Neither vaginal nor buccal administration of 800 μg misoprostol alters mucosal and systemic immune activation or the cervicovaginal microbiome: a pilot study

Abstract

Objectives: The aim of the study was to assess the extent to which misoprostol alters mucosal or systemic immune responses following either buccal or vaginal administration.

Methods: This was a prospective, crossover pilot study of 15 healthy, reproductive-age women. Women first received 800 μg misoprostol either via buccal or vaginal administration and were crossed over 1 month later to receive the drug via the other route. Cervicovaginal lavage samples, cervical Cytobrush samples, cervicovaginal swabs, urine and blood were obtained immediately prior to drug administration and the following day. Parameters assessed included urine and cervicovaginal misoprostol levels, whole blood cytokine responses (by ELISA) to immune stimulation with lipopolysaccharide, peripheral blood and cervical lymphocyte phenotyping by flow cytometry, cervicovaginal antimicrobial peptide measurement by ELISA and vaginal microbial ecology assessment by 16S rRNA sequencing.

Results: Neither buccal nor vaginal misoprostol significantly altered local or systemic immune and microbiological parameters.

Conclusion: In this pilot study, we did not observe significant alteration of mucosal or systemic immunology or vaginal microbial ecology 1 day after drug administration following either the buccal or vaginal route.

Chinese abstract

目的: 该研究的目的是评估米索前列醇含服或阴道给药后改变粘膜和全身免疫应答的程度。

方法: 这是包含15名健康育龄妇女的一项前瞻性、交叉试验性研究。妇女首先通过口腔或阴道给药接受800ug米索前列醇, 并且在1个月后通过其它途径接受药物测定。在即将给药前和给药第二天获得宫颈阴道灌洗样品, 宫颈细胞浆样品, 宫颈阴道拭子, 尿和血液样品。评估的参数包括尿液和子宫颈阴道米索前列醇水平, 依赖脂多糖的全血细胞因子测定免疫刺激反应 (通过ELISA测定) , 通过流式细胞术测定外周血和宫颈淋巴细胞表型, 通过ELISA的宫颈阴道抗微生物肽测量和通过16SrRNA序列测定评估阴道微生态。

结果: 含化和阴道米索前列醇均不显着改变局部或全身免疫应答和微态参数。

结论: 在这项初步研究中, 我们并没有观察到含服或阴道途径给药1天后全身免疫学或阴道微生物生态学的显著改变。

Keywords:

• Abortion
• microbial ecology
• mucosal immunology
• prostaglandins

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Study team members from Gynuity Health Projects LLC assisted in the study design and in the writing of this report but did not participate in the collection, analysis or interpretation of data.