Mouse model of cervicovaginal toxicity and inflammation for preclinical evaluation of topical vaginal microbicides

Antimicrob Agents Chemother. 2004 May;48(5):1837-47. doi: 10.1128/AAC.48.5.1837-1847.2004.

Abstract

Clinical trials evaluating the efficacy of nonoxynol-9 (N-9) as a topical microbicide concluded that N-9 offers no in vivo protection against human immunodeficiency virus type 1 (HIV-1) infection, despite demonstrated in vitro inactivation of HIV-1 by N-9. These trials emphasize the need for better model systems to determine candidate microbicide effectiveness and safety in a preclinical setting. To that end, time-dependent in vitro cytotoxicity, as well as in vivo toxicity and inflammation, associated with N-9 exposure were characterized with the goal of validating a mouse model of microbicide toxicity. In vitro studies using submerged cell cultures indicated that human cervical epithelial cells were inherently more sensitive to N-9-mediated damage than human vaginal epithelial cells. These results correlated with in vivo findings obtained by using Swiss Webster mice in which intravaginal inoculation of 1% N-9 or Conceptrol gel (containing 4% N-9) resulted in selective and acute disruption of the cervical columnar epithelial cells 2 h postapplication accompanied by intense inflammatory infiltrates within the lamina propria. Although damage to the cervical epithelium was apparent out to 8 h postapplication, these tissues resembled control tissue by 24 h postapplication. In contrast, minimal damage and infiltration were associated with both short- and long-term exposure of the vaginal mucosa to either N-9 or Conceptrol. These analyses were extended to examine the relative toxicity of polyethylene hexamethylene biguanide (PEHMB), a polybiguanide compound under evaluation as a candidate topical microbicide. In similar studies, in vivo exposure to 1% PEHMB caused minimal damage and inflammation of the genital mucosa, a finding consistent with the demonstration that PEHMB was >350-fold less cytotoxic than N-9 in vitro. Collectively, these studies highlight the murine model of toxicity as a valuable tool for the preclinical assessment of toxicity and inflammation associated with exposure to candidate topical microbicides.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Intravaginal
  • Animals
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / toxicity*
  • Cell Line
  • Cells, Cultured
  • Cervix Uteri / drug effects
  • Cervix Uteri / pathology*
  • Female
  • Keratinocytes / drug effects
  • Mice
  • Nonoxynol / administration & dosage
  • Nonoxynol / adverse effects
  • Vagina / drug effects
  • Vagina / pathology*
  • Vaginal Creams, Foams, and Jellies / administration & dosage
  • Vaginal Creams, Foams, and Jellies / toxicity
  • Vaginitis / chemically induced*
  • Vaginitis / pathology

Substances

  • Anti-HIV Agents
  • Anti-Infective Agents, Local
  • Vaginal Creams, Foams, and Jellies
  • Nonoxynol