PRO 2000 elicits a decline in genital tract immune mediators without compromising intrinsic antimicrobial activity

• Published in: AIDS (London) Vol. 21; no. 4; pp. 467 - 476
• Main Authors: KELLER, Marla J, GUZMAN, Esmeralda, HOGARTY, Kathleen, HEROLD, Betsy C, HAZRATI, Ehsan, KASOWITZ, Andrea, CHESHENKO, Natalia, WALLENSTEIN, Sylvan, COLE, Amy L, COLE, Alexander M, PROFY, Albert T, WIRA, Charles R
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 19-02-2007
• Subjects: Administration, Intravaginal; Adolescent; Adult; AIDS/HIV; Anti-Infective Agents, Local - administration & dosage; Anti-Infective Agents, Local - pharmacology; Antiviral Agents - administration & dosage; Antiviral Agents - pharmacology; Biological and medical sciences; Chemokines - biosynthesis; Cytokines - biosynthesis; Defensins - biosynthesis; Double-Blind Method; Drug Administration Schedule; Escherichia coli; Female; Herpes Genitalis - prevention & control; Herpes simplex virus; HIV Infections - prevention & control; Human immunodeficiency virus; Human viral diseases; Humans; Immunity, Mucosal - drug effects; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Inflammation Mediators - metabolism; Medical sciences; Middle Aged; Naphthalenesulfonates - administration & dosage; Naphthalenesulfonates - pharmacology; Polymers - administration & dosage; Polymers - pharmacology; Staphylococcus aureus; Therapeutic Irrigation; Vagina - immunology; Vagina - metabolism; Vaginal Creams, Foams, and Jellies; Viral diseases; Viral diseases of the genital and urinary system; Viral diseases of the lymphoid tissue and the blood. Aids; Escherichia coli; Mucosa; Uterine cervix; Genital herpes; Antimicrobial agent; innate immunity; Bacteria; Micrococcales; Micrococcaceae; cytokines; Staphylococcus aureus; Enterobacteriaceae; Immunopathology; defensins; microbicides; Genital system; Cytokine; Vagina; AIDS; Immune deficiency; Infection; Virus; Sexually transmitted disease; HIV; Viral disease; Bacteriosis; Mediator; Defensin
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0b013e328013d9b5

Vaginal microbicides should protect against infection without disrupting the mucosal environment or its mediators of host defense. The objective of this study was to examine the effect of 14 daily applications of 0.5% PRO 2000 or placebo gel on mediators of mucosal immunity and intrinsic antimicrobial activity.
A randomized, prospective, double-blind, placebo-controlled study was conducted among 24 healthy, abstinent women. Levels of cytokines, chemokines, defensins, and other protective factors and intrinsic antimicrobial activity were determined in cervicovaginal lavage samples collected on study days 0, 7, 14, and 21.
No increase in pro-inflammatory cytokines was observed. Rather cytokines and protective factors including interleukin (IL)-1 receptor antagonist, immunoglobulins and human beta-defensin 2 were lower in the drug compared with the placebo group. All of the mediators returned towards baseline on day 21. Women who were cycling had lower levels of most proteins on study days 7 and/or 14 compared with women on oral contraceptives; however, the magnitude of decline was greater in women who received PRO 2000 compared with placebo gel. The reduction in protective factors was not associated with a loss in the intrinsic anti-viral (HIV or herpes simplex virus) activity or anti-bacterial activity (Escherichia coli or Staphylococcus aureus).
In contrast to experience with nonoxynol-9, PRO 2000 did not trigger an inflammatory response in cervicovaginal secretions. There was a modest reduction in mucosal immune mediators, but this loss was not associated with a reduction in intrinsic antimicrobial activity.