Trichomonas vaginalis is a flagellated protozoan that causes trichomoniasis, a common nonviral sexually transmitted infection. T. vaginalis infection is asymptomatic in most infected men but can lead to chronic infection. The inflammatory response to chronic T. vaginalis infection may contribute to prostatic diseases, such as prostatitis and benign prostatic hyperplasia (BPH); however, studies on the relationship between T. vaginalis infection and prostate diseases are scarce. In this review, we discuss evidence from our studies on the involvement of T. vaginalis in the pathogenesis of prostate diseases, such as prostatitis and BPH. Studies of prostatitis have demonstrated that the attachment of T. vaginalis trophozoite to prostate epithelial cells (PECs) induces inflammatory cytokine production and inflammatory cell migration, leading to prostatitis. T. vaginalis also causes pathological changes, such as inflammatory cell infiltration, acinar changes, interstitial fibrosis, and mast cell infiltration, in prostate tissues of infected rats. Thus, T. vaginalis is considered an infectious agent that triggers prostatitis. Meanwhile, studies of prostatic hyperplasia revealed that mast cells activated by T. vaginalis-infected prostate cells secreted inflammatory mediators, such as β-hexosaminidase and tryptase, which promoted proliferation of prostate stromal cell (PSC). Moreover, interleukin-6 produced by proliferating PSCs induced the multiplication of BPH-1 epithelial cells as a result of stromal–epithelial interaction, suggesting that the proliferation of T. vaginalis-infected prostate cells can be induced through crosstalk with mast cells. These collective findings suggest that T. vaginalis contributes to the progression of prostatitis and prostatic hyperplasia by creating an inflammatory microenvironment involving PECs and PSCs.
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Our objective was to investigate whether inflammatory microenvironment induced by Trichomonas vaginalis infection can stimulate proliferation of prostate cancer (PCa) cells in vitro and in vivo mouse experiments. The production of CXCL1 and CCL2 increased when cells of the mouse PCa cells (TRAMP-C2 cell line) were infected with live T. vaginalis. T. vaginalis-conditioned medium (TCM) prepared from co-culture of PCa cells and T. vaginalis increased PCa cells migration, proliferation and invasion. The cytokine receptors (CXCR2, CCR2, gp130) were expressed higher on the PCa cells treated with TCM. Pretreatment of PCa cells with antibodies to these cytokine receptors significantly reduced the proliferation, mobility and invasiveness of PCa cells, indicating that TCM has its effect through cytokine-cytokine receptor signaling. In C57BL/6 mice, the prostates injected with T. vaginalis mixed PCa cells were larger than those injected with PCa cells alone after 4 weeks. Expression of epithelial-mesenchymal transition markers and cyclin D1 in the prostate tissue injected with T. vaginalis mixed PCa cells increased than those of PCa cells alone. Collectively, it was suggested that inflammatory reactions by T. vaginalis-stimulated PCa cells increase the proliferation and invasion of PCa cells through cytokine-cytokine receptor signaling pathways.
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Leptin is a type of adipokine mainly produced by adipocytes and reported to be overproduced in prostate cancer. However, it is not known whether it stimulates the proliferation of prostate cells. In this study, we investigated whether benign prostatic hyperplasia epithelial cells (BPH-1 cells) infected with Trichomonas vaginalis induced the proliferation of prostate cells via a leptin signaling pathway. To investigate the effect of crosstalk between adipocyte leptin and inflamed epithelial cell in proliferation of prostate cells, adipocytes 3T3-L1 cells were incubated in conditioned medium of BPH-1 cells infected with T. vaginalis (T. vaginalis-conditioned medium, TCM), and then the adipocyte-conditioned medium (ATCM) was identified to cause proliferation of prostate cells. BPH-1 cells incubated with live T. vaginalis released pro-inflammatory cytokines, and conditioned medium of these cells caused migration of adipocytes. When prostate stromal cells and BPH-1 cells were incubated with adipocyte conditioned medium containing leptin, their growth rates increased as did expression of the leptin receptor (known as OBR) and signaling molecules such as JAK2/STAT3, Notch and survivin. Moreover, blocking the OBR reduced this proliferation and the expression of leptin signaling molecules in response to ATCM. In conclusion, our findings show that inflamed BPH-1 cells infected with T. vaginalis induce the proliferation of prostate cells through leptin-OBR signaling. Therefore, it is likely that T. vaginalis contributes to prostate enlargement in BPH via adipocyte leptin released as a result of inflammation of the prostate.
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Trichomonas vaginalis causes inflammation of the prostate and has been detected in tissues of prostate cancers (PCa), prostatitis and benign prostatic hyperplasia. Obesity is a risk factor for PCa and causes a chronic subclinical inflammation. This chronic inflammation further exacerbates adipose tissue inflammation as results of migration and activation of macrophages. Macrophages are the most abundant immune cells in the PCa microenvironment. M2 macrophages, known as Tumor-Associated Macrophages, are involved in increasing cancer malignancy. In this study, conditioned medium (TCM) of PCa cells infected with live trichomonads contained chemokines that stimulated migration of the mouse preadipocytes (3T3-L1 cells). Conditioned medium of adipocytes incubated with TCM (ATCM) contained Th2 cytokines (IL-4, IL-13). Macrophage migration was stimulated by ATCM. In macrophages treated with ATCM, expression of M2 markers increased, while M1 markers decreased. Therefore, it is suggested that ATCM induces polarization of M0 to M2 macrophages. In addition, conditioned medium from the macrophages incubated with ATCM stimulates the proliferation and invasiveness of PCa. Our findings suggest that interaction between inflamed PCa treated with T. vaginalis and adipocytes causes M2 macrophage polarization, so contributing to the progression of PCa.
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Most men infected with Trichomonas vaginalis are asymptomatic and can remain undiagnosed and untreated. This has been hypothesized to result in chronic persistent prostatic infection. Adhesion of the protozoan organisms to mucosal cells is considered a first and prerequisite step for T. vaginalis infection. Adhesion of T. vaginalis to prostate epithelial cells has not yet been observed; however, there are several reports about inflammation of prostate epithelial cells induced by T. vaginalis. The aim of this study was to investigate whether adhesion and cytotoxicity of T. vaginalis are involved in inflammation of prostate epithelial cells. When RWPE-1 cells were infected with T. vaginalis (1:0.4 or 1:4), adhesion of T. vaginalis continuously increased for 24 hr or 3 hr, respectively. The cytotoxicity of prostate epithelial cells infected with T. vaginalis (RWPE-1: T. vaginalis=1:0.4) increased at 9 hr; at an infection ratio of 1:4, cytotoxicity increased after 3 hr. When the RWPE-1 to T. vaginalis ratio was 1:0.4 or 1:4, production of IL-1β, IL-6, CCL2, and CXCL8 also increased. Epithelial-mesenchymal transition (EMT) was verified by measuring decreased E-cadherin and increased vimentin expression at 24 hr and 48 hr. Taken together, the results indicate that T. vaginalis adhered to prostate epithelial cells, causing cytotoxicity, pro-inflammatory cytokine production, and EMT. Our findings suggest for the first time that T. vaginalis may induce inflammation via adhesion to normal prostate epithelial cells.
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Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-1β, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-κB were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-κB, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-κB inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS).
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Trichomonas vaginalis commonly causes vaginitis and perhaps cervicitis in women and urethritis in men and women. Macrophages are important immune cells in response to T. vaginalis infection. In this study, we investigated whether human macrophages could be involved in inflammation induced by T. vaginalis. Human monocyte-derived macrophages (HMDM) were co-cultured with T. vaginalis. Live, opsonized-live trichomonads, and T. vaginalis lysates increased proinflammatory cytokines, such as TNF-α, IL-1β, and IL-6 by HMDM. The involvement of nuclear factor (NF)-κB signaling pathway in cytokine production induced by T. vaginalis was confirmed by phosphorylation and nuclear translocation of p65 NF-κB. In addition, stimulation with live T. vaginalis induced marked augmentation of nitric oxide (NO) production and expression of inducible NO synthase (iNOS) levels in HMDM. However, trichomonad-induced NF-κB activation and TNF-α production in macrophages were significantly inhibited by inhibition of iNOS levels with L-NMMA (NO synthase inhibitor). Moreover, pretreatment with NF-κB inhibitors (PDTC or Bay11-7082) caused human macrophages to produce less TNF-α. These results suggest that T. vaginalis stimulates human macrophages to produce proinflammatory cytokines, such as IL-1, IL-6, and TNF-α, and NO. In particular, we showed that T. vaginalis induced TNF-α production in macrophages through NO-dependent activation of NF-κB, which might be closely involved in inflammation caused by T. vaginalis.
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Immune cell arrival kinetics to peritoneum and role during murine-experimental trichomoniasis F. J. Rangel-Mata, E. E. Ávila-Muro, J. E. Reyes-Martínez, L. M. Olmos-Ortiz, M. E. Brunck, L. A. Arriaga-Pizano, P. Cuéllar-Mata Parasitology.2021; 148(13): 1624. CrossRef
Trichomonas vaginalis triggers the release of THP-1 extracellular traps Li Fei, Wei Zhengkai, Jiang Weina, Cao Lili, Gao Yuhang, Yang Zhengtao, Li Jianhua, Yu Biao, Zhang Xichen, Gong Pengtao Parasitology Research.2019; 118(1): 267. CrossRef
Immune Response of BALB/c Mice toward Putative Calcium Transporter Recombinant Protein of Trichomonas vaginalis Tahali Mendoza-Oliveros, Victor Arana-Argáez, Leidi C. Alvaréz-Sánchez, Julio Lara-Riegos, María Elizbeth Alvaréz-Sánchez, Julio C. Torres-Romero The Korean Journal of Parasitology.2019; 57(1): 33. CrossRef
Heterogeneous macrophages: Supersensors of exogenous inducing factors Caiyun Qian, Zehui Yun, Yudi Yao, Minghua Cao, Qiang Liu, Song Hu, Shuhua Zhang, Daya Luo Scandinavian Journal of Immunology.2019;[Epub] CrossRef
Immunopathology of Recurrent Vulvovaginal Infections: New Aspects and Research Directions Namarta Kalia, Jatinder Singh, Manpreet Kaur Frontiers in Immunology.2019;[Epub] CrossRef
ReducedTrichomonas vaginalisviability in mice pretreated with parasite DNA Marco Antonio Barajas-Mendiola, Laura E. Castellano, Miriam Barrios-Rodiles, Martha A. Deveze-Alvarez, Eva E. Avila, Patricia Cuéllar-Mata Parasitology.2019; 146(13): 1636. CrossRef
Trichomonas vaginalis Induces NLRP3 Inflammasome Activation and Pyroptotic Cell Death in Human Macrophages Angelica Montenegro Riestra, J. Andrés Valderrama, Kathryn A. Patras, Sharon D. Booth, Xing Yen Quek, Chih-Ming Tsai, Victor Nizet Journal of Innate Immunity.2019; 11(1): 86. CrossRef
Humoral and T cell–mediated immune response against trichomoniasis M. Nemati, N. Malla, M. Yadav, H. Khorramdelazad, A. Jafarzadeh Parasite Immunology.2018;[Epub] CrossRef
Trichomonas vaginalis Induces Production of Proinflammatory Cytokines in Mouse Macrophages Through Activation of MAPK and NF-κB Pathways Partially Mediated by TLR2 Ling Li, Xin Li, Pengtao Gong, Xichen Zhang, Zhengtao Yang, Ju Yang, Jianhua Li Frontiers in Microbiology.2018;[Epub] CrossRef
BLT1-mediated O-GlcNAcylation is required for NOX2-dependent migration, exocytotic degranulation and IL-8 release of human mast cell induced by Trichomonas vaginalis-secreted LTB4 Arim Min, Young Ah Lee, Kyeong Ah Kim, Myeong Heon Shin Microbes and Infection.2018; 20(6): 376. CrossRef
Effect of iNOS inhibitor LNMMA along with antibiotics Chloramphenicol or Ofloxacin in murine peritoneal macrophages regulates S.aureus infection as well as inflammation: An in vitro study Somrita Dey, Biswadev Bishayi Microbial Pathogenesis.2017; 105: 307. CrossRef
Trichomonas vaginalis exosome‐like vesicles modify the cytokine profile and reduce inflammation in parasite‐infected mice L. M. Olmos‐Ortiz, M. A. Barajas‐Mendiola, M. Barrios‐Rodiles, L. E. Castellano, S. Arias‐Negrete, E. E. Avila, P. Cuéllar‐Mata Parasite Immunology.2017;[Epub] CrossRef
The anti‐Trichomonas vaginalis phloroglucinol derivative isoaustrobrasilol B modulates extracellular nucleotide hydrolysis Camila Braz Menezes, Graziela Vargas Rigo, Henrique Bridi, Danielle da Silva Trentin, Alexandre José Macedo, Gilsane Lino von Poser, Tiana Tasca Chemical Biology & Drug Design.2017; 90(5): 811. CrossRef
Adenosine reduces reactive oxygen species and interleukin-8 production by Trichomonas vaginalis-stimulated neutrophils Amanda Piccoli Frasson, Camila Braz Menezes, Gustavo Krumel Goelzer, Simone Cristina Baggio Gnoatto, Solange Cristina Garcia, Tiana Tasca Purinergic Signalling.2017; 13(4): 569. CrossRef
Trichomonas vaginalis α-Actinin 2 Modulates Host Immune Responses by Inducing Tolerogenic Dendritic Cells via IL-10 Production from Regulatory T Cells Hye-Yeon Lee, Juri Kim, Jae-Sook Ryu, Soon-Jung Park The Korean Journal of Parasitology.2017; 55(4): 375. CrossRef
SNAP23-Dependent Surface Translocation of Leukotriene B
4
(LTB
4
) Receptor 1 Is Essential for NOX2-Mediated Exocytotic Degranulation in Human Mast Cells Induced by Trichomonas vaginalis-Secrete Arim Min, Young Ah Lee, Kyeong Ah Kim, Jamel El-Benna, Myeong Heon Shin, Judith A. Appleton Infection and Immunity.2017;[Epub] CrossRef
OsmC and incomplete glycine decarboxylase complex mediate reductive detoxification of peroxides in hydrogenosomes of Trichomonas vaginalis Eva Nývltová, Tamara Smutná, Jan Tachezy, Ivan Hrdý Molecular and Biochemical Parasitology.2016; 206(1-2): 29. CrossRef
Symbiotic Association with Mycoplasma hominis Can Influence Growth Rate, ATP Production, Cytolysis and Inflammatory Response of Trichomonas vaginalis Valentina Margarita, Paola Rappelli, Daniele Dessì, Gianfranco Pintus, Robert P. Hirt, Pier L. Fiori Frontiers in Microbiology.2016;[Epub] CrossRef
Trichomoniasis immunity and the involvement of the purinergic signaling Camila Braz Menezes, Tiana Tasca Biomedical Journal.2016; 39(4): 234. CrossRef
Modulation of dendritic cell function by Trichomonas vaginalis-derived secretory products Min-Ji Song, Jong-Joo Lee, Young Hee Nam, Tae-Gyun Kim, Youn Wook Chung, Mikyoung Kim, Ye-Eun Choi, Myeong Heon Shin, Hyoung-Pyo Kim BMB Reports.2015; 48(2): 103. CrossRef
Involvement of PI3K/AKT and MAPK Pathways for TNF-α Production in SiHa Cervical Mucosal Epithelial Cells Infected with <i>Trichomonas vaginalis</i> Jung-Bo Yang, Juan-Hua Quan, Ye-Eun Kim, Yun-Ee Rhee, Byung-Hyun Kang, In-Wook Choi, Guang-Ho Cha, Jae-Min Yuk, Young-Ha Lee The Korean Journal of Parasitology.2015; 53(4): 371. CrossRef
Analysis of the Oxidative Stress Status in Nonspecific Vaginitis and Its Role in Vaginal Epithelial Cells Apoptosis Zhaojie Chen, Zhen Zhang, Haiyan Zhang, Beibei Xie BioMed Research International.2015; 2015: 1. CrossRef
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 Olamide D. Jarrett, Kirsten E. Brady, Sharada P. Modur, Jill Plants, Alan L. Landay, Mahmood Ghassemi, Elizabeth T. Golub, Greg T. Spear, Richard M. Novak, Clive M. Gray PLOS ONE.2015; 10(6): e0130146. CrossRef
Prostatic Disease Associated withTrichomonas vaginalis Jae-Sook Ryu The Korean Journal of Urogenital Tract Infection and Inflammation.2014; 9(2): 61. CrossRef
Immunity in urogenital protozoa N. Malla, K. Goyal, R. S. Dhanda, M. Yadav Parasite Immunology.2014; 36(9): 400. CrossRef
Differential Regulation of Proinflammatory Cytokine Expression by Mitogen-Activated Protein Kinases in Macrophages in Response to Intestinal Parasite Infection Mei Xing Lim, Chin Wen Png, Crispina Yan Bing Tay, Joshua Ding Wei Teo, Huipeng Jiao, Norbert Lehming, Kevin Shyong Wei Tan, Yongliang Zhang, J. A. Appleton Infection and Immunity.2014; 82(11): 4789. CrossRef
IL‐22 Levels are Associated with Trichomonas vaginalis Infection in the Lower Genital Tract Hadijat Moradeke Makinde, Reza Zariffard, Paria Mirmonsef, Richard M Novak, Olamide Jarrett, Alan L Landay, Gregory T Spear American Journal of Reproductive Immunology.2013; 70(1): 38. CrossRef
IL-10 release by bovine epithelial cells cultured with Trichomonas vaginalis and Tritrichomonas foetus Ricardo Chaves Vilela, Marlene Benchimol Memórias do Instituto Oswaldo Cruz.2013; 108(1): 110. CrossRef
Involvement of purinergic signaling on nitric oxide production by neutrophils stimulated with Trichomonas vaginalis Amanda Piccoli Frasson, Geraldo Attilio De Carli, Carla Denise Bonan, Tiana Tasca Purinergic Signalling.2012; 8(1): 1. CrossRef
Leukotriene B4 receptors BLT1 and BLT2 are involved in interleukin-8 production in human neutrophils induced by Trichomonas vaginalis-derived secretory products Young Hee Nam, Arim Min, Seong Hoon Kim, Young Ah Lee, Kyeong Ah Kim, Kyoung-Ju Song, Myeong Heon Shin Inflammation Research.2012; 61(2): 97. CrossRef
Involvement of mast cells in inflammation induced by Trichomonas vaginalis via crosstalk with vaginal epithelial cells I. H. HAN, S. J. PARK, M. H. AHN, J. S. RYU Parasite Immunology.2012; 34(1): 8. CrossRef
Leukotriene B4 receptor BLT-mediated phosphorylation of NF-κB and CREB is involved in IL-8 production in human mast cells induced by Trichomonas vaginalis-derived secretory products Young Hee Nam, Deulle Min, Hyoung-Pyo Kim, Kyoung-Ju Song, Kyeong Ah Kim, Young Ah Lee, Seong Hoon Kim, Myeong Heon Shin Microbes and Infection.2011; 13(14-15): 1211. CrossRef
NF-κB and CREB Are Involved in IL-8 Production of Human Neutrophils Induced byTrichomonas vaginalis-Derived Secretory Products Young Hee Nam, Deulle Min, Soon-Jung Park, Kyeong Ah Kim, Young Ah Lee, Myeong Heon Shin The Korean Journal of Parasitology.2011; 49(3): 291. CrossRef
Trichomoniasis Jae-Sook Ryu Hanyang Medical Reviews.2010; 30(3): 213. CrossRef