A Mixed Methods Study of STI Co-Infections and Cervical Immune Microenvironment (

STI 合并感染与宫颈免疫微环境的混合方法研究（

• 批准号: 8769915
• 负责人: PATTI E GRAVITT
• 金额: $ 19.63万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8769915
• 关键词: Address; Affect; Age; Animals; Antibiotic Therapy; Antibodies; Antigen-Antibody Complex; Azithromycin; Behavioral; Biocompatible Materials; Cervical; Cervical Cancer Screening; Cervical Intraepithelial Neoplasia; Cervicitis; Chlamydia Infections; Chlamydia trachomatis; Cohort Studies; Collection; Computerized Medical Record; Control Groups; Cytology; Data; Development; Diagnosis; Disease; Disease Outcome; Ectopic Pregnancy; Epidemiology; Equilibrium; Evaluation; Female; Future; Genital system; Genotype; Growth Factor; HPV-High Risk; Hospitals; Human; Human Papillomavirus; Immune; Immune response; Immunologic Markers; Immunologics; Immunology; Individual; Infection; Infertility; Inflammation; Lesion; Link; Liquid substance; Longitudinal Studies; Low Birth Weight Infant; Malignant neoplasm of cervix uteri; Measures; Methods; Morbidity - disease rate; Mucosal Immune Responses; Mucosal Immunity; Mycoplasma genitalium; Neisseria gonorrhoeae; New Mexico; Outcome; Pathologic; Pathology; Pelvic Inflammatory Disease; Population; Population Heterogeneity; Pregnancy Complications; Premature Birth; Prevalence; Prevention; Preventive Intervention; Protozoa; Random Allocation; Registries; Reproductive Health; Research; Research Design; Research Infrastructure; Residual state; Resources; Risk; Role; Sampling; Sexual Transmission; Sexually Transmitted Diseases; Squamous intraepithelial lesion; Surveys; Testing; Therapeutic Intervention; Time; Tissues; Trichomonas vaginalis; United States; Viral; Vital Statistics; Woman; base; chemokine; cytokine; design; epidemiologic data; high risk; human female; improved; knowledge base; novel; pathogen; population based; programs; prospective; reproductive; screening; translational study; vaccine development

EPIC-STI PROJECT 3 (GRAVITT): A Mixed Methods Study of STI Co-infections and Cervical Immune Microenvironment SUMMARY The need to obtain better basic epidemiologic data on the burden of sexually transmitted infections (STIs) and co-infections and to conduct translational studies in human populations to expand the knowledge base on mucosal immunity in the genital tract were among several critical research gaps identified by expert panels convened to identify barriers to effective prevention and control of STIs and their disease sequelae. Using a mixed design approach, Project 3 of the Epidemiology Prevention Interdisciplinary center for STIs (EPIC-STI) will address these two research gaps in the following specific aims. Aim 1 will utilize a novel data and biospecimen resource, the New Mexico HPV Pap Registry (NMHPVPR), to conduct a population-based survey of age-specific prevalence of four common STIs - Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG). The results from Aim 1 of this project and the human papillomavirus (HPV) prevalence estimates derived in Project 4 of the EPIC-STI will be combined to provide a comprehensive evaluation of the age-specific prevalence of co-infections with the most common viral, bacterial, and protozoal sexually transmitted infections in an ethnic and geographically diverse population in New Mexico, which ranks 8th in Chlamydia infection in the United States. In synergy with Project 4, Aim 2 will investigate the association between CT, NG, TV, and MG co-infections with high risk (HR)-HPV on the development of high grade cervical intraepithelial neoplasia (CIN2+). By linking the STI testing in Aim 1 with the NMHPVPR, we will improve on previous studies evaluating the role of CT infection with the development of CIN2+ and cervical cancer by linking co-infections on an individual basis to the NMHPVPR reportable disease outcomes, enabling a unique opportunity to study the long term consequence of STI and HR-HPV co- infections. Finally, a prospective cohort study will be conducted in Aim 3 to describe the immunological microenvironment in CT-infected women and a control group of CT uninfected women by measuring a panel of 60 soluble immune markers (cytokines, chemokines, growth factors, antibodies) from sequentially collected cervical secretion samples before and after azithromycin treatment. Through extensive collection of STI co- infection and behavioral epidemiologic data, this aim will also provide the opportunity to evaluate differences in immune profiles in (1) CT positive symptomatic and asymptomatic women, (2) before and after antibiotic treatment, (3) women with persistent vs. resolved infection at treatment, and (4) women with and without reinfection within 1 year. Aim 3 will provide critical data and biological material to Projects 1 and 2 of the EPIC- STI, creating a necessary bridge between animal and human studies targeting a better understanding of the immune response to CT infection and effective vaccine development.

Epic-Sti项目3（Gravitt）：STI共感染和宫颈免疫的混合方法研究 微环境 概括 需要获得有关性传播感染负担（ETI）和 共同感染并在人群中进行转化研究，以扩大知识基础 生殖道中的粘膜免疫属于专家小组确定的几个关键研究差距 召集以确定有效预防和控制性传播疾病及其疾病后遗症的障碍。使用 混合设计方法，预防流行病学预防跨学科中心（EPIC-STI）项目3 将在以下具体目标中解决这两个研究差距。 AIM 1将利用一个新颖的数据， 新墨西哥州HPV PAP注册中心（NMHPVPR）生物传播资源进行基于人群的调查 四个常见性传播性 - 沙眼衣原体（CT）的年龄特异性患病率，淋病奈瑟氏菌（NG）， 阴道（TV）和支原体生殖器（MG）。该项目的AIM 1的结果以及 EPIC-Sti项目4中得出的人类乳头瘤病毒（HPV）患病率估计值将合并为 提供对最常见的共同感染的特定年龄特异性的全面评估 病毒，细菌和原生动物在种族和地理种群中的性传播感染 在新墨西哥州，在美国的衣原体感染中排名第八。与项目4协同作用，目标2 将研究CT，NG，TV和MG共同感染与高风险（HR）-HPV之间的关联 高级宫颈上皮内肿瘤（CIN2+）的发展。通过将AIM 1中的STI测试与 NMHPVPR，我们将改进先前的研究，以评估CT感染的作用 CIN2+和宫颈癌通过单独将共同感染与NMHPVPR疾病联系起来。 成果，为研究STI和HR-HPV共同的长期后果提供了独特的机会 感染。最后，将在AIM 3中进行一项前瞻性队列研究，以描述免疫学 通过测量一个小组 从顺序收集的60种可溶性免疫标记（细胞因子，趋化因子，生长因子，抗体） 阿奇霉素治疗前后的宫颈分泌样品。通过大量的STI共同收集 感染和行为流行病学数据，此目标还将提供评估差异的机会 （1）CT阳性症状和无症状女性的免疫特征，（2）抗生素前后 治疗，（3）治疗时持续性与解决感染的妇女，以及（4）有和没有的妇女 在1年内重新感染。 AIM 3将为Epic-的项目1和2提供关键数据和生物材料 STI，在动物和人类研究之间建立必要的桥梁，以更好地了解 对CT感染和有效疫苗发育的免疫反应。