Levels of vaginal secretory leukocyte protease inhibitor are decreased in women with lower reproductive tract infections

Deborah L. Draper, Daniel V. Landers, Marijane A. Krohn, Sharon L. Hillier, Harold C. Wiesenfeld, R. Phillip Heine

Research output: Contribution to journalArticlepeer-review

91 Scopus citations


OBJECTIVE: Secretory leukocyte protease inhibitor contributes resistance to primary human immunodeficiency virus infection in the oral cavity. However, the levels of this inhibitor in the genital tract of women with sexually transmitted diseases or vaginitis are not well described. The objective was to determine vaginal inhibitor levels in women with symptomatic and asymptomatic genital infections. STUDY DESIGN: We tested 207 nonpregnant women for Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, Candida species, and bacterial vaginosis by standard methods. A second group of symptom-free pregnant women (N = 231) was also studied. Secretory leukocyte protease inhibitor was measured by enzyme-linked immunosorbent assay, and results were compared by nonparametric methods. RESULTS: Vaginal levels of secretory leukocyte protease inhibitor in both groups were significantly lower in women with any sexually transmitted disease than in those without infection (P < .0001). Patients with bacterial vaginosis and those with bacterial vaginosis with yeast vaginitis also had decreased levels (P < .025). CONCLUSIONS: Levels of secretory leukocyte protease inhibitor in vaginal fluid are decreased in women with lower genital tract infection. This may represent a common mechanism of increasing susceptibility to infection with human immunodeficiency virus.

Original languageEnglish (US)
Pages (from-to)1243-1248
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Issue number5
StatePublished - 2000
Externally publishedYes

Bibliographical note

Funding Information:
Supported by grants from the National Institutes of Health (U19 AI38513) and the Department of Defense (DAMD17-96-1-6298).


  • Infection with human immunodeficiency virus
  • Mucosal defenses
  • Secretory leukocyte protease inhibitor
  • Sexually transmitted diseases
  • Vaginal infections


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