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, manuscript GDC 941 in preparation). We and Berlier et al.72 have demonstrated that SP also induces the expression of CCL20, a key chemotactic factor involved in recruitment and maturation of Langerhans cells and dendritic cells, which, together with intraepithelial T lymphocytes, are considered to be the first target cells for HIV genital mucosal infection.73–75 A common gene overexpressed in pathological conditions involving mucosal inflammation is cyclooxygenase (COX)-2. Semen exposure leads to overexpression of COX-2

in pig and mare endometrium.76,77 COX-2 catalyzes the rate-limiting step in the synthesis of prostaglandins from arachidonic acid.78 Prostaglandins are considered to be important biological modulators of inflammation. They attract immune cells to the area of inflammation. They also act in an autocrine/paracrine manner to elevate COX-2 expression.79,80 Seminal plasma contains 1000-fold higher concentration of prostaglandins, mainly PGE2, compared to normal endometrium.81 Seminal plasma PGE2 has been reported to induce

COX-2 in immortalized human endocervical cells.82 This induction is because Rapamycin mw of the intracellular activation of cAMP pathway via PGE2 receptor subtypes, EP2 and EP4. Our laboratory has demonstrated that SP also induces COX-2 in human vaginal cells (Joseph et al., manuscript in preparation). Furthermore, it potentiates COX-2 induction by microbial products such as bacterial lipopeptides (Fig. 1). This enhanced expression of COX-2 could be one of the main causes of inflammation associated with STIs and CV infections. In addition, SP has been shown

to activate multiple signal transduction pathways, which are involved in inflammatory responses. In cervical cells, SP induces the phosphorylation of extracellular signal-regulated kinase (ERK1/2) via EP4 receptor.83 In endometrial cells, SP induces the phosphorylation of c-Src, ERK, and activation of cAMP pathway via EP2 receptor.84 SP has also been shown to activate NF-kB signaling pathway in vaginal cells. This pathway is considered central to inflammation and is involved in the control of numerous proinflammatory genes including COX-2 and multiple chemokines and Docetaxel cytokines. NF-kB activation has also been linked to the enhancement of HIV replication.11 The role of semen in HIV-1 transmission is defined by a complex array of factors and processes involved in semen, virus, and female genital tract interactions. Semen carries CF and CA virus and is believed to be the main vector for HIV-1 in male-to-female sexual transmission. Seminal viral load varies with multiple factors such as stage of infection and disease in the male, presence of reproductive tract inflammation, and whether or not the man is on antiretroviral therapy. However, semen is more than a carrier for HIV.

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