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02417 VAGINAL FLUID SLPI IS RELATED TO VAGINAL FLORA AND HORMONAL CONTRACEPTION Hillier, Sharon L* SLPI is a serine protease inhibitor which is found on mucosal secretions including vaginal fluid, semen, breast milk and saliva. SLPI is thought to protect epithelial surfaces from damage due to release of proteases from inflammatory cells. SLPI may also act as a endogenous microbicide. Although the in vitro activity of SLPI against HIV has been inconsistent, recent data suggests that women having elevated vaginal levels of SLPI have decreased mother to child transmission of HIV, and that infants having higher SLPI levels in the saliva have decreased HIV acquisition during breatfeeding. The goal of this study was to assess the effects of vaginal microflora constituents and hormonal contraception on vaginal fluid SLPI levels. A group of 245 reproductive aged women were evaluated for SLPI by ELISA. SLPI levels were not correlated with ethnicity, age, or day in menstrual cycle. However, the median SLPI concentration was decreased among 36 women using Depo Provera for contraception compared to 52 women using oral contraceptives (244 vs 378 ng/ml, p = .03) and 146 women not using hormonal birth control methods (244 vs 305 ng/ml, p = .08). Further, the 98 women having bacterial vaginosis had significantly decreased levels of vaginal fluid levels SLPI compared to women having normal or intermediate flora (256 ng/ml versus 341 ng/ml and 384 ng/ml, respectively, p = 0.01). These data suggests that hormonal contraception and microbial constituents of the vaginal flora may influence vaginal fluid levels of SLPI, which may, in turn, impact susceptibility to sexually transmitted infections including HIV. Sharon L. Hillier, Ph.D. |
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