Human Vaginal Epithelial Immunity

................................................................................4 ABBREVIATIONS......................................................................7 ORIGINAL PAPERS..................................................................8 INTRODUCTION ........................................................................9 THE HUMAN VAGINA ................................................................................ 9 THE FEMALE REPRODUCTIVE SYSTEM.................................................. 10 THE VAGINAL EPITHELIUM................................................................... 11 THE MENSTRUAL CYCLE AND STEROID HORMONES ............................. 14 STEROID RECEPTORS............................................................................. 16 HORMONAL CONTRACEPTIVES.............................................................. 18 IMMUNOLOGY .......................................................................................... 20 INNATE IMMUNITY ................................................................................ 20 ADAPTIVE IMMUNITY............................................................................ 24 MUCOSAL IMMUNOLOGY ...................................................................... 26 IMMUNITY AND SEX STEROID HORMONES ............................................ 28 STD–HIV ............................................................................................. 29 AIMS OF THE STUDY ............................................................32 SUBJECTS AND METHODS ................................................33 SUBJECTS (PAPERS I–III) ......................................................................... 33 SUBJECTS (PAPER IV) ............................................................................. 35 ETHICAL CONSIDERATIONS................................................................... 35 TISSUE SAMPLING AND PREPARATION (PAPERS I–III) ........................... 36 IMMUNOHISTOCHEMISTRY...................................................................... 36 STAINING FOR IMMUNE CELL TYPES ..................................................... 36 STAINING FOR T CELL RECEPTOR TYPES............................................... 37 STAINING FOR STEROID RECEPTORS ..................................................... 38 MORPHOMETRY....................................................................................... 38 EPITHELIAL THICKNESS AND MORPHOLOGY......................................... 39 INTRAEPITHELIAL IMMUNE CELL TYPES AND TCR UTILIZATION ........... 39 STEROID RECEPTORS............................................................................. 40 BLOOD SAMPLING AND HORMONAL ANALYSES..................................... 42 ANALYSIS OF DEFENSIN GENE EXPRESSION AT THE mRNA LEVEL (PAPER IV)............................................................................................... 42 TISSUE SAMPLING AND PROCESSING..................................................... 42 CELL ISOLATION ................................................................................... 42 mRNA EXTRACTION AND REAL-TIME qRT-PCR................................. 43 CLONING AND SEQUENCING.................................................................. 43 IN SITU HYBRIDIZATION ........................................................................ 44