Journal List > Hanyang Med Rev > v.30(3) > 1044052

Ryu: Trichomoniasis

Abstract

Vaginal trichomoniasis, caused by Trichomonas vaginalis, is the most common sexually transmitted disease. However, despite its high prevalence, the pathogenesis of T. vaginalis infection has not been clearly characterized although neutrophil infiltration is considered to be primarily responsible for the cytologic changes associated with this infection. We investigated that trichomonads in the vagina sometime after an acute infection secrete proteins like excretory-secretory product that have a chemotactic effect on neutrophils, and that these neutrophils are further stimulated by T. vaginalis to produce chemokines like IL-8 and GRO-α, which further promote neutrophil recruitment and chemotaxis. Thus, neutrophil accumulation is believed to maintain or aggravate inflammation. However, enhanced neutrophil apoptosis induced by live T. vaginalis could contribute to resolution of inflammation via anti-inflammatory cytokine produced by human macrophage phagocytosed of apoptotic neutrophils. Macrophages may constitute an important component of host defense against T. vaginalis infection, and may be involved in inflammation via production of proinflammatory cytokines and nitric oxide. In the host, T. vaginalis uses a capping phenomenon and cleave host immunoglobulins with proteinases as the evasion methods from host immune responses. Recently, we developed a highly sensitive and specific diagnostic polymerase chain reaction (PCR) technique, and found that the method enables the detection of T. vaginalis at concentrations as low as 1 cell per PCR mixture.

References

1. Soper D. Trichomoniasis: Under control or undercontrolled? Am J Obstet Gynecol. 2004. 190:281–290.
crossref
2. McClelland RS. Trichomonas vaginalis infection: can we afford to do nothing? J Infect Dis. 2008. 197:487–489.
crossref
3. Johnston VJ, Mabey DC. Global epidemiology and control of Trichomonas vaginalis. Curr Opin Infect Dis. 2008. 21:56–64.
4. Ryu JS, Chung HL, Min DY, Cho YH, Ro YS, Kim SR. Diagnosis of trichomoniasis by polymerase chain reaction. Yonsei Med J. 1999. 40:56–60.
crossref
5. Minkoff H, Grune baum AN, Schwarz RH, Feldman J, Cummings MC, Clark WL, Pringle G, McCormack WM. Risk factors for prematurity and premature rupture of membranes: a prospective study of the vaginal flora in pregnancy. Am J Obstet Gynecol. 1984. 150:965–972.
crossref
6. Soper DE, Bump RC, Hurt WG. Bacterial vaginosis and trichomonas vaginitis are risk factors for cuff cellulitis after abdominal hysterectomy. Am J Obstet Gynecol. 1990. 163:1016–1023.
7. Laga M, Manoka A, Kivuvu M, Malele B, Tuliza M, Nzila N, Goeman JB, Batter FV, Alary M, Heyward WL, Ryder RW, Piot P. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS. 1993. 7:95–102.
crossref
8. Ryu JS, Min DY. Trichomonas vaginalis and trichomoniasis in the Republic of Korea. Korean J Parasitol. 2006. 44:101–116.
crossref
9. Müller M. Gooday G, Trinci AP, Lloyd D, editors. The hydrogenosome. The Eukaryotic Cell. Symposia of the Society for General Microbiology. 1980. UK: Cambridge University Press;127–142.
10. Donné MA. Animacules observes dans les matieres purulentes et le produit des secretions des organs genitaux de I'home et de la femme. C R Acad Sci. 1836. 3:385–386.
11. Trussell RE, Plass ED. The pathogenicity and physiology of a pure culture of Trichomonas vaginalis. Am J Obstet Gynecol. 1940. 40:883–890.
crossref
12. Na KY. Incidence of Trichomonas vaginalis among Korean women. 1947 Annual Meeting of Korean Society of Obstetrics and Gynecology held in Seoul.
13. Shin HS, Kim YC. Clinical observations on trichomonad vaginitis among Korean women. J Korean Med Assoc. 1957. 2:282–283.
14. Soh CT, Lee KT, Shin EW, Kang TC. Incidence of parasites in Seoul area based on an examination of the severance hospital out-patients. Yonsei Med J. 1961. 2:31–41.
crossref
15. Kim YC. Incidence of Trichomonas vaginalis and Candida in vagina of women, using saline-glucose diagnostic medium. Korean J Obstet Gynecol. 1962. 5:203–208.
16. Chae FJ. Investigation of Trichomonas vaginalis. Korean J Obstet Gynecol. 1965. 8:153–155.
17. Chung PR, Lee BH, Lee JH, Chun HB, Kim YH. Prevalence of Trichomonas vaginalis and Candida albicans in vagina of the prostitutes at Yosu and Kunsan, Korea. J Rural Health. 1969. 3:283–287.
18. Chang SS, Choi DW. Demonstration of Trichomonas vaginalis in Taegu, Korea. Kyungpook Univ Med J. 1976. 17:76–81.
19. Ro HT. Clinical manifestation of trichomoniasis and candidiasis. Chungnam Med J. 1977. 4:217–225.
20. Lee HD. Vaginal infections of Trichomonas and fungus. Chungnam Med J. 1977. 4:158–162.
21. Kang MS, Lee YH, Na YE, Shin DW. Studies on Trichomonas vaginalis infection in out-patients and prostitutes at Daejeon Area. Chungnam Med J. 1989. 16:50–55.
22. Choi KS, Kwon JY, Uh Y, Koo JS, Cha DS, Kim MC. Prevalence of vaginal Trichomonas vaginalis in Kangwon Area. Korean J Obstet Gynecol. 1996. 39:1273–1278.
23. Beaver PC, Jung RC, Cupp EW. Trichomonas vaginalis. Clinical Parasitology. 1985. 9th ed. Philadelphia, USA: Lea & Febiger;49–51.
24. Chu JK, Chang MC, Chung SB, Cho MJ. Urinary tract infection with Trichomonas vaginalis in men. Korean Centr J Med. 1974. 26:325–330.
25. Chu JP, Ki NS, Lee JH. A study of Trichomonas vaginalis infection rate by urinalysis. Chonbuk Univ Med J. 1990. 14:39–43.
26. Joo CY, Choi DW. Prevalence of Trichomonas vaginalis in Korean military personnel. Korean J Parasitol. 1980. 18:247–252.
crossref
27. Kim SG. Observation on trichomoniasis in the lower urinary tract in the male. Korean J Urol. 1977. 18:41–46.
28. Lee HY, Joo KW. Trichomonas vaginalis as cause of nongonococcal urethritis. Korean Centr J Med. 1961. 1:575–582.
29. Krieger JN. Urologic aspects of trichomoniasis. Invest Urol. 1981. 18:411–417.
30. Jeong EC, Kim JH, Ro YS, Lee CW. Urine culture and serologic test for diagnosis of trichomoniasis in male patients with nongonococcal urethritis. Korean J Dermatol. 1993. 31:47–57.
31. Ryu JS, Lee MH, Park H, Kang JH, Min DY. Survival of Trichomonas vaginalis exposed on various environmental conditions. Korean J Infect Dis. 2002. 34:373–379.
32. Markell EK, John DT, Krotoski WA. Trichomonas vaginalis. Markell and Voge's Medical Parasitology. 1999. 8th ed. Philadelphia, USA: WB Saunders Company;64–68.
33. Conrad ME, Umbreit JN, Moore EG. Iron absorption and transport. Am J Med Sci. 1999. 318:213–229.
crossref
34. Ryu JS, Choi HK, Min DY, Ha SE, Ahn MH. Effect of iron on the virulence of Trichomonas vaginalis. J Parasitol. 2001. 87:457–460.
35. Peterson KM, Alderete JF. Iron uptake and increased intracellular enzyme activity follow lactoferrin binding by Trichomonas vaginalis receptors. J Exp Med. 1984. 160:1261–1271.
36. Lehker MW, Arroyo R, Alderete JF. Specific erythrocyte binding is an additional nutrient acquisition system for Trichomonas vaginalis. J Exp Med. 1990. 171:2165–2170.
crossref
37. Cohen MS, Britigan BE, French M, Bean K. Preliminary observation on lactoferrin secretion in human vaginal mucus: Variation during the menstrual cycle, evidence of hormonal regulation, and implications for infection with Neisseria gonorrhoeae. Am J Obstet Gynecol. 1987. 157:1122–1125.
crossref
38. Alderete JF, Pearlman E. Pathogenic Trichomonas vaginalis cytotoxicity to cell culture monolayers. Br J Vener Dis. 1984. 60:99–105.
crossref
39. Alderete JF, Garza GE. Specific nature of Trichomonas vaginalis parasitism of host cell surfaces. Infect Immun. 1985. 50:701–708.
crossref
40. Alderete JF, Lehker MW, Arroyo R. The mechanisms and molecules involved in cytoadherence and pathogenesis of Trichomonas vaginalis. Parasitol Today. 1995. 11:70–74.
crossref
41. Krieger JN, Ravdin JI, Rein MF. Contact-dependent cytopathogenic mechanism of Trichomonas vaginalis. Infect Immun. 1985. 50:778–786.
crossref
42. Kim DW, Kim JJ, Lee KT. Cytotoxicity of Trichomonas vaginalis to the monolayers of tissue cell lines. Yonsei J Med Sci. 1987. 20:41–55.
43. Shim YK, Park KH, Chung PR, Im KI. Proteinase activity in the isolates of Trichomonas vaginalis according to their pathogenicity. Korean J Parasitol. 1993. 31:117–127.
crossref
44. Mendoza-Lopez MR, Becerril-Garcia C, Fattel-Facenda LV, Avila-Gonzalez L, Ruiz-Tachiquin ME, Ortega-Lopez J, Arroyo R. CP30, a cysteine proteinase involved in Trichomonas vaginalis cytoadherence. Infect Immun. 2000. 68:4907–4912.
crossref
45. Kim SR, Ryu JS. Scanning electron microscopic observation of Trichomonas vaginalis contacted with human vaginal epithelial cells. Korean J Electron Microsc . 2001. 31:235–244.
46. Ryu JS, Kang JH, Jung SY, Shin MH, Kim JM, Park H, Min DY. Production of interleukin-8 by human neutrophils stimulated with Trichomonas vaginalis. Infect Immun. 2004. 72:1326–1332.
crossref
47. Fouts AC, Kraus SJ. Trichomonas vaginalis: Reevaluation of its clinical presentation and laboratory diagnosis. J Infect Dis. 1993. 141:137–143.
crossref
48. Graves A, Gardner WA. Pathogenicity of Trichomonas vaginalis. Clin Obstet Gynecol. 1993. 36:145–152.
49. Shaio MF, Lin PR, Liu JY, Yang KD. Monocyte-derived interleukin-8 involved in the recruitment of neutrophils induced by Trichomonas vaginalis infection. J Infect Dis. 1994. 170:1638–1640.
crossref
50. Shaio MF, Lin PR. Leukotriene B4 levels in the vaginal discharges from cases of trichomoniasis. Ann Trop Med Parasitol. 1995. 89:85–88.
crossref
51. Park KJ, Ryu JS, Min DY, Lee KT. Leukocyte chemotaxis to Trichomonas vaginalis. Arch Theses Med Sci, YUMC. 1984. 17:77–88.
52. Kang JH, Song HO, Ryu JS, Shin MH, Kim JM, Cho YS, Alderete JF, Ahn MH, Min DY. Trichomonas vaginalis promotes apoptosis of human neutrophils by activating caspase-3 and reducing Mcl-1 expression. Parasite Immunol. 2006. 28:439–446.
crossref
53. Song HO, Shin MH, Ahn MH, Min DY, Kim YS, Ryu JS. Trichomonas vaginalis : Reactive oxygen species mediates caspase-3 dependent apoptosis of human neutrophils. Exp Parasitol. 2008. 118:59–65.
crossref
54. Song HO, Lim YS, Moon SJ, Ahn MH, Ryu JS. Delayed human neutrophil apoptosis by Trichomonas vaginalis lysate. Korean J Parasitol. 2010. 48:1–7.
crossref
55. Ahn MH, Song HO, Ryu JS. Trichomonas vaginalis-induced neutrophil apoptosis causes anti-inflammatory cytokine production by human monocyte-derived macrophages. Parasite Immunol. 2008. 30:410–416.
crossref
56. Ryu JS, Ahn MH, Min DY. Cytotoxicity of resident and lymphokine-activated mouse peritoneal macrophage against Trichomonas vaginalis. Korean J Parasitol. 1990. 28:85–89.
crossref
57. Yoon K, Ryu JS, Min DY. Cytotoxicity of lymphokine activated peritoneal macrophages against Trichomonas vaginalis. Korean J Parasitol. 1991. 29:381–388.
crossref
58. Park GC, Ryu JS, Min DY. The role of nitric oxide as an effector of macrophage-mediated cytotoxicity against Trichomonas vaginalis. Korean J Parasitol. 1997. 35:189–195.
crossref
59. Han IH, Goo SY, Park SJ, Hwang SJ, Kim YS, Yang MS, Ahn MH, Ryu JS. Proinflammatory cytokine and nitric oxide production by human macrophages stimulated with Trichomonas vaginalis. Korean J Parasitol. 2009. 47:205–212.
crossref
60. Shin SJ, Ryu JS, Shin MH, Ahn MH, Min DY. Cell-mediated immune response in mice experimentally immunized with Trichomonas vaginalis. Hanyang J Med. 1990. 10:237–244.
61. Cohen S. Cohen S, Warren KS, editors. Survival of parasites in the immunocompetent host. Immunology of parasitic infection. 1982. Oxford, UK: Blackwell Scientific publications;138–161.
62. Alderete JF. Enzyme linked immunosorbent assay for detecting antibody to Trichomonas vaginalis: Use of whole cells and aqueous extract as antigen. Br J Vener Dis. 1984. 60:164–170.
crossref
63. Ryu JS, Shin MH, Min DY. Antibody induced capping of surface antigens in Trichomonas vaginalis. Yonsei Rep Trop Med. 1992. 23:27–31.
64. Min DY, Ryu JS, Park SY, Shin MH, Cho WY. Degradation of human immunoglobulins and cytotoxicity on HeLa cells by live Trichomonas vaginalis. Korean J Parasitol. 1997. 35:39–46.
crossref
65. Min DY, Hyun KH, Ryu JS, Ahn MH, Cho MH. Degradations of human immunoglobulins and hemoglobin by a 60 kDa cysteine proteinase of Trichomonas vaginalis. Korean J Parasitol. 1998. 36:261–268.
crossref
66. Yi MR, Shin MH, Leem MH, Ryu JS, Ahn MH, Min DY. Detection of IgG and IgM antibodies with ELISA technique in human trichomoniasis. Korean J Parasitol. 1990. 28:25–30.
crossref
67. Ryu JS, Yoon K, Ha SE, Min DY, Ahn MH. Comparison of three Trichomonas antigens for the detection of IgG antibody in serum. Korean J Clin Microbiol. 2000. 3:62–68.
68. Yoon K, Kim KM, Ahn MH, Min DY, Cha DS. Detection of IgG and IgM antibodies with immunofluorescent antibody technique in human trichomoniasis. Korean J Parasitol. 1987. 25:7–12.
crossref
69. Kim JK, Kim JJ, Im KI, Lee KT. Comparative study on immunodiagnostic methods in Trichomonas vaginalis infection. Arch Theses Med Sci, YUMC. 1983. 16:106–115.
70. Paces J, Urbankova V, Urbanek P. Cloning and characterization of a repetitive DNA sequence specific for Trichomonas vaginalis. Mol Biochem Parasitol. 1992. 54:247–256.
71. Choi C. Clinical analysis of Trichomonas vaginalis vaginitis; a comparison of metronidazole and tinidazole therapy. Chonnam Med J. 1976. 13:209–217.
72. Cho KM, Lee KS, Chang JK, Soh CT. Chemotherapeutic evaluation of Tiberal (Ro7-0207) in Entamoeba histolytica, Giardia lamblia, and Trichomonas vaginalis infections using double blind trial method versus metronidazole. Yonsei Rep Trop Med. 1976. 7:77–87.
73. Ko ST, Kim DH, Chung SO. One day treatment of Trichomonas vaginitis with 1gm of ornidazole ("Tiberal"). Korean J Obstet Gynecol. 1976. 19:855–859.
74. Soh CT, Lim CK, Chung PR, Chang JK. Effects of "Ornidazole", nitroimidazole compound, on the micromorphology of Trichomonas vaginalis. Yonsei Rep Trop Med. 1988. 19:3–11.
75. You KS, Kim BI, Han GT, Kim JH, Lee JM, Lee JK, Lee HY. A clinical study of secnidazole on the Trichomonas vaginitis with one day therapy. Korean J Obstet Gynecol. 1985. 28:114–117.
76. Legator MS, Connor TH, Stoeckel M. Detection of mutagenic activity of metronidazole and niridazole in body fluids of human and mice. Science. 1975. 188:1118–1119.
crossref
77. Rosenkranz HS, Speck WT. Mutagenicity of metronidazole: activation by mammalian liver microsomes. Biochem Biophys Res Commun. 1975. 66:520–525.
crossref
78. Sobel JD, Nagappan V, Nyirjesy P. Metronidazole-resistant vaginal trichomoniasis - an emerging problem. New Eng J Med. 1999. 341:292–293.
crossref
79. Moldwin RM. Sexually transmitted protozoal infection: Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia. Urol Clin North Am. 1992. 19:93–101.
80. Ryu JS, Lloyd D. Cell cytotoxicity of sodium nitrite, sodium nitroprusside and Roussin's black salt against Trichomonas vaginalis. FEMS Microbiol Lett. 1995. 130:183–187.
crossref
81. Ryu JS, Park JW, Min DY. Effect of sodium nitrite on Trichomonas vaginalis. Korean J Parasitol. 1995. 33:349–356.
82. Ryu JS, Min DY, Kim MC, Kim NS, Shin MH. In vitro activities of 2,2'-dipyridyl against Trichomonas vaginalis, Candida albicans, and Gardnerella vaginalis. Korean J Appl Microbiol Bioeng. 2001. 11:124–130.
83. Park CU, Lee GM, Kim YC, Ryu JS, Kim TK, Kim JH, Kim MK, Song HC, Park H. Antitrichomonas activity of herb-medicine generally used in Dong-Eui-Bo-Kham. Korean J Orient Physiol Pathol. 2005. 19:191–195.
84. Kim DJ, Cho YJ, Chu JP. In vitro effect of Kalopanax-saponin A on the ultrastructure of Trichomonas vaginalis. Infect Chemother. 2003. 35:446–453.
85. Choi WG, Cho YJ, Chu JP. In vitro effect of Sophora flavescens on the ultrastructure of Trichomonas vaginalis Donne. Korean J Infect Dis. 2002. 34:248–254.
86. Park WS, Jung Y, Chu JP. Growth inhibitory effects of various herbal extracts on metronidazole resistant strain of Trichomonas vaginalis. Infect Chemother. 2004. 36:97–104.
87. Ryang YS, Im JA, Kim I, Cho YK, Sung HJ, Park JY, Min DY, Ha JY. Antiparasitic effects of a herb extract from Gentiana scabra var buergeri on Trichomonas vaginalis. Korean J Biomed Lab Sci. 2001. 7:53–58.
TOOLS
Similar articles