BACTERIAL VAGINOSIS--PATHOGENESIS AND IMPACT ON SEXUALLY TRANSMITTED DISEASES

细菌性阴道病——发病机制及其对性传播疾病的影响

• 批准号: 6661393
• 负责人: JANE R SCHWEBKE
• 金额: $ 23.07万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2003-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6661393
• 关键词: Chlamydia trachomatis; Lactobacillus; Mycoplasma; Mycoplasmatales; Neisseria gonorrhoeae; antibody formation; bacterial disease; cervical /vaginal smear; clinical research; clinical trials; communicable disease transmission; cooperative study; cytokine; disease /disorder proneness /risk; host organism interaction; human subject; longitudinal human study; microorganism immunology; pathologic process; sex behavior; sex partner; sexually transmitted diseases; vaginitis

Bacterial vaginosis (BV) is the most prevalent cause of symptomatic vaginal discharge in women. Its etiology is unknown, however, it is characterized by displacement of the normal lactobacillus-predominant vaginal flora with large numbers of anaerobic and facultatively anaerobic bacteria. These changes do not appear to be all-or-none, but instead abnormal vaginal flora can be viewed as a continuum of change. Microbiological changes can be quantified by using a standardized interpretative methods for vaginal fluid Gram stains. Epidemiologic associations exist between BV and sexually transmitted diseases (STDs) including human immunodeficiency virus (HIV), however cause and effect are unknown. One hypothesis is that without "protective" lactobacilli, women with abnormal vaginal flora (BV) are at increased risk of acquiring an STD upon exposure. The specific aims of this proposal are to determine the impact of BV on the acquisition of STDs by conducting prospective studies of women at high risk for STD. These studies represent continuation and extension of our ongoing work in this area. We will conduct a randomized controlled trial of treatment versus placebo for women with symptomatic BV. The women will be followed for a total of one year with serial examinations with the study outcome being acquisition of STD. In addition, we will utilize information and specimens obtained from these women to investigate issues related to the pathogenesis of abnormal vaginal flora, including the relationships of behaviors to changes in flora and description of the immunological factors associated with the patterns of vaginal flora and symptomatology in each of the three groups of women.

细菌性阴道病（BV）是女性出现症状性阴道分泌物的最常见原因。其病因尚不清楚，但其特征是正常的以乳酸杆菌为主的阴道菌群被大量厌氧和兼性厌氧细菌取代。这些变化似乎并不是全有或全无，而是异常的阴道菌群可以被视为连续的变化。微生物变化可以通过使用阴道液革兰氏染色的标准化解释方法来量化。 BV 与包括人类免疫缺陷病毒 (HIV) 在内的性传播疾病 (STD) 之间存在流行病学关联，但原因和影响尚不清楚。一种假设是，如果没有“保护性”乳酸杆菌，阴道菌群异常 (BV) 的女性在接触乳酸菌后患 STD 的风险就会增加。该提案的具体目的是通过对性传播疾病高危女性进行前瞻性研究，确定细菌性阴道病对传播性传播疾病的影响。这些研究代表了我们在该领域正在进行的工作的延续和延伸。我们将对有症状 BV 的女性进行治疗与安慰剂对比的随机对照试验。 这些女性将接受为期一年的连续检查，研究结果是感染性病。此外，我们将利用从这些女性身上获得的信息和标本来调查与异常阴道菌群发病机制相关的问题，包括行为与菌群变化的关系以及与阴道菌群模式和症状相关的免疫因素的描述。三组妇女中的每组。