The cervical microbiome mediates hormonal increases in HIV1 susceptibility

描述（由申请人提供）：绝经和宫颈阴道（CV）微生物群落失衡均与HIV-1感染风险增加相关。最近的研究表明，绝经后妇女表现出表达C-C趋化因子受体5型（CCR 5），一种HIV-1辅助受体的CD 4 + T淋巴细胞丰度升高。由于绝经后出现的低雌激素与CV微生物群的明显改变有关，我们的主要目标是确定绝经后CV微生物群落是否介导绝经与女性生殖道中CCR 5 + CD 4 + T细胞群体升高之间的关联。我们推测，先天性粘膜免疫功能的绝经依赖性抑制改变了宫颈阴道粘膜暴露的微生物和微生物产物的类型和数量。由此产生的新型微生物抗原的增加的负担进一步被假设为损害宫颈免疫稳态，从而增加HIV-1靶细胞向宫颈粘膜下层的募集。将使用CV灌洗液和宫颈组织标本的高通量宏基因组分析来测试这些假设，以实现以下特定目标：目标1。确定宫颈阴道微生物群的组成改变是否与表达趋化因子共受体（例如，CCR 5，CXCR 4）或活化标志物（例如，HLA-DR，CD38）。目标二。确定绝经是否与宫颈上皮附近细菌密度的改变有关。目标3：确定绝经前和绝经后妇女宫颈粘膜上皮和常驻微生物群的基因表达模式是否不同。 公共卫生相关性：绝经期和通常居住在女性生殖道的细菌群落的失衡都与HIV-1感染风险增加有关。最近的研究表明，绝经后妇女表现出对HIV-1感染易感的免疫细胞（某些T淋巴细胞）丰度升高;然而，为什么会发生这种情况尚不清楚。我们假设宫颈阴道细菌的这些变化增加了宫颈中这些HIV-1易感T淋巴细胞的数量，从而增加了HIV-1向女性异性传播的风险。通过对明确定义的人群进行观察性研究，我们将使用高通量DNA测序方法，沿着先进的显微镜检查，全面确定绝经是否导致1）不同种类的细菌栖息在女性生殖道; 2）不同细菌基因的表达;和/或3）宫颈基因表达的修饰。

DESCRIPTION (provided by applicant): Both menopause and imbalances in cervicovaginal (CV) microbial communities are associated with increased risk of HIV-1 acquisition. Recent studies indicate that postmenopausal women exhibit elevated abundances of CD4+ T-lymphocytes expressing C-C chemokine receptor type 5 (CCR5), a HIV-1 coreceptor. Because low estrogen, as occurs following menopause, is linked to distinct alterations in the CV microbiota, our primary objective is to determine whether commensal CV microbial communities mediate the association between menopause and elevated populations of CCR5+CD4+ T-cells in the female reproductive tract. We hypothesize that menopause-dependent suppression of innate mucosal immune function alters the types and quantities of microbes and microbial products to which the cervicovaginal mucosa is exposed. The resulting increased burden of novel microbial antigens is further hypothesized to compromise cervical immune homeostasis, thereby increasing recruitment of HIV-1 target cells to the cervical sub-mucosa. These hypotheses will be tested using high-throughput, metagenomic analysis of CV lavage and cervical tissue specimens in order to accomplish the following specific aims: Aim 1. Determine whether an altered composition of the cervicovaginal microbiota is associated with elevated levels of CD4+ T-lymphocytes expressing chemokine coreceptors (e.g., CCR5, CXCR4) or activation markers (e.g., HLA-DR, CD38). Aim 2. Determine whether menopause is associated with altered densities of bacteria in proximity to the cervical epithelium. Aim 3. Determine whether gene expression patterns of cervical mucosal epithelia and resident microbiota differ in a comparison of premenopausal and postmenopausal women. PUBLIC HEALTH RELEVANCE: Both menopause and imbalances in the bacterial communities normally inhabiting the female reproductive tract are associated with increased risk of HIV-1 acquisition. Recent studies indicate that postmenopausal women exhibit elevated abundances of immune cells (certain T-lymphocytes) that are susceptible to HIV-1 infection; however, why this occurs is not known. We hypothesize those changes in cervicovaginal bacteria increase the quantities of these HIV-1 susceptible T-lymphocytes in the cervix, and thereby increase the risk of heterosexual transmission of HIV-1 to females. Through observational studies of well-defined human populations, we will test this hypothesis by using high-throughput DNA sequencing methods, along with advanced microscopy, to comprehensively determine whether menopause results in 1) different kinds of bacteria inhabiting the female reproductive tract; 2) expression of different bacterial genes; and/or 3) modification of cervical gene expression.