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 合并感染和宫颈免疫的混合方法研究 微环境 概括 需要获得关于性传播感染（STI）负担的更好的基本流行病学数据 共同感染并在人群中进行转化研究，以扩大有关的知识基础 生殖道粘膜免疫是专家小组确定的几个关键研究空白之一 召开会议是为了查明有效预防和控制性传播感染及其疾病后遗症的障碍。使用 混合设计方法，性传播感染流行病学预防跨学科中心项目 3 (EPIC-STI) 将在以下具体目标中解决这两个研究空白。目标 1 将利用新颖的数据和 生物样本资源，新墨西哥州 HPV 巴氏涂片登记处 (NMHPVPR)，开展一项基于人群的调查 四种常见 STI 的特定年龄患病率 - 沙眼衣原体 (CT)、淋病奈瑟菌 (NG)、 阴道毛滴虫 (TV) 和生殖支原体 (MG)。该项目目标 1 的结果以及 EPIC-STI 项目 4 中得出的人乳头瘤病毒 (HPV) 患病率估计值将合并为 提供对最常见的合并感染的特定年龄患病率的综合评估 不同种族和地域人群中的病毒、细菌和原虫性传播感染 新墨西哥州的衣原体感染率在​​美国排名第八。与项目 4、目标 2 协同 将调查 CT、NG、TV 和 MG 合并感染与高危 (HR)-HPV 之间的关联 发展为高级别宫颈上皮内瘤变（CIN2+）。通过将目标 1 中的 STI 测试与 NMHPVPR，我们将改进之前评估 CT 感染的作用的研究，并随着疾病的发展 通过将个体合并感染与 NMHPVPR 可报告疾病联系起来，了解 CIN2+ 和宫颈癌 结果，提供了一个独特的机会来研究 STI 和 HR-HPV 共同的长期后果 感染。最后，目标 3 中将进行一项前瞻性队列研究来描述免疫学 通过测量一组 CT 感染女性和未感染 CT 女性的对照组的微环境 连续收集的 60 个可溶性免疫标记物（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物样本。通过广泛收集 STI 合作 感染和行为流行病学数据，这一目标还将提供评估差异的机会 (1) CT 阳性、有症状和无症状女性的免疫特征，(2) 抗生素治疗前和治疗后 治疗，(3) 治疗时感染持续存在与已消退的女性，以及 (4) 有或没有感染的女性 1年内再次感染。目标 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，旨在更好地了解 对 CT 感染的免疫反应和有效的疫苗开发。