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Wasti S, Sah N, Kuehu DL, Kim YS, Jha R, Mishra B. Expression of follistatin is associated with egg formation in the oviduct of laying hens. Anim Sci J 2020; 91:e13396. [PMID: 32468659 DOI: 10.1111/asj.13396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 03/20/2020] [Accepted: 04/01/2020] [Indexed: 12/15/2022]
Abstract
The objective of this study was to examine the expression profiles of follistatin (FST) and its associated molecules (MSTN, INHA, INHBB, INHBA, ACVR2A, and ACVR2B) in the oviduct of laying hens at 3 hr and 20 hr post-ovulation (p.o., n = 5; 35 weeks old), molting (n = 5; 60 weeks old), and non-laying (n = 4; 35-60 weeks old) hens and also to localize the FST by using immunohistochemistry assay. Expression of FST was significantly higher (p < .05), and MSTN was lower in the uterus of laying hens around 15-20 hr p.o. (during eggshell formation), however, their expressions in the magnum remain unchanged across different physiological stages of hens. FST was mainly expressed in the luminal and glandular epithelium of the uterine tissues, and their expression intensity was highest in laying hens during the eggshell mineralization. There was a relatively increased expression of INHA in the magnum of laying hens around 3 hr p.o. as compared to non-laying and molting hens. At the same time (3 hr p.o.), there was a significant (p < .05) decrease in the expression of the INHBB, ACVR2A, and ACV2B. These results indicate that follistatin may regulate the differentiation of uterine luminal and glandular epithelium during eggshell biomineralization.
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Affiliation(s)
- Sanjeev Wasti
- Department of Human Nutrition Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Nirvay Sah
- Department of Human Nutrition Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Donna L Kuehu
- Department of Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yong S Kim
- Department of Human Nutrition Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Rajesh Jha
- Department of Human Nutrition Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Birendra Mishra
- Department of Human Nutrition Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
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2
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Wijayarathna R, Hedger MP. Activins, follistatin and immunoregulation in the epididymis. Andrology 2019; 7:703-711. [DOI: 10.1111/andr.12682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 12/21/2022]
Affiliation(s)
- R. Wijayarathna
- Centre for Reproductive Health Hudson Institute of Medical Research Clayton Vic. Australia
- Department of Molecular and Translational Sciences School of Clinical Sciences Monash University Clayton Vic. Australia
| | - M. P. Hedger
- Centre for Reproductive Health Hudson Institute of Medical Research Clayton Vic. Australia
- Department of Molecular and Translational Sciences School of Clinical Sciences Monash University Clayton Vic. Australia
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Fullerton PT, Monsivais D, Kommagani R, Matzuk MM. Follistatin is critical for mouse uterine receptivity and decidualization. Proc Natl Acad Sci U S A 2017; 114:E4772-E4781. [PMID: 28559342 PMCID: PMC5474784 DOI: 10.1073/pnas.1620903114] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Embryo implantation remains a significant challenge for assisted reproductive technology, with implantation failure occurring in ∼50% of in vitro fertilization attempts. Understanding the molecular mechanisms underlying uterine receptivity will enable the development of new interventions and biomarkers. TGFβ family signaling in the uterus is critical for establishing and maintaining pregnancy. Follistatin (FST) regulates TGFβ family signaling by selectively binding TGFβ family ligands and sequestering them. In humans, FST is up-regulated in the decidua during early pregnancy, and women with recurrent miscarriage have lower endometrial expression of FST during the luteal phase. Because global knockout of Fst is perinatal lethal in mice, we generated a conditional knockout (cKO) of Fst in the uterus using progesterone receptor-cre to study the roles of uterine Fst during pregnancy. Uterine Fst-cKO mice demonstrate severe fertility defects and deliver only 2% of the number of pups delivered by control females. In Fst-cKO mice, the uterine luminal epithelium does not respond properly to estrogen and progesterone signals and remains unreceptive to embryo attachment by continuing to proliferate and failing to differentiate. The uterine stroma of Fst-cKO mice also responds poorly to artificial decidualization, with lower levels of proliferation and differentiation. In the absence of uterine FST, activin B expression and signaling are up-regulated, and bone morphogenetic protein (BMP) signals are impaired. Our findings support a model in which repression of activin signaling by FST enables uterine receptivity by preserving critical BMP signaling.
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Affiliation(s)
- Paul T Fullerton
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX 77030
- Center for Drug Discovery, Baylor College of Medicine, Houston, TX 77030
| | - Diana Monsivais
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX 77030
- Center for Drug Discovery, Baylor College of Medicine, Houston, TX 77030
| | - Ramakrishna Kommagani
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030
| | - Martin M Matzuk
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030;
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX 77030
- Center for Drug Discovery, Baylor College of Medicine, Houston, TX 77030
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030
- Department of Pharmacology, Baylor College of Medicine, Houston, TX 77030
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Wijayarathna R, Sarraj MA, Genovese R, Girling JE, Michel V, Ludlow H, Loveland KL, Meinhardt A, de Kretser DM, Hedger MP. Activin and follistatin interactions in the male reproductive tract: activin expression and morphological abnormalities in mice lacking follistatin 288. Andrology 2017; 5:578-588. [PMID: 28235253 DOI: 10.1111/andr.12337] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 12/12/2016] [Accepted: 01/11/2017] [Indexed: 12/29/2022]
Abstract
Activin A is an important regulator of testicular and epididymal development and function, as well as inflammation and immunity. In the adult murine reproductive tract, activin A mRNA (Inhba) expression levels are highest in the caput epididymis and decrease progressively towards the distal vas deferens. The activin-binding protein, follistatin (FST), shows the opposite expression pattern, with exceptionally high levels of the Fst288 mRNA variant in the vas deferens. This unique pattern of expression suggests that activin A and follistatin, in particular FST288, play region-specific roles in regulating the epididymis and vas deferens. The cellular distribution of activin and follistatin and structural organization of the male reproductive tract was examined in wild-type and transgenic (TghFST315) mice lacking FST288. Compared to wild-type littermates, TghFST315 mice showed a 50% reduction in serum follistatin and a significant elevation of both activin A and B. Testicular, epididymal and seminal vesicle weights were reduced, but intra-testicular testosterone was normal. A decrease in the epididymal duct diameter in the corpus and thickening of the peritubular smooth muscle in the cauda, together with increased coiling of the proximal vas deferens, were observed in TghFST315 mice. No immune cell infiltrates were detected. Immunohistochemistry indicated that epithelial cells are the main source of activins and follistatin in the epididymis and vas deferens. Activin A, but not activin B, was also localized to sperm heads in the lumen of the epididymis and vas deferens. Expression of Inhba and another immunoregulatory gene, indoleamine-2,3-dioxygenase (Ido-1), was increased approximately twofold in the TghFST315 caput epididymis, but several other genes associated with immunoregulation, inflammation or fibrosis were unaffected. Our novel data indicate that disruption of follistatin expression has significant effects on the testis and epididymis, and suggest an association between activin A and indoleamine-2,3-dioxygenase in the caput epididymis, with implications for the epididymal immunoenvironment.
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Affiliation(s)
- R Wijayarathna
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia.,Department of Anatomy and Cell Biology, Justus-Liebig University, Giessen, Germany
| | - M A Sarraj
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - R Genovese
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - J E Girling
- Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne and Royal Women's Hospital, Parkville, VIC, Australia
| | - V Michel
- Department of Anatomy and Cell Biology, Justus-Liebig University, Giessen, Germany
| | - H Ludlow
- Oxford Brookes University, Oxford, UK
| | - K L Loveland
- Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia.,School of Clinical Sciences, Monash University, Monash Medical Centre, Clayton, VIC, Australia
| | - A Meinhardt
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia.,Department of Anatomy and Cell Biology, Justus-Liebig University, Giessen, Germany
| | - D M de Kretser
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - M P Hedger
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
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Holdsworth-Carson SJ, Zhao D, Cann L, Bittinger S, Nowell CJ, Rogers PAW. Differences in the cellular composition of small versus large uterine fibroids. Reproduction 2016; 152:467-80. [PMID: 27528771 DOI: 10.1530/rep-16-0216] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/15/2016] [Indexed: 12/19/2022]
Abstract
Uterine fibroids are clonally derived from a single cell; however, despite being monoclonal, the cellular phenotypes that make up uterine fibroids are heterogeneous consisting of predominantly smooth muscle cells (SMC) and fibroblasts. This raises the question as to when clonal cell differentiation occurs during fibroid development, and does this information provide clues about possible mechanisms regulating the growth process that leads to fibroids of symptom-causing size? This study investigated the differences in the cellular composition of fibroids by immunohistochemistry (IHC). A tissue microarray (n = 21 hysterectomy cases) was used for the investigation of large uterine fibroids and normal myometrium. An investigation of small fibroids (≤ 5mm) used a separate group of samples (n = 7 hysterectomy cases, total of n = 17 fibroids). A panel of cell phenotypic markers was selected based on our previous in situ investigations and included aldehyde dehydrogenase 1 (ALDH1A1) and vimentin for different fibroblast sub-populations, smooth muscle actin (SMA) as a marker for SMCs, CD31 for endothelial cells and CD45 for leucocytes. Proliferating cell nuclear antigen (PCNA) was also studied to identify proliferating cells. The cellular composition of small fibroids differs significantly from large fibroids. Small fibroids are more cellular (increased cells/mm(2)) than large fibroids, have more blood vessels and also have a higher ratio of SMC to fibroblasts than large fibroids. Large fibroids have more cell proliferation (measured by PCNA) and fewer leucocytes (measured by CD45) than adjacent myometrium, whereas small fibroids are less proliferative and have similar number of leucocytes to myometrium. Different cellular composition between fibroids of different sizes may provide important clues as to the mechanisms that drive fibroid growth.
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Affiliation(s)
- Sarah J Holdsworth-Carson
- Department of Obstetrics and GynaecologyUniversity of Melbourne, Gynaecology Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Dong Zhao
- Department of Obstetrics and GynaecologyUniversity of Melbourne, Gynaecology Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia Department of Minimally Invasive Gynecologic SurgeryShanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Leonie Cann
- Department of Obstetrics and GynaecologyUniversity of Melbourne, Gynaecology Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Sophie Bittinger
- Department of Anatomical PathologyRoyal Women's Hospital, Parkville, Victoria, Australia
| | - Cameron J Nowell
- Monash Institute of Pharmaceutical SciencesMonash University, Parkville, Victoria, Australia
| | - Peter A W Rogers
- Department of Obstetrics and GynaecologyUniversity of Melbourne, Gynaecology Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia
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Wijayarathna R, de Kretser DM. Activins in reproductive biology and beyond. Hum Reprod Update 2016; 22:342-57. [PMID: 26884470 DOI: 10.1093/humupd/dmv058] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/20/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Activins are members of the pleiotrophic family of the transforming growth factor-beta (TGF-β) superfamily of cytokines, initially isolated for their capacity to induce the release of FSH from pituitary extracts. Subsequent research has demonstrated that activins are involved in multiple biological functions including the control of inflammation, fibrosis, developmental biology and tumourigenesis. This review summarizes the current knowledge on the roles of activin in reproductive and developmental biology. It also discusses interesting advances in the field of modulating the bioactivity of activins as a therapeutic target, which would undoubtedly be beneficial for patients with reproductive pathology. METHODS A comprehensive literature search was carried out using PUBMED and Google Scholar databases to identify studies in the English language which have contributed to the advancement of the field of activin biology, since its initial isolation in 1987 until July 2015. 'Activin', 'testis', 'ovary', 'embryonic development' and 'therapeutic targets' were used as the keywords in combination with other search phrases relevant to the topic of activin biology. RESULTS Activins, which are dimers of inhibin β subunits, act via a classical TGF-β signalling pathway. The bioactivity of activin is regulated by two endogenous inhibitors, inhibin and follistatin. Activin is a major regulator of testicular and ovarian development. In the ovary, activin A promotes oocyte maturation and regulates granulosa cell steroidogenesis. It is also essential in endometrial repair following menstruation, decidualization and maintaining pregnancy. Dysregulation of the activin-follistatin-inhibin system leads to disorders of female reproduction and pregnancy, including polycystic ovary syndrome, ectopic pregnancy, miscarriage, fetal growth restriction, gestational diabetes, pre-eclampsia and pre-term birth. Moreover, a rise in serum activin A, accompanied by elevated FSH, is characteristic of female reproductive aging. In the male, activin A is an autocrine and paracrine modulator of germ cell development and Sertoli cell proliferation. Disruption of normal activin signalling is characteristic of many tumours affecting reproductive organs, including endometrial carcinoma, cervical cancer, testicular and ovarian cancer as well as prostate cancer. While activin A and B aid the progression of many tumours of the reproductive organs, activin C acts as a tumour suppressor. Activins are important in embryonic induction, morphogenesis of branched glandular organs, development of limbs and nervous system, craniofacial and dental development and morphogenesis of the Wolffian duct. CONCLUSIONS The field of activin biology has advanced considerably since its initial discovery as an FSH stimulating agent. Now, activin is well known as a growth factor and cytokine that regulates many aspects of reproductive biology, developmental biology and also inflammation and immunological mechanisms. Current research provides evidence for novel roles of activins in maintaining the structure and function of reproductive and other organ systems. The fact that activin A is elevated both locally as well as systemically in major disorders of the reproductive system makes it an important biomarker. Given the established role of activin A as a pro-inflammatory and pro-fibrotic agent, studies of its involvement in disorders of reproduction resulting from these processes should be examined. Follistatin, as a key regulator of the biological actions of activin, should be evaluated as a therapeutic agent in conditions where activin A overexpression is established as a contributing factor.
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Affiliation(s)
- R Wijayarathna
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, VIC 3800, Australia Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31, Wright Street, Clayton, VIC 3168, Australia
| | - D M de Kretser
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, VIC 3800, Australia Centre for Reproductive Health, Hudson Institute of Medical Research, 27-31, Wright Street, Clayton, VIC 3168, Australia
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Sharkey DJ, Schjenken JE, Mottershead DG, Robertson SA. Seminal fluid factors regulate activin A and follistatin synthesis in female cervical epithelial cells. Mol Cell Endocrinol 2015; 417:178-90. [PMID: 26415587 DOI: 10.1016/j.mce.2015.09.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/28/2015] [Accepted: 09/22/2015] [Indexed: 12/16/2022]
Abstract
Seminal fluid induces pro-inflammatory cytokines and elicits an inflammation-like response in the cervix. Here, Affymetrix microarray and qPCR was utilised to identify activin A (INHBA) and its inhibitor follistatin (FST) amongst the cytokines induced by seminal plasma in Ect1 ectocervical epithelial cells, and a similar response was confirmed in primary ectocervical epithelial cells. TGFB is abundant in seminal plasma and all three TGFB isoforms induced INHBA in Ect1 and primary cells, and neutralisation of TGFB in seminal plasma suppressed the INHBA response. Bacterial lipopolysaccharide in seminal plasma also elicited INHBA, but potently suppressed FST production. There was moderate reciprocal inhibition between FST and INHBA, and cross-attenuating effects were seen. These data identify TGFB and potentially LPS as factors mediating seminal plasma-induced INHBA synthesis in cervical cells. INHBA and FST induced by seminal fluid in cervical tissues may thus contribute to regulation of the post-coital response in women.
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Affiliation(s)
- David J Sharkey
- Robinson Research Institute and School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - John E Schjenken
- Robinson Research Institute and School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - David G Mottershead
- Robinson Research Institute and School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Sarah A Robertson
- Robinson Research Institute and School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
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Winnall WR, Lloyd SB, De Rose R, Alcantara S, Amarasena TH, Hedger MP, Girling JE, Kent SJ. Simian immunodeficiency virus infection and immune responses in the pig-tailed macaque testis. J Leukoc Biol 2015; 97:599-609. [PMID: 25605872 DOI: 10.1189/jlb.4a0914-438r] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The testis is a site of immune privilege in rodents, and there is evidence that T cell responses are also suppressed in the primate testis. Local immunosuppression is a potential mechanism for HIV persistence in tissue reservoirs that few studies have examined. The response of the pig-tailed macaque testis to SIVmac239 infection was characterized to test this possibility. Testes were surgically removed during early-chronic (10 wk) and late-chronic (24-30 wk) SIV infection in 4 animals and compared with those from 7 uninfected animals. SIV infection caused only minor disruption to the seminiferous epithelium without marked evidence of inflammation or consistent changes in total intratesticular leukocyte numbers. Infection also led to an increase in the relative proportion of testicular effector memory CD8(+) T cell numbers and a corresponding reduction in central memory CD4(+) T cells. A decrease in the relative proportion of resident-type CD163(+) macrophages and DCs was also observed. SIV-specific CD8(+) T cells were detectable in the testis, 10-11 wk after infection by staining with SIV Gag-specific or Tat-specific MHC-I tetramers. However, testicular CD8(+) T cells from the infected animals had suppressed cytokine responses to mitogen activation. These results support the possibility that local immunosuppression in the testis may be restricting the ability of T cells to respond to SIV or HIV infection. Local immunosuppression in the testis may be an underexplored mechanism allowing HIV persistence.
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Affiliation(s)
- Wendy R Winnall
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Sarah B Lloyd
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Robert De Rose
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Sheilajen Alcantara
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Thakshila H Amarasena
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Mark P Hedger
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Jane E Girling
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Stephen J Kent
- *Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Centre for Reproductive Health, Monash Institute of Medical Research-Prince Henry's Institute of Medical Research, Victoria, Australia; and Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia
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