生殖道防禦機制之探討

Defense Mechanism of the Human Genital Tract

張樂心(Le-Shin Chang)

《通識研究集刊》 11期 (2007/06) Pp. 39-52

https://doi.org/10.6488/JCGE.200706.0039

摘要

私密處困擾是女大學生最常遇到，也是最想了解的健康問題之一，國外研究顯示高達1/4的大學女生曾有生殖道成染病史，俗諺十女九帶，加上台灣氣候潮濕悶熱，私密處困擾應該更加普遍。傳統徹底清潔的錯誤觀念只會讓陰道感染更形惡化，即使以抗生素治療，不僅效果不彰，副作用大且覆發率高達5成，約有1/12的女性深受每年4次以上的反覆感染之苦。生殖道與外界相通且緊鄰肛門，為衹抗各式病原菌入侵，已演化出複雜且高效率的防禦機制。本文將回顧生殖道防禦機制的相關研究，探討共生乳酸菌與先天免疫的重要角色。乳酸菌是生殖道中的優勢共生菌種，籍由維持酸性環境、分泌抗菌物質來抑制其它菌種生長或粘附在上皮組織中，我們也討論可能會破壞菌種平衡的一些行為。先天免疫防禦系統則包括能辨識病原體聯合分子模式的模式辨識接受體，及數量種類龐大的細胞激素與抗菌胜肽，先天免疫亦可引發生殖道獨特的復天抗體免疫系統。女性生殖系統就是藉由結合乳酸菌，先天與後天免疫反應來預防病原體的入侵與生長。

關鍵字

生殖道 ； 乳酸菌 ； 先天免疫 ； 模式辨識接受體 ； 抗菌胜肽

並列摘要

Urogenital infections are major medical problems affecting female college/university students. They are also some of the medical issues they want to learn more about. A foreign study have shown that 1 in every 4 female students indicated having had a urogenital infection previously. A traditional China's proverb stated that ”9 in 10 women have leucorrhea” which reveal that this issue is common. We can conclude that it is more common in Taiwan due to its warm and humid climate. Thorough cleaning may cause the infection to grow worse, and even through antibiotics treatment the likelihood of recurrence rate could be as high as 50% and associated with side effects. 1 in12 has reported more than 4 episodes a year. This exposure of the female genital tract to the external environment already carries risks of infection, not to mention its position near the anus. In order to prevent genital infection, the human body has evolved an extremely complicated and high-efficiency mechanism of defense against genital infections. In this article, we will review the evidence on the pivotal role of commensal microbes and innate immune system. Lactobacilli, the predominant vaginal commensal microbes, compete with exogenous microbes for attachment sites, nutrients and suppress exogenous flora by maintaining a low pH while secreting antimicrobial substances. We will also review the correlation of behaviors with microbiologic changes in vaginal flora. The innate immune system is the most primitive and evolutionarily conserved arm of the immune system. Components of innate immunity operation in the vagina are soluble factors, pattern recognition receptors, as well as huge cytokines and antimicrobial peptides. The commensal microbes composition of the vagina, along with the presence of a range of innate and acquired immune system component combine to prevent microbial pathogens from invading and/or proliferating.

並列關鍵字

Female genital tract ； Lactobacilli ； Innate immunity ； Toll-like receptors ； Antimicrobial polypeptides