Trichomonas Typing System

阴道毛滴虫(TV)占全球所有可治愈的性传播疾病的近一半，包括美国每年500万新感染病例。虽然感染在男性和女性中通常是无症状的，但尿道炎、阴道炎和宫颈炎症并不少见。在妇女中，电视与不良生育结局有关，而感染是艾滋病毒传播的一个重要辅助因素。目前尚不清楚TV毒株的变异程度，以及某些毒株是否更有可能产生症状或无症状感染。关于甲硝唑耐药性的报道已经出现，而且还在增加，但很少有研究记录治疗失败的真实程度，因为再感染和持续感染之间的区别还有待实用的分型系统。开发一种可靠的分子电视分型系统将提高对电视感染流行病学的了解，从而更好地发现和治疗滴虫病，这反过来又需要改善妇女的 在电视普遍存在的地方，促进生殖健康和减少艾滋病毒传播。其具体目标是：1)根据寄生虫基因组中包含串联DNA重复序列的位置的序列和长度多态，建立TV基因分型。含有数量可变的串联重复序列的基因座将通过聚合酶链式反应进行扩增。等位基因长度多态将被用来产生一个多位点分型系统。2)明确近期临床分离株中TV病毒(TVV)的遗传异质性，以确定TVV+亚群。病毒聚合酶cDNA序列将被生成并进行比较，以揭示TVV的相关性和聚集性。3)检验性伴侣TV等现有临床标本的毒株类型。使用AIMS 1和2中开发的分型系统，我们将比较在北卡罗来纳州两家性病诊所和AL一家诊所就诊的感染女性及其男性伴侣的阴道毛滴虫毒株类型，以确定性伴内和性伴之间以及临床人群内部和之间的毒株差异程度。我们还将检验电视上的差异是否会导致 通过比较有症状或无症状的妇女以及其伴侣感染或未感染TV的妇女中TV类型的分布，TTV类型有助于临床表现和传播。这些研究的结果可能导致开发识别特别重要的TV毒株的方法，改进治疗，从而减少这种巨大流行的性传播感染对健康的不利影响。

Trichomonas vaginalis (Tv) accounts for nearly half of all curable sexually transmitted infections worldwide, including 5 million new infections annually in the US. Though infection is often asymptomatic in men and women, urethritis, vaginitis and cervicitis are not uncommon. In women, Tv has been associated with adverse birth outcomes, and infection is an important co-factor in HIV transmission. The extent of Tv strain variation and whether some strains are more likely to produce symptomatic or asymptomatic infection are not known. Reports of resistance to metronidazole have appeared and are increasing, but there have been few studies documenting the true extent of treatment failures, since distinction between reinfection and persistent infection await a practical typing system. Development of a reliable, molecular Tv typing system would improve understanding the epidemiology of Tv infection, resulting in better detection and treatment of trichomoniasis, which in turn are needed improve women's reproductive health and reduce HIV transmission where Tv is common. The specific aims are 1) To establish Tv genotypes based on sequence and length polymorphisms at sites in the parasite genome containing tandem DNA repeats. Loci containing variable numbers of tandem repeats will be amplified by PCR. Allele length polymorphisms will be exploited to generate a multi-locus typing system. 2) To define the genetic heterogeneity of Tv viruses (TVV) in recent clinical isolates to identify subgroups of TVV+ strains. Viral polymerase cDNA sequences will be generated and compared to reveal the relatedness and clustering patterns of TVVs. 3) To examine strain types of existing clinical specimens including Tv from sexual partners. Using the typing system developed in Aims 1 and 2, we will compare T. vaginalis strain types from infected women and their male partners attending two STD clinics in NC and one in AL to define the extent of strain differences within and between sexual partnerships and within and between clinic populations. We will also test the hypotheses that differences in Tv strain types contribute to clinical presentation and transmission by comparing the distribution of Tv types among women with or without symptoms and whose partners were or were not infected with Tv. The results of these studies may lead to the development of methods to identify particularly important Tv strains, improving treatment, and thereby reducing the adverse health consequences of this enormously prevalent STI.