Virus-associated chronic endometritis: treatment options

Aim. To evaluate the effectiveness of Alloferon (Allokin-alfa) in the complex treatment of virus-associated chronic endometritis (CE) in patients with infertility, papillomavirus infection (PVI) persisting in the uterine cavity, and recurrent herpes-virus infection localized in the genital area. Materials and methods. A prospective (n=33) open randomized (2:1) study was conducted to assess the efficacy of Alloferon (Allokin-alfa) in the complex treatment of CE in patients with infertility, PVI, and recurrent herpes-virus infection, aged 25 to 37 years (median age 31 [29; 32.5] years). All patients received valacyclovir therapy at 500 mg once daily for 30 days from the day of randomization. Patients in the main group (n=21) simultaneously with the start of antiviral therapy received Allokin-alfa as 9 subcutaneous injections once every two days (one injection every other day). The uterine cavity microbiota of the patients was assessed 3 months after treatment, and histological and immunohistochemical studies of endometrial biopsy specimens were performed. Results. The microbiological data analysis showed HPV elimination in 71.4% vs 16.7% of patients in the alloferon and control groups, respectively (2 7.102, p=0.008). Also, in the main group, a significant decrease in the severity of CE (2 27.586, p0.001) and p16ink4a protein expression levels (2 6.17, p=0.013) were observed. Conclusion. In the treatment of virus-associated CE, the addition of alloferon to virus-suppressive therapy leads to higher rates of HPV elimination from the uterine cavity and significantly reduces the severity of CE

Risk of newly detected infections and cervical abnormalities in adult women seropositive or seronegative for naturally acquired HPV-16/18 antibodies

Funder: GlaxoSmithKline Biologicals SAPeer reviewedPublisher PD

Pooling samples : the key to sensitive, specific and cost-effective genetic diagnosis of Chlamydia trachomatis in low-resource countries

The aims of this study were to compare the performance characteristics and cost-effectiveness of pooling endocervical samples for screening and diagnosis of Chlamydia trachomatis, and to investigate the prevalence of C. trachomatis infection in women in Leningrad Oblast, Russia. A total of 1500 endocervical samples were tested individually and when pooled in groups of 5 and 10 samples, respectively. A previously evaluated in-house diagnostic polymerase chain reaction (PCR) assay was utilized. The sensitivity and specificity of the PCR were not affected by either pooling strategy. The estimated prevalence of genital C. trachomatis infection was 6.6%, 6.1% and 6.0% based on individually tested samples, and pools of 5 and 10, respectively. For diagnosis of individual samples, the pooling strategies resulted in cost savings of 53.3% (5 samples per pool) and 44.0% (10 samples per pool). Pooling samples for PCR detection of C. trachomatis is an accurate and cost-saving approach for diagnosis and large-scale prevalence studies in St Petersburg, Russia

Pooling samples : the key to sensitive, specific and cost-effective genetic diagnosis of Chlamydia trachomatis in low-resource countries

The aims of this study were to compare the performance characteristics and cost-effectiveness of pooling endocervical samples for screening and diagnosis of Chlamydia trachomatis, and to investigate the prevalence of C. trachomatis infection in women in Leningrad Oblast, Russia. A total of 1500 endocervical samples were tested individually and when pooled in groups of 5 and 10 samples, respectively. A previously evaluated in-house diagnostic polymerase chain reaction (PCR) assay was utilized. The sensitivity and specificity of the PCR were not affected by either pooling strategy. The estimated prevalence of genital C. trachomatis infection was 6.6%, 6.1% and 6.0% based on individually tested samples, and pools of 5 and 10, respectively. For diagnosis of individual samples, the pooling strategies resulted in cost savings of 53.3% (5 samples per pool) and 44.0% (10 samples per pool). Pooling samples for PCR detection of C. trachomatis is an accurate and cost-saving approach for diagnosis and large-scale prevalence studies in St Petersburg, Russia

Infection of Human Retinal Pigment Epithelium with Chlamydia trachomatis.

Little is known about the susceptibility of posterior segment tissues, particularly the human retinal pigment epithelium (hRPE), to Chlamydia trachomatis. The purpose of the study was to investigate the possibility of infecting the hRPE with Chlamydia trachomatis, and to examine the infectivity of different Chlamydia trachomatis clinical isolates for hRPE cells and the hRPE cell response to the infection.Cultured hRPE and McCoy cells were inoculated with eight Chlamydia trachomatis (serovar E) clinical isolates at multiplicity of infection (MOI) of 2.0 or 0.3. To detect Chlamydia trachomatis, samples were stained immunohistochemically with anti-major outer membrane protein antibodies at 24h, 48h, and 72h postinoculation (PI). The changes in the expression of signaling molecules and proteins of cytoskeleton and extracellular matrix in hRPE cells were examined immunohistochemically.All eight clinical isolates demonstrated ability to infect hRPE cells. At equal MOI of 0.3, the infectivity of Chlamydia trachomatis clinical isolates for RPE culture was found to be at least as high as that for McCoy cell culture. At 24h PI, the percentage of inclusion-containing cells varied from 1.5 ± 0.52 to 14.6 ± 3.3% in hRPE cell culture infected at MOI of 2.0 against 0.37 ± 0.34 to 8.9 ± 0.2% in McCoy cell culture infected at MOI of 0.3. Collagen type I, collagen type IV, basic fibroblast growth factor, transforming growth factor-beta and interleukin-8 expression at 48h PI were maximally increased, by 2.1-, 1.3-, 1.5-, 1.5- and 1.6-fold, respectively, in the Chlamydia trachomatis-infected compared with control hRPE cell culture specimens (P < 0.05).This study, for the first time, proved the possibility of infecting hRPE cultured cells with Chlamydia trachomatis, which leads to proproliferative and proinflammatory changes in the expression of signaling molecules and extracellular matrix components

Immunohistochemistry and direct immunofluorescent staining of hRPE and McCoy cell cultures at different time-points postinoculation with <i>Chlamydia trachomatis</i> (clinical isolate No.24032).

<p>In both types of cultures, both techniques reveal highly immunoreactive inclusions (arrowheads). Twenty-four to 72 h postinoculation, a reduction in the number of intracellular inclusions is observed due to the release of a new generation of EBs to the extracellular environment. Scale bar: 50 μm.</p

Changes in the percentage of inclusion-containing cells in hRPE and McCoy cell cultures following inoculation with <i>Chlamydia trachomatis</i> (clinical isolate No.24032).

<p>Changes in the percentage of inclusion-containing cells in hRPE and McCoy cell cultures following inoculation with <i>Chlamydia trachomatis</i> (clinical isolate No.24032).</p

Immunohistochemistry micrographs of hRPE cell culture at 72 hours postinoculation with <i>Chlamydia trachomatis</i> clinical isolate No.24032.

<p>(A) Intracellular inclusions (arrowhead) exhibiting weak immune responsiveness (due to release of EBs to extracellular environment). (B) Numerous EBs (arrowheads) in microscopy projection of cells without inclusions. Scale bar: 10 μm.</p

Clinical Isolates of <i>C</i>. <i>trachomatis</i>, the Doses Used to Infect Cell Cultures and Multiplicities of Infection Corresponding to the Doses and to the Isolates.

<p><i>IFU</i>, inclusion forming units; <i>MOI</i>, multiplicity of infection</p