The innate immune system: gatekeeper to the female reproductive tract.

Abstract

Sexually transmitted diseases (STDs) are a major worldwide health problem that compromise reproductive fecundity as well as cut short the lives of millions of men, women and children.1,2 Despite extensive efforts, only limited success has been achieved in dealing with STDs, including herpes simplex virus type 2 (HSV-2), Chlamydia trachomatis, group B streptococcus and human immunodeficiency virus [(HIV), the causative agent of acquired immune-deficiency syndrome (AIDS)],3 which collectively devastate both adults and newborns. It is now well recognized that the heterosexual transmission of HIV, which is reponsible for 70–80% of the new cases identified in the last 2 years, is the major route of infection worldwide.4,5 With the identification of HIV in semen and cervical secretions,6–8 AIDS is now the major life-threatening STD.9,10 As strategies are developed to prevent and effectively treat this growing global health problem, understanding the immune system in the female reproductive tract and the way it is regulated by the endocrine system has particular importance.