; p<0.001; Fig 4A), indicating a similar profile of cytokines isolated from MC and CVL specimens. This trend was also observed when comparing the median cytokine concentrations in CVL sampled immediately after MC removal (n = 18) with that of matching MC specimens (Spearman r = 0.903, 95% CI 0.83–0.95, p<0.001; Fig 4B). Furthermore, comparing cytokine concentrations in CVL collected after MC sampling (n = 18) with CVLs collected from women randomised to undergo CVL sampling alone (n = 20), 47/48 cytokines measured were similar in concentration, further supporting the observation that CVL sampling immediately after MC removal does not significantly alter the cytokine profile. Only CTACK concentrations differed between groups (p<0.001), being 38% lower in CVL sampled after MC (median 26.6 pg/ml, IQR 14.5–34.4 pg/ml) compared to CVL sampled alone (42.8 pg/ml, IQR 31.7–50.2 pg/ml).

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