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Jeanne M Marrazzo - One of the best experts on this subject based on the ideXlab platform.
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management of women with Cervicitis
Clinical Infectious Diseases, 2007Co-Authors: Jeanne M Marrazzo, David H MartinAbstract:In the past several years, the collective understanding of Cervicitis has extended beyond the recognition of Chlamydia trachomatis and Neisseria gonorrhoeae as the prime etiologic suspects. Trichomonas vaginalis and herpes simplex virus cause Cervicitis, and both Mycoplasma genitalium and bacterial vaginosis have emerged as new candidate etiologic agents or conditions. However, major gaps in our knowledge of this common condition remain. Putative etiologic agents have not been identified in many women with Cervicitis. Moreover, Cervicitis occurs in a relatively small proportion of women with chlamydia or gonorrhea. Finally, scant research has addressed the clinical response of nonchlamydial and nongonococcal Cervicitis to antibiotic therapy, and there are no data on the benefit of sex partner treatment for such women. New research into the etiology, immunology, and natural history of this common condition is needed, especially in view of the well-established links between Cervicitis and an increased risk of upper genital tract infection and human immunodeficiency virus type 1 acquisition.
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risk factors for Cervicitis among women with bacterial vaginosis
The Journal of Infectious Diseases, 2006Co-Authors: Jeanne M Marrazzo, Harold C. Wiesenfeld, Pamela J Murray, Barbara Busse, Leslie A Meyn, Marijane A Krohn, Sharon L. HillierAbstract:Background. Cervicitis commonly occurs in women with bacterial vaginosis (BV), often without concomitant chlamydial or gonococcal infection. The risk factors for Cervicitis have not been described. Methods. We characterized the risk factors for Cervicitis, which is defined as endocervical mucopurulent discharge or easily induced bleeding, among women with BV who were 14-45 years of age. Associations between Cervicitis and the characteristics of the subjects, including the presence of specific vaginal bacteria and chlamydial or gonococcal infection detected by strand displacement assay, were analyzed. Results. Of 424 women with BV, 63 (15%) had Cervicitis. Of these 63 women, only 8 (13%) had chlamydia or gonorrhea. The risk factors for Cervicitis, adjusted for variables, included older age (P<.001, for trend), ≤12 years of education (odds ratio [OR], 2.4 [95% confidence interval {CI}, 1.3-4.6]; P =.006), new male sex partner (OR, 2.7 [95% CI, 1.4-5.4]; P =.004), female sex partner (OR, 6.2 [95% CI, 1.3-28.3]; P =.02), recent oral sex (OR, 2.3 [95% CI, 1.2-4.2]; P =.008), and absence of vaginal H 2 O 2 -producing Lactobacillus species (OR, 2.7; 95% CI, 3.3-5.9; P =.01). No association with Cervicitis was seen for current douching or smoking, race, time since or frequency of intercourse, or presence or quantity of vaginal bacteria other than H 2 O 2 -producing Lactobacillus species. Conclusions. Cervicitis is common among women with BV and is associated with some risk factors that are distinct from those associated with endocervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. Absence of H 2 O 2 -producing lactobacilli may contribute to the development of Cervicitis.
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mucopurulent Cervicitis no longer ignored but still misunderstood
Infectious Disease Clinics of North America, 2005Co-Authors: Jeanne M MarrazzoAbstract:The last decade has produced considerable advances in the diagnosis of the common etiologies of mucopurulent Cervicitis (MPC), including Chlamydia trachomatis and Neisseria gonorrhoeae, and in the delineation of key aspects of their pathogenesis. Despite this, clear understanding of why these bacteria cause cervical inflammation in a minority of women who is infected with either organism is limited. Furthermore, many women who have MPC have neither of these infections detected, even when highly sensitive diagnostic tests are used. This article describes current data regarding this common condition, and charts new developments that might inform a more comprehensive understanding of MPC and its management, and of the more subtle signs of cervical inflammation that may impact women's susceptibility to a variety of infectious diseases, including HIV-1.
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predicting chlamydial and gonococcal cervical infection implications for management of Cervicitis
Obstetrics & Gynecology, 2002Co-Authors: Jeanne M Marrazzo, Hunter H Handsfield, William L H WhittingtonAbstract:Abstract OBJECTIVE: To define utility of age and cervical findings in predicting infection with Chlamydia trachomatis and Neisseria gonorrhoeae among women universally tested for both infections, and to assess the independent contribution of Gram stain (GS) smear of endocervical secretions. METHODS: Visits by women to Seattle sexually transmitted diseases clinics from 1995 through 1999 were retrospectively reviewed. All women had endocervical GS and cultures for C trachomatis and N gonorrhoeae performed. Predictive values of age, cervical signs, and inflammation on GS (more than 30 polymorphonuclear leukocytes per 1000× field) were calculated. RESULTS: Among 6230 women, prevalence of C trachomatis and N gonorrhoeae was 6.9% and 2.1%, respectively; 520 women (8.3%) had either organism detected. Age, cervical signs (mucopus, induced bleeding), and inflammation on endocervical GS were independently associated with infection. However, the positive predictive value (PPV) of any cervical finding for infection was less than 19% in women 25 years and older. Inflammation on endocervical GS was the sole indicator of infection in 79 of 520 (15%) infections, but was insensitive in the absence of mucopurulent Cervicitis (sensitivity, 26%; PPV, 21%). CONCLUSION: Cervical signs suggesting chlamydial or gonococcal infection have higher positive predictive value (PPV) in younger women. The PPV of inflammation on endocervical GS is too low to recommend its use to direct empiric treatment in the absence of mucopurulent Cervicitis, especially in women 25 years and older. Further, its low sensitivity in detecting infection in women without mucopurulent Cervicitis does not justify routine use. Signs suggesting mucopurulent Cervicitis should be interpreted in the context of age, and empiric treatment may not be indicated in women aged 25 years and older.
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performance and cost effectiveness of selective screening criteria for chlamydia trachomatis infection in women implications for a national chlamydia control strategy
Sexually Transmitted Diseases, 1997Co-Authors: Jeanne M Marrazzo, Connie Celum, Susan D Hillis, David Fine, Susan Delisle, Hunter H HandsfieldAbstract:Background and Objectives:Detection of subclinicalChlamydia trachomatisinfection in women is a high but costly public health priority.Goals:To develop and test simple selective screening criteria for chlamydia in women, to assess the contribution of Cervicitis to screening criteria, and to evaluate
Thomas C Quinn - One of the best experts on this subject based on the ideXlab platform.
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mycoplasma genitalium as a contributor to the multiple etiologies of Cervicitis in women attending sexually transmitted disease clinics
Sexually Transmitted Diseases, 2009Co-Authors: Charlotte A Gaydos, Nancy E Maldeis, Andrew Hardick, Justin Hardick, Thomas C QuinnAbstract:Objectives The purpose of this study was to investigate the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium, in women attending a sexually transmitted disease (STD) clinic, as well as the frequency of coinfections, and relationship of each organism to Cervicitis.
Yulin Feng - One of the best experts on this subject based on the ideXlab platform.
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an integrative investigation of the therapeutic mechanism of ainsliaea fragrans champ in Cervicitis using liquid chromatography tandem mass spectrometry based on a rat plasma metabolomics strategy
Journal of Pharmaceutical and Biomedical Analysis, 2018Co-Authors: Xiaoyong Zhang, Shuangxia Lei, Hui Ouyang, Ting Tan, Yulin FengAbstract:Cervicitis is an extremely common gynecological disease and can be induced by diverse factors such as Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium infections. Long-term unhealed Cervicitis may lead to a series of diseases including endometritis, salpingitis, pelvic inflammatory disease, and chorioamnionitis. However, the pathogenesis of Cervicitis remains unknown. Ainsliaea fragrans Champ. (AFC) has been widely used in clinical treatment of Cervicitis. In the present study, we performed an integrative investigation involving histopathology analysis and non-target plasma metabolomics analysis in a Cervicitis rat model induced by phenol mucilage, using ultra-performance liquid chromatography coupled with a tandem quadrupole time-of-flight mass spectrometry approach. Based on the integrative investigation, marked metabolomic differences were identified between the Cervicitis and control groups using multivariate analysis. As a result, 32 potential biomarkers were identified in the response to Cervicitis, and were involved in arachidonic acid metabolism, linoleic acid metabolism, primary bile acid biosynthesis, taurine and hypotaurine metabolism, pantothenate and CoA biosynthesis, and glycerophospholipid metabolism. After treatment, a total of 27 potential biomarkers exhibited altered levels in the AFC group compared to the model group, and 12 metabolites including 1-stearoylglycerophosphoinositol, bolasterone, lysoPC(16:0), lysoPC(20:4), lysoPC(P-16:0), lysoPC(P-18:0), lysoPC(P-18:1), stearoylcarnitine, taurine, lysoPC(17:0), 20-hydroxyeicosatetraenoic acid, and 1-arachidonoylglycerophosphoinositol returned to their normal levels. This study suggested that the therapeutic mechanism of AFC is related to those altered endogenous metabolites.
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comparative metabolomics analysis of Cervicitis in human patients and a phenol mucilage induced rat model using liquid chromatography tandem mass spectrometry
Frontiers in Pharmacology, 2018Co-Authors: Xiaoyong Zhang, Bin Xie, Shuangxia Lei, Yun Yao, Hui Ouyang, Yulin Feng, Shilin YangAbstract:Cervicitis is an exceedingly common gynecological disorder that puts women at high risk of sexually transmitted infections and induces a series of reproductive system diseases. This condition also has a significant impact on quality of life and is commonly misdiagnosed in clinical practice due to its complicated pathogenesis. In the present study, we performed non-targeted plasma metabolomics analysis of Cervicitis in both plasma samples obtained from human patients and plasma samples from a phenol mucilage induced rat model of Cervicitis, using ultra-performance liquid chromatography coupled to quadrupole time-of-flight tandem mass spectrometry. In addition to differences in histopathology, we identified differences in the metabolic profile between the Cervicitis and control groups using unsupervised principal component analysis and orthogonal projections to latent structures discriminant analysis. These results demonstrated changes in plasma metabolites, with 27 and 22 potential endogenous markers identified in rat and human samples, respectively. The metabolic pathway analysis showed that linoleic acid, arachidonic acid, ether lipid, and glycerophospholipid metabolism are key metabolic pathways involved in Cervicitis. This study showed the rat model was successfully created and applied to understand the pathogenesis of Cervicitis.
Xiaoyong Zhang - One of the best experts on this subject based on the ideXlab platform.
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an integrative investigation of the therapeutic mechanism of ainsliaea fragrans champ in Cervicitis using liquid chromatography tandem mass spectrometry based on a rat plasma metabolomics strategy
Journal of Pharmaceutical and Biomedical Analysis, 2018Co-Authors: Xiaoyong Zhang, Shuangxia Lei, Hui Ouyang, Ting Tan, Yulin FengAbstract:Cervicitis is an extremely common gynecological disease and can be induced by diverse factors such as Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium infections. Long-term unhealed Cervicitis may lead to a series of diseases including endometritis, salpingitis, pelvic inflammatory disease, and chorioamnionitis. However, the pathogenesis of Cervicitis remains unknown. Ainsliaea fragrans Champ. (AFC) has been widely used in clinical treatment of Cervicitis. In the present study, we performed an integrative investigation involving histopathology analysis and non-target plasma metabolomics analysis in a Cervicitis rat model induced by phenol mucilage, using ultra-performance liquid chromatography coupled with a tandem quadrupole time-of-flight mass spectrometry approach. Based on the integrative investigation, marked metabolomic differences were identified between the Cervicitis and control groups using multivariate analysis. As a result, 32 potential biomarkers were identified in the response to Cervicitis, and were involved in arachidonic acid metabolism, linoleic acid metabolism, primary bile acid biosynthesis, taurine and hypotaurine metabolism, pantothenate and CoA biosynthesis, and glycerophospholipid metabolism. After treatment, a total of 27 potential biomarkers exhibited altered levels in the AFC group compared to the model group, and 12 metabolites including 1-stearoylglycerophosphoinositol, bolasterone, lysoPC(16:0), lysoPC(20:4), lysoPC(P-16:0), lysoPC(P-18:0), lysoPC(P-18:1), stearoylcarnitine, taurine, lysoPC(17:0), 20-hydroxyeicosatetraenoic acid, and 1-arachidonoylglycerophosphoinositol returned to their normal levels. This study suggested that the therapeutic mechanism of AFC is related to those altered endogenous metabolites.
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comparative metabolomics analysis of Cervicitis in human patients and a phenol mucilage induced rat model using liquid chromatography tandem mass spectrometry
Frontiers in Pharmacology, 2018Co-Authors: Xiaoyong Zhang, Bin Xie, Shuangxia Lei, Yun Yao, Hui Ouyang, Yulin Feng, Shilin YangAbstract:Cervicitis is an exceedingly common gynecological disorder that puts women at high risk of sexually transmitted infections and induces a series of reproductive system diseases. This condition also has a significant impact on quality of life and is commonly misdiagnosed in clinical practice due to its complicated pathogenesis. In the present study, we performed non-targeted plasma metabolomics analysis of Cervicitis in both plasma samples obtained from human patients and plasma samples from a phenol mucilage induced rat model of Cervicitis, using ultra-performance liquid chromatography coupled to quadrupole time-of-flight tandem mass spectrometry. In addition to differences in histopathology, we identified differences in the metabolic profile between the Cervicitis and control groups using unsupervised principal component analysis and orthogonal projections to latent structures discriminant analysis. These results demonstrated changes in plasma metabolites, with 27 and 22 potential endogenous markers identified in rat and human samples, respectively. The metabolic pathway analysis showed that linoleic acid, arachidonic acid, ether lipid, and glycerophospholipid metabolism are key metabolic pathways involved in Cervicitis. This study showed the rat model was successfully created and applied to understand the pathogenesis of Cervicitis.
Rupert Kaul - One of the best experts on this subject based on the ideXlab platform.
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gonococcal Cervicitis is associated with reduced systemic cd8 t cell responses in human immunodeficiency virus type 1 infected and exposed uninfected sex workers
The Journal of Infectious Diseases, 2002Co-Authors: Rupert Kaul, Sarah Rowlandjones, Geraldine M Gillespie, Joshua Kimani, Tao Dong, Peter Kiama, J N Simonsen, Job J Bwayo, Andrew J McmichaelAbstract:Neisseria gonorrhoeae Cervicitis and human immunodeficiency virus (HIV) type 1 frequently coinfect core transmitter populations, such as female sex workers. Gonococcal Cervicitis is associated with increased viral shedding and plasma viremia in HIV-1-infected women and increased HIV-1 susceptibility in uninfected women. We studied the influence of gonococcal Cervicitis on CD8(+) interferon (IFN)-gamma responses to HIV-1 and cytomegalovirus (CMV) epitopes in HIV-1-infected and in highly-exposed, persistently seronegative (HEPS) female sex workers. In HIV-1-infected women, gonococcal Cervicitis was associated with reduced IFN-gamma responses in bulk CD8(+) lymphocyte populations, and intracellular cytokine staining, combined with class I major histocompatibility complex (MHC)-peptide tetramer studies, demonstrated reduced IFN-gamma production by HIV-1 epitope-specific CD8(+) lymphocytes. In HEPS sex workers, Cervicitis was associated with the transient loss of systemic HIV-1-specific CD8(+) responses and with reduced function of CMV-specific CD8(+) lymphocytes. Impaired function of virus-specific CD8(+) lymphocytes may partly explain the deleterious effects of gonococcal Cervicitis on HIV-1 immune control and susceptibility.