Multi-Study Assessment of Vaginal Cytokines and Microflora in the Safety Evaluation of Intravaginal Rings in Pig-Tailed Macaques

BACKGROUND: HIV microbicide trials have emphasized the need to evaluate the safety of topical microbicides and delivery platforms in an animal model prior to conducting clinical efficacy trials. An ideal delivery device should provide sustainable and sufficient concentrations of effective products to prevent HIV transmission while not increasing transmission risk by either local mucosal inflammation and/or disruption of the normal vaginal microflora.

METHODS: Safety analyses of macaque-sized elastomeric silicone and polyurethane intravaginal rings (IVRs) loaded with candidate antiretroviral (ARV) drugs were tested in four studies ranging in duration from 49 to 73 days with retention of the IVR being 28 days in each study. Macaques were assigned to 3 groups; blank IVR, ARV-loaded IVR, and naïve. In sequential studies, the same macaques were used but rotated into different groups. Mucosal and systemic levels of cytokines were measured from vaginal fluids and plasma, respectively, using multiplex technology. Changes in vaginal microflora were also monitored. Statistical analysis (Mann-Whitney test) was used to compare data between two groups of unpaired samples (with and without IVR, and IVR with and without ARV) for the groups collectively, and also for individual macaques.

RESULTS: There were few statistically significant differences in mucosal and systemic cytokine levels measured longitudinally when the ring was present or absent, with or without ARVs. Of the 8 proinflammatory cytokines assayed a significant increase (p = 0.015) was only observed for IL8 in plasma with the blank and ARV loaded IVR (median of 9.2 vs. 5.7 pg/ml in the absence of IVR). There were no significant differences in the prevalence of H2O2-producing lactobacilli or viridans streptococci, or other microorganisms indicative of healthy vaginal microflora. However, there was an increase in the number of anaerobic gram negative rods in the presence of the IVR (p= < 0.0001).

CONCLUSIONS: IVRs with or without ARVs neither significantly induce the majority of potentially harmful proinflammatory cytokines locally or systemically, nor alter the lactobacillus or G. vaginalis levels. The increase in anaerobic gram negative rods alone suggests minimal disruption of normal vaginal microflora. The use of IVRs as a long-term sustained delivery device for ARVs is promising and preclinical studies to demonstrate the prevention of transmission in the HIV/SHIV nonhuman primate model should continue.

Nebular and auroral emission lines of [Cl III] in the optical spectra of planetary nebulae

Electron impact excitation rates in Cl III, recently determined with the R-matrix code, are used to calculate electron temperature (T-e) and density (N-e) emission line ratios involving both the nebular (5517.7, 5537.9 Angstrom) and auroral (8433.9, 8480.9, 8500.0 Angstrom) transitions. A comparison of these results with observational data for a sample of planetary nebulae, obtained with the Hamilton Echelle Spectrograph on the 3-m Shane Telescope, reveals that the R-1 = /(5518 Angstrom)/I(5538 Angstrom) intensity ratio provides estimates of N-e in excellent agreement with the values derived from other line ratios in the echelle spectra. This agreement indicates that R-1 is a reliable density diagnostic for planetary nebulae, and it also provides observational support for the accuracy of the atomic data adopted in the line ratio calculations. However the [Cl III] 8433.9 Angstrom line is found to be frequently blended with a weak telluric emission feature, although in those instances when the [Cl III] intensity may be reliably measured, it provides accurate determinations of T-e when ratioed against the sum of the 5518 and 5538 Angstrom line fluxes. Similarly, the 8500.0 Angstrom line, previously believed to be free of contamination by the Earth's atmosphere, is also shown to be generally blended with a weak telluric emission feature. The [CI III] transition at 8480.9 Angstrom is found to be blended with the He I 8480.7 Angstrom line, except in planetary nebulae that show a relatively weak He I spectrum, where it also provides reliable estimates of T-e when ratioed against the nebular lines. Finally, the diagnostic potential of the near-UV [Cl III] lines at 3344 and 3354 Angstrom is briefly discussed.

Nebular and Auroral Emission Lines of [Ar IV] in the Optical Spectra of Planetary Nebulae

Recent R-matrix calculations of electron impact excitation rates in Ar IV are used to calculate the emission-line ratio: ratio diagrams (R₁, R₂), (R_1, R₃), and (R_1, R₄), where K₁ = I(4711 Å)/I(4740 Å), R₂ = I(7238 Å)/I(4711 + 4740 Å), R₃ = I(7263 Å)/I(4711 + 4740 Å), and R₄ = I(7171 Å)/I(4711 + 4740 Å), for a range of electron temperatures (T_e = 5000-20,000 K) and electron densities (N_e = 10-10⁶ cm^-3) appropriate to gaseous nebulae. These diagrams should, in principle, allow the simultaneous determination of T_e and N_e from measurements of the [Ar IV] lines in a spectrum. Plasma parameters deduced for a sample of planetary nebulae from (R_1, R₃) and (R_1, R₄), using observational date obtained with the Hamilton echelle spectrograph on the 3 m Shane Telescope at the Lick Observatory, are found to show excellent internal consistency and to be in generally good agreement with the values of T_e and N_e estimated from other line ratios in the echelle spectra. These results provide observational support for the accuracy of the theoretical ratios and, hence, the atomic data adopted in their derivation. In addition, they imply that the 7171 Å line is not as seriously affected by telluric absorption as previously thought. However, the observed values of R₂ are mostly larger than the theoretical high-temperature and density limit, which is due to blending of the Ar IV 7237.54 Å line with the strong C II transition at 7236 Å.