Biocompatibility of solid-dosage forms of anti-human immunodeficiency virus type 1 microbicides with the human cervicovaginal mucosa modeled ex vivo

Antimicrob Agents Chemother. 2006 Dec;50(12):4005-10. doi: 10.1128/AAC.00588-06. Epub 2006 Oct 9.

Abstract

Topical anti-human immunodeficiency virus (HIV) microbicides are being sought to reduce the spread of HIV type 1 (HIV-1) during sexual intercourse. The success of this strategy depends upon the selection of formulations compatible with the natural vaginal mucosal barrier. This study applied ex vivo-modeled human cervicovaginal epithelium to evaluate experimental solid-dosage forms of the anti-HIV-1 microbicide cellulose acetate 1,2-benzenedicarboxylate (CAP) and over-the-counter (OTC) vaginal products for their impact on inflammatory mediators regarded as potential HIV-1-enhancing risk factors. We assessed product-induced imbalances between interleukin-1alpha (IL-1alpha) and IL-1beta and the natural IL-1 receptor antagonist (IL-1RA) and changes in levels of IL-6, tumor necrosis factor alpha, IL-8, gamma interferon inducible protein 10 (IP-10), and macrophage inflammatory protein 3alpha (MIP-3alpha), known to recruit and activate monocytes, dendritic cells, and T cells to the inflamed mucosa. CAP film and gel formulation, similarly to the hydroxyethylcellulose universal vaginal placebo gel and the OTC K-Y moisturizing gel, were nontoxic and caused no significant changes in any inflammatory biomarker. In contrast, OTC vaginal cleansing and contraceptive films containing octoxynol-9 or nonoxynol-9 (N-9) demonstrated similar levels of toxicity but distinct immunoinflammatory profiles. IL-1alpha, IL-1beta, IL-8, and IP-10 were increased after treatment with both OTC vaginal cleansing and contraceptive films; however, MIP-3alpha was significantly elevated by the N-9-based film only (P < 0.01). Although both films increased extracellular IL-1RA, the cleansing film only significantly elevated the IL-1RA/IL-1 ratio (P < 0.001). The N-9-based film decreased intracellular IL-1RA (P < 0.05), which has anti-inflammatory intracrine functions. This study identifies immunoinflammatory biomarkers that can discriminate between formulations better than toxicity assays and should be clinically validated in relevance to the risk of HIV-1 acquisition.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Intravaginal
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / pharmacology*
  • Biocompatible Materials / adverse effects
  • Biocompatible Materials / pharmacology*
  • Cell Line
  • Cell Survival / drug effects
  • Cervix Uteri / cytology
  • Cervix Uteri / drug effects*
  • Cervix Uteri / immunology
  • Cytokines / analysis
  • Cytokines / metabolism
  • Epithelial Cells / drug effects
  • Epithelial Cells / immunology
  • Epithelial Cells / virology
  • Female
  • HIV-1 / drug effects*
  • Humans
  • Models, Biological
  • Mucous Membrane / cytology
  • Mucous Membrane / drug effects
  • Mucous Membrane / immunology
  • Time Factors
  • Vagina / cytology
  • Vagina / drug effects*
  • Vagina / immunology
  • Vaginal Creams, Foams, and Jellies / administration & dosage
  • Vaginal Creams, Foams, and Jellies / adverse effects
  • Vaginal Creams, Foams, and Jellies / pharmacology*

Substances

  • Anti-Infective Agents
  • Biocompatible Materials
  • Cytokines
  • Vaginal Creams, Foams, and Jellies