Increased type 1 inflammation in gynecologic cervicovaginal samples in patients with APS-1 - 05/06/24

Abstract |
Background |
Inborn errors of immunity offer important insights into mucosal immunity. In autoimmune polyendocrine syndrome type-1 (APS-1), chronic mucocutaneous candidiasis has been ascribed to neutralizing IL-17 autoantibodies. Recent evidence implicates excessive T-cell IFN-γ secretion and ensuing epithelial barrier disruption in predisposition to candidiasis, but these results remain to be replicated. Whether IL-17 paucity, increased type I inflammation, or their combination underlies susceptibility to chronic mucocutaneus candidiasis in APS-1 is debated.
Objective |
Our aim was to characterize the immunologic features in the cervicovaginal mucosa of females with APS-1.
Methods |
Vaginal fluid was collected with a flocked swab from 17 females with APS-1 and 18 controls, and cytokine composition was analyzed using Luminex (Luminex Corporation, Austin, Tex). Cervical cell samples were obtained with a cervix brush from 6 patients and 6 healthy controls and subjected to transcriptome analysis.
Results |
The vaginal fluid samples from patients with APS-1 had IFN-γ concentrations comparable to those of the controls (2.6 vs 2.4 pg/mL) but high concentrations of the TH1 chemokines CXCL9 and CXCL10 (1094 vs 110 pg/mL [P < .001] and 4033 vs 273 pg/mL [P = .001], respectively), whereas the IL-17 levels in the samples from the 2 groups were comparable (28 vs 8.8 pg/mL). RNA sequencing of the cervical cells revealed upregulation of pathways related to mucosal inflammation and cell death in the patients with APS-1.
Conclusion |
Excessive TH1 cell response appears to underlie disruption of the mucosal immune responses in the genital tract of patients with APS-1 and may contribute to susceptibility to candidiasis in the genital tract as well.
El texto completo de este artículo está disponible en PDF.Key words : AIRE, APECED, autoantibody, IFN-γ, IL-17, CXCL9, CXCL10, candidiasis, female genital tract, mucosal immunology
Abbreviations used : AIRE, APS-1, fc, POI
Esquema
Vol 153 - N° 6
P. 1736-1742 - juin 2024 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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