Personal and Clinical Vaginal Lubricants: Impact on Local Vaginal Microenvironment and Implications for Epithelial Cell Host Response and Barrier Function

• Published in: The Journal of infectious diseases 2019-11, Vol.220 (12), p.2009-2018
• Main Authors: Wilkinson, Ellen M, Łaniewski, Paweł, Herbst-Kralovetz, Melissa M, Brotman, Rebecca M
• Format: Article
• Language: English
• Subjects: Biomarkers; Cell culture; Cell viability; Cells, Cultured; Chromatin; Cytokines - metabolism; Cytotoxicity; Epithelial cells; Epithelial Cells - drug effects; Epithelial Cells - metabolism; Female; Humans; Hydrogen-Ion Concentration; Inflammation; Inflammation Mediators - metabolism; Lubricants; Lubricants & lubrication; Lubricants - chemistry; Lubricants - pharmacology; Major and Brief Reports; Morphology; Mucosa; Mucous Membrane - drug effects; Mucous Membrane - physiology; Nonoxynol; Osmolar Concentration; Osmotic pressure; Vagina; Vagina - drug effects; Vagina - metabolism
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiz412

Vaginal lubricants are widely used both in-clinic and for personal use. Here, we employed monolayer and 3-dimensional vaginal epithelial cell models to show that select hyperosmolar lubricants induce cytotoxicity, reduce cell viability, and alter barrier and inflammatory targets. Abstract Background A majority of US women report past use of vaginal lubricants to enhance the ease and comfort of intimate sexual activities. Lubricants are also administered frequently in clinical practice. We sought to investigate if hyperosmolar lubricants are toxic to the vaginal mucosal epithelia. Methods We tested a panel of commercially available lubricants across a range of osmolalities in human monolayer vaginal epithelial cell (VEC) culture and a robust 3-dimensional (3-D) VEC model. The impact of each lubricant on cellular morphology, cytotoxicity, barrier targets, and the induction of inflammatory mediators was examined. Conceptrol, containing nonoxynol-9, was used as a cytotoxicity control. Results We observed a loss of intercellular connections, and condensation of chromatin, with increasing lubricant osmolality. EZ Jelly, K-Y Jelly, Astroglide, and Conceptrol induced cytotoxicity in both models at 24 hours. There was a strong positive correlation (r = 0.7326) between lubricant osmolality and cytotoxicity in monolayer VECs, and cell viability was reduced in VECs exposed to all the lubricants tested for 24 hours, except McKesson. Notably, select lubricants altered cell viability, barrier targets, and inflammatory mediators in 3-D VECs. Conclusions These findings indicate that hyperosmolar lubricants alter VEC morphology and are selectively cytotoxic, inflammatory, and barrier disrupting in the 3-D VEC model.