An estrogen-dominant state is associated with protection against HIV transmission in both non-human primate animal models and in epidemiologic studies of HIV transmission in women. Although estrogen regulates expression of many genes and modulates immune responses, especially at mucosal surfaces, the underlying mechanism for this protection is unclear. Two separate observations from our lab and others suggest that estrogen may regulate HIV transmission and/or HIV infection beyond its effects on vaginal wall remodeling: (1) We recently identified a ubiquitous signaling cascade, the Wnt/b-catenin pathway, as a potent represser of HIV replication. This pathway was induced by estrogen treatment in human peripheral blood mononuclear cells (PBMCs) and estrogen inhibited HIV replication in PBMCs and in ex vivo cervical tissue. We propose that the ability of estrogen to activate this anti-HIV pathway (Wnt/b-catenin) contributes to its ability to mediate inhibition of HIV replication in target cells (AIM 1). (2) Mounting evidence indicates that estrogen has complex and profound effects on leukocyte recruitment and activity in several physiologic compartments, including the female genital tract. In particular, estrogen at peak physiologic levels decreases inflammatory T cell and macrophage recruitment and reduces production of Th1/proinflammatory cytokines by T cells, macrophages, and dendritic cells. We propose that estrogen also attenuates HIV transmission and infection by reducing leukocyte recruitment, immune activation, and inflammation in the female genital tract (AIM 2). The above two propositions form the basis of our central hypothesis - that estrogen diminishes HIV transmission and replication by modulating two mechanisms essential for establishing HIV infection in women: 1) Wnt/b-catenin signaling and 2) mucosal immune responses. The net outcome is diminished HV transmission and replication under an estrogen-dominant state. We will use a cervical explant model and a dual chamber model of leukocyte transmigration to evaluate the two proposed mechanisms by which estrogen reduces HV replication and transmission in the female genital tract. We will also determine if this reationship occurs in vivo by determining the impact of estrogen on Wnt/b-catenin and HIV replication among HIV-infected premenapausal and post-menapousal women (cross-sectional study) and during the menstrual cycle (longitudinal study)(Aim 3). Identifying these mechanisms is critical because it will improve our understanding of female sex hormone effects on HIV infection, which will, in turn, provide new approaches to anti-HIV therapy and prophylaxis in women.

Public Health Relevance

Our studies will define the mechanism(s) by which estrogen is protective against HIV transmission and replication. This knowledge is essential towards efforts to devise novel targets for HIV intervention. Such strategies would exploit the pathway that estrogen engages to diminish HIV transmission and replication.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Program Projects (P01)
Project #
Application #
Study Section
Special Emphasis Panel (ZAI1-TP-A)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Rush University Medical Center
United States
Zip Code
Mehta, Supriya D; Pradhan, Ashish K; Green, Stefan J et al. (2017) Microbial Diversity of Genital Ulcers of HSV-2 Seropositive Women. Sci Rep 7:15475
Chehoud, Christel; Stieh, Daniel J; Bailey, Aubrey G et al. (2017) Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors. AIDS 31:895-904
Gianella, Sara; Chaillon, Antoine; Mutlu, Ece A et al. (2017) Effect of cytomegalovirus and Epstein-Barr virus replication on intestinal mucosal gene expression and microbiome composition of HIV-infected and uninfected individuals. AIDS 31:2059-2067
Gianella, Sara; Chaillon, Antoine; Mutlu, Ece A et al. (2017) Effect of CMV and EBV replication on intestinal mucosal gene expression and microbiome composition of HIV-infected and uninfected individuals. AIDS :
Arslan, Sevim Yildiz; Yu, Yanni; Burdette, Joanne E et al. (2015) Novel three dimensional human endocervix cultures respond to 28-day hormone treatment. Endocrinology 156:1602-9
Tjernlund, Annelie; Carias, Ann M; Andersson, Sonia et al. (2015) Progesterone-based intrauterine device use is associated with a thinner apical layer of the human ectocervical epithelium and a lower ZO-1 mRNA expression. Biol Reprod 92:68
Archary, Derseree; Liebenberg, Lenine J; Werner, Lise et al. (2015) Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage. PLoS One 10:e0131906
Aziz, Mariam; Mahmood, Fareeha; Mata, Mariana et al. (2015) Development of IgG Mediated Antibody Dependent Cell-mediated Cytotoxicity (ADCC) in the Serum and Genital Mucosa of HIV Seroconverters. J AIDS Clin Res 6:
Jarrett, Olamide D; Brady, Kirsten E; Modur, Sharada P et al. (2015) T. vaginalis Infection Is Associated with Increased IL-8 and TNFr1 Levels but with the Absence of CD38 and HLADR Activation in the Cervix of ESN. PLoS One 10:e0130146
Allen, Shannon A; Carias, Ann M; Anderson, Meegan R et al. (2015) Characterization of the Influence of Semen-Derived Enhancer of Virus Infection on the Interaction of HIV-1 with Female Reproductive Tract Tissues. J Virol 89:5569-80

Showing the most recent 10 out of 40 publications