INTRAVAGINAL PRODUCTS EFFECT ON VAGINAL PHYSIOLOGY

阴道是许多生殖器感染的中转站。长期的 这个项目的目标是了解阴道产品的使用如何 增加或降低在性行为中感染的易感性 性交。阴道对感染的抵抗力在很大程度上是 依赖于三种成分：正常的阴道菌群，抑制 通过产生低pH和过氧化氢，减少 细菌附着在阴道上皮上，这会降低感染能力 建立定植的细菌，和一个完整的阴道 机械地抵抗入侵的上皮细胞。许多人开了处方，而且超额- 已知放置在阴道中的非处方药具有潜在的效果 一种或多种这样的阴道保护机制。这项建议是 旨在检查各种条件和产品对 阴道生理学。研究中的影响包括阴道分泌物， 阴道微生物区系，细菌在阴道上皮的附着和 阴道上皮的细胞学和组织学。定量阴道 将对选定的物种进行培养，附件 乳杆菌和大肠埃希菌对受试者阴道上皮的影响 对细胞进行检查，镜，细胞学和组织学检查 阴道细胞上皮的检查将在基线和 在实验条件下。我们打算检查以下内容 它们对阴道生理影响的条件：正常 增生期、黄体期和月经期的月经周期、荷尔蒙 避孕，性交，有没有避孕套，各种 含壬醇-9的阴道内杀精剂的剂量和使用频率， 常用的阴道冲洗产品，包括一种含有 聚维酮碘阴道内注射过氧化氢 产乳酸菌与绝经前后雌激素的关系 替代疗法。这项研究旨在回答以下一些问题 细菌附着是否在月经期间发生变化的问题 周期，在这种情况下，细菌在 性交有助于乳酸菌的过度生长， 荷尔蒙避孕对细菌生长、细菌细胞附着和 上皮细胞，无论是壬基酚-9还是聚维酮-碘的使用都会干扰 并导致阴道上皮损伤，如果是这样的话， 损伤的程度，阴道内乳杆菌的情况 滴注导致阴道定植和绝经后妇女的影响 雌激素替代对阴道菌群和细菌附着的影响。使用 女性控制的阴道杀菌剂将成为重要的公共卫生 减少性传播中异性传播的措施 包括人类免疫缺陷病毒在内的疾病。拟议的研究将 提供有关内生和外生因素的关键新信息 影响阴道生理，从而改变阴道对 感染。

The vagina is the staging site for many genital infections. The long-term goal of this project is to understand how use of vaginal products could increase or decrease susceptibility to infections acquired during sexual intercourse. Vaginal resistance to the development of infection is largely dependent upon three components: normal vaginal flora which inhibits microorganisms by producing a low pH and hydrogen peroxide, reducing the attachment of bacteria to the vaginal epithelium which reduces the ability of the bacteria to establish colonization, and an intact vaginal epithelium which mechanically resists invasion. Many prescribed and over- the-counter products placed in the vagina are known to potentially effect one or more of these vaginal protective mechanisms. This proposal is designed to examine the effects of a variety of conditions and products on the vaginal physiology. The effects under study include vaginal discharge, vaginal microbial flora, attachment of bacteria to vaginal epithelium and the cytology and histology of the vaginal epithelium. Quantitative vaginal cultures will be performed for selected species, attachment of Lactobacillus and Escherichia coli to the subject's vaginal epithelial cells will be examined and colposcopic, cytologic and histologic examination of the vaginal cell epithelium will be studied at baseline and under experimental conditions. We intend to examine the following conditions for their effect on the vaginal physiology: the normal menstrual cycle in the proliferative, luteal and menstrual phase, hormonal contraception, sexual intercourse with and without condoms, a variety of doses and frequent use of intravaginal spermicide containing nonoxynol-9, commonly used vaginal douche products, including one that contains povidone-iodine, the intravaginal instillation of hydrogen peroxide producing Lactobacillus, and menopause before and after estrogen replacement therapy. The research is intended to answer some of the questions of whether bacterial attachment varies during the menstrual cycle, under which conditions bacteria introduced into the vagina during intercourse contributes to the overgrowth of lactobacilli, the effect of hormonal contraception on bacterial growth, bacterial cell attachment and the epithelium, whether nonoxynol-9 or povidone-iodine use disturbs bacterial flora and causes vaginal epithelial damage, and if so, the extent of the damage, conditions where intravaginal Lactobacillus instillation leads to vaginal colonization and the effect of menopause and estrogen replacement on vaginal flora and bacterial attachment. Use of female-controlled vaginal microbicides will be an important public health measure to decrease the heterosexual transmission of sexually transmitted diseases including human immunodeficiency virus. The proposed studies will provide critical new information on endogenous and exogenous factors which effect vaginal physiology, and thereby alter resistance of the vagina to infection.