Immunology of the genital tract [Elektronische Ressource] : a review / vorgelegt von Monika Wirth

Monika Wirth

Sujets

• Gesundheit

Informations

• Publié par: ludwig-maximilians-universitat_munchen
• Publié le: 01 janvier 2007
• Nombre de lectures: 39
• Langue: Deutsch
• Poids de l'ouvrage: 3 Mo

Extrait

Immunology of the genital tract
A review








Monika Wirth





Aus der Klinik und Poliklinik
für Frauenheilkunde und Geburtshilfe
der Ludwig-Maximilians-Universität München

Direktor: Prof. Dr. med. Friese




Immunology of the genital tract
A review





Dissertation
zum Erwerb des Doktorgrades der Medizin
an der Medizinischen Fakultät der
Ludwig-Maximilians-Universität zu München




vorgelegt von
Monika Wirth
aus
Fürstenfeldbruck
2007


Mit Genehmigung der Medizinischen Fakultät
der Universität München










Berichterstatter: Prof. Dr. Dr. E.R. Weissenbacher


Mitberichterstatter: Prof. Dr. Dr. J. Heesemann
Prof. Dr. P. Bartenstein


Mitbetreuung durch den
promovierten Mitarbeiter: Prof. Dr. H. Spitzbart


Dekan: Prof. Dr. D. Reinhardt


Tag der mündlichen Prüfung: 19.04.2007




Meinen Eltern






















Index
INDEX
I. INTRODUCTION ............................................................................I-1
A. General introduction .......................................................................................... I-1
B. Methods and goals of this study ......................................................................... I-1
II. IMMUNOLOGY OF THE GENITAL TRACT....................................II-4
A. Fundamentals of immunology............................................................................ II-4
1. Concepts of innate and specific immunity.............................................................II-4
a) The innate immune response to infectious agents..............................................II-4
(1) Cellular factors ..........................................................................................II-6
(2) Humoral factors.........................................................................................II-7
b) Specific acquired immunity...............................................................................II-9
(1) The major histocompatibility complex (MHC) ..............................................II-9
(2) B lymphocytes ......................................................................................... II-10
(3) T lymphocytes.......................................................................................... II-11
2. Mucosal immunology ......................................................................................... II-14
a) S-IgA as the major Ig subclass in the mucosal immune system........................ II-16
b) Inductive sites of the mucosal immune system, in the example of the GALT..... II-17
c) Effector sites of the mucosal immune system, in the example of the GALT ....... II-19
d) Cytokine regulation of the gut mucosal immune response ............................... II-20
B. General immunology of the genital tract ......................................................... II-22
1. Distinct features of the genital mucosal tissue .................................................... II-22
2. Functions and regulations of innate immune responses in the human reproductive
tract ......................................................................................................................... II-26
a) Epithelial cells in mucosal immunity............................................................... II-26
(1) The role of epithelial cells as mechanical barrier ....................................... II-27
(2) Stromal cell regulation of epithelial cell function....................................... II-28
(3) Production of antimicrobial molecules ...................................................... II-29
(4) Cytokine and chemokine production ........................................................ II-32
(5) Regulation of Ig secretions into the lumen ................................................ II-35
(6) Antigen presentation................................................................................ II-36
(7) TLRs on epithelial cells ............................................................................ II-37
b) The role of macrophages in the female genital tract ......................................... II-40
(1) Distribution and function......................................................................... II-41
(2) Regulation by sex hormones..................................................................... II-41
I Index
c) Dendritic cells in the female genital tract......................................................... II-43
d) Natural killer cells in the female genital tract................................................... II-44
(1) Distribution and characteristics ............................................................... II-45
(2) Functions and hormonal regulation.......................................................... II-46
(3) NK cell recognition and interactions ......................................................... II-48
(4) TLRs........................................................................................................ II-50
e) Neutrophils in the female genital tract............................................................. II-50
(1) Distribution............................................................................................. II-51
(2) Characteristics and functions .................................................................. II-54
3. Functions and regulations of adaptive humoral and cell-mediated immunity in the
female genital tract ................................................................................................... II-56
a) Immunoglobulins in the female genital tract.................................................... II-56
(1) Distribution of immunoglobulin classes and subtypes .............................. II-56
(2) Production of immunoglobulins in female genital tract tissue.................... II-58
(3) Regulation of Ig levels by sex hormones.................................................... II-61
b) Prevalence of T lymphocytes............................................................................ II-63
4. Immunization studies ........................................................................................ II-65
a) Vaginal immunization..................................................................................... II-66
b) Rectal immunization....................................................................................... II-67
c) Nasal immunization........................................................................................ II-67
d) Systemic immunization................................................................................... II-68
5. Immunology of menstruation – menstruation as an inflammatory process........... II-69
a) Classic concepts of menstruation.................................................................... II-69
b) Distinct features of endometrium during menstruation.................................... II-70
(1) Non-resident cellular components of human endometrium ....................... II-71
(2) Regulation of leukocytes in endometrium ................................................. II-76
(3) Matrix metalloproteinases ........................................................................ II-79
C. Immunology of genital tract infections............................................................ II-85
1. Viral infections of the genital tract...................................................................... II-85
a) Herpes simplex virus ...................................................................................... II-85
(1) Innate immune responses in genital herpes infections .............................. II-87
(2) Specific immune responses in genital herpes infection.............................. II-92
(3) The role of cytokines ................................................................................ II-98
(4) New immunologic therapeutic aproaches.................................................. II-99
(5) Vaccination strategies ............................................................................ II-102
b) Human immunodeficiency virus.................................................................... II-111
(1) HIV transmission and shedding in the genital tract................................. II-112
(2) Innate immune responses in HIV infections............................................ II-117
(3) Specific immune responses in HIV infection............................................ II-118
(4) Cytokine profiles.................................................................................... II-121
II Index
(5) Impact of hormones and menstrual cycle on HIV .................................... II-122
c) Human papillomavirus ..................