Changes in Inflammatory Cytokine Levels in Rectal Mucosa Associated with Neisseria Gonorrheae and/or Chlamydia trachomatis Infection and Treatment Among Men Who Have Sex with Men in Lima, Peru
J L Clark, C E Oldenburg, R C Passaro, E R Segura, W Godwin, J A Fulcher, R Cabello- Infectious Diseases
- Immunology and Allergy
Abstract
Background
Neisseria gonorrheae (NG) and Chlamydia trachomatis (CT) are associated with mucosal inflammation and HIV-1 transmission. We assessed levels of inflammatory cytokines in men who have sex with men (MSM) with and without rectal gonorrhea and/or chlamydia in Lima, Peru.
Methods
We screened 605 MSM reporting condomless receptive anal intercourse for rectal NG/CT using nucleic acid testing. We identified 101 cases of NG and/or CT and randomly selected 50 NG/CT (+) cases and matched 52 NG/CT (-) controls. We measured levels of IL-1β, IL-6, IL-8, and TNF-α in rectal secretions. Testing for HIV-1, rectal NG/CT, and mucosal cytokines were repeated after 3 and 6 months. Cytokine levels in cases and uninfected controls were compared using Wilcoxon Rank-Sum tests and linear regression.
Results
MSM with NG/CT had elevated levels of all cytokines in rectal mucosa compared with matched controls (all p-values <0.001). Following antibiotic treatment there were no significant differences in cytokine levels at 3- or 6-month Follow-up evaluations between case and control groups (all p-values >0.05).
Discussion
Rectal NG/CT infection is associated with transient mucosal inflammation and cytokine recruitment that resolves following treatment. Our data provides “proof of concept” for rectal STI screening as an HIV prevention strategy for MSM.