阴道IL-2、IL-12、IFN-γ、sIgA的表达及微生物与HPV感染的关系

Association Between the Expression of IL-2,IL-12,IFN-γ,and sIgA and Microorganisms in the Vagina and HPV Infection

阐明人乳头瘤病毒(Human papilloma virus,HPV)感染的女性阴道局部免疫及阴道微生物菌群的情况,并探讨其与HPV感染的相关性。本研究收集2017年10月至2018年3月于我院初诊为HPV阳性的175名女性,根据其宫颈细胞学结果分为4组,分别为无上皮内病变或恶性病变(No intraepithelial lesions or malignant lesions,NILM)、意义未明的不典型鳞状细胞(Atypical squamous cells of undetermined significance,ASCUS)、低级别鳞状上皮内病变(Low-grade squamous intraepithelial lesion,LSIL)、高级别鳞状上皮内病变(High-grade squamous intraepithelial lesion,HSIL),将同期体检为NILM/HPV(-)的62名健康女性作为对照组。在显微镜下检测患者的阴道微生物(细菌、真菌等)、滴虫,采用酶联免疫法检测阴道局部IL-2、IL-12、IFN-γ、sIgA的表达量。结果显示:与对照组相比,HPV(+)组阴道清洁程度Ⅲ°~Ⅳ°概率增高(P<0.05);细菌性阴道病(Bacterial vaginosis,BV)发病率增高(P<0.05);真菌感染率增高(P<0.05);IL-2、IL-12、sIgA在阴道局部的表达量降低(P<0.05);IL-2、sIgA随着宫颈病变的加重,在阴道局部的表达量逐渐降低(P<0.05)。本研究揭示,HPV感染可改变阴道局部的免疫应答及阴道微生物菌种,为HPV感染后的阴道局部治疗及预防HPV感染提供了依据。

The aim of this study was to clarify the relationships between vaginal local immunity and microbiota in women infected by human papilloma virus(HPV),and to explore the correlations with HPV infection. A total of 175 patients who were initially diagnosed as HPV-positive at the Third Affiliated Hospital of Zhengzhou University from October 2017 to March 2018 were divided into four groups:no intraepithelial lesions or malignant lesions(NILM),atypical squamous cells of undetermined significance(ASCUS),low-grade squamous intraepithelial lesions(LSIL),and high-grade squamous intraepithelial lesions(HSIL). Sixty-two NILM/HPV-negative patients were included as the control group. Vaginal microbes(bacteria, fungi,Trichomonas,and so on)and the expression of interleukin(IL)-2,IL-12,interferon(IFN)-γ,and secretory immunoglobulin A(sIgA)were determined in all patients. Compared with the control[HPV(-)]group,the probability of vaginal cleanliness degree Ⅲ° ~Ⅳ° in the HPV(+)group was higher(P < 0.05),and the probability of being with bacterial vaginosis or being fungus(+)was increased(P < 0.05). The expression of IL-2,IL-12,and sIgA in the HPV(+)groups was significantly lower than that in the control group(P <0.05). The expression of IL-2 and sIgA decreased gradually with the aggravation of cervical lesions(P <0.05). Imbalance of the microbiota in the vagina can accelerate,and affect the outcome of,HPV infection. HPV infection can change the local vaginal immune response and vaginal microbial species. These findings provide a basis for local vaginal treatment after HPV infection and prevention of HPV infection.