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Alcohol use disorders (AUDs) and cigarette smoking both increase risk for the development of community‐acquired pneumonia (CAP), likely through adverse effects on proximal airway mucociliary clearance and pathogen recognition. Smoking‐related alterations on airway gene expression are well described, but little is known about the impact of AUDs. We measured gene expression in human airway epithelial cells (AECs), hypothesizing that AUDs would be associated with novel differences in gene expression that could alter risk for CAP. Bronchoscopy with airway brushings was performed in participants with AUDs and controls to obtain AECs. An AUD Identification Test was used to define AUD. RNA was extracted from AECs, and mRNA expression data were collected on an Agilent micro‐array. Differential expression analyses were performed on the filtered and normalized data with correction for multiple testing. Enrichment analyses were performed using clusterProfiler. Expression data from 19 control and 18 AUD participants were evaluated. After adjustment for smoking, AUDs were associated with significant differential expression of 520 AEC genes, including genes for ribosomal proteins and genes involved in protein folding. Enrichment analyses indicated significant differential expression of 24 pathways in AUDs, including those implicated in protein targeting to membrane and viral gene expression. Smoking‐associated AEC gene expression differences mirrored previous reports, but differed from those associated with AUDs. AUDs have a distinct impact on AEC gene expression that may influence proximal airway function independent of smoking. Alcohol‐associated alterations may influence risk for CAP through modifying key mechanisms important in protecting proximal airway integrity. Harmful alcohol use has been linked to development of pneumonia, a major cause for hospitalization and the most common cause for sepsis and septic shock. Alcohol use has been linked to abnormalities in upper airway mucociliary clearance that may be partly to blame. In human airways epithelial cells from participants with harmful alcohol use, we observed novel gene expression differences independent of cigarette smoking that may alter risk for pneumonia through compromising mechanisms important in maintaining airways integrity.

Studies reveal that prenatal health-care providers and educators often refrain from discussing sexuality with their patients. The present study explored the relationship between sexuality and pregnancy by considering whether the way in which women view themselves sexually is associated with their experience of pregnancy. Findings revealed that a positive sexual self was significantly related to a positive experience of pregnancy and that particular experiences of pregnancy were more significantly related to how women viewed themselves sexually than others. The findings encourage further discussion regarding the role that comprehensive sex education and training of prenatal health-care providers might play in ultimately establishing open, honest, and nonjudgmental discussions about sexuality between providers and their pregnant patients and partners.

ABSTRACTMen who have sex with men (MSM), regardless of HIV infection status, have an intestinal microbiome that is compositionally distinct from men who have sex with women (MSW) and women. We recently showed HIV-negative MSM have elevated levels of intestinal CD4+T cells expressing CCR5, a critical co-receptor for HIV. Whether elevated expression of CCR5 is driven by the altered gut microbiome composition in MSM has not been explored. Here we used in vitrostimulation of gut Lamina Propria Mononuclear Cells (LPMCs) with whole intact microbial cells isolated from stool to demonstrate that fecal bacterial communities (FBCs) from HIV-positive/negative MSM induced higher frequencies of CCR5+CD4+T cells compared to FBCs from HIV-negative MSW and women. To identify potential microbial drivers, we related the frequency of CCR5+CD4+T cells to the abundance of individual microbial taxa in rectal biopsy of HIV-positive/negative MSM and controls, and Holdemanella biformiswas strongly associated with increased frequency of CCR5+CD4+T cells. We used in vitrostimulation of gut LPMCs with the type strain of H. biformis, a second strain of H.biformisand an isolate of the closely related Holdemanella porci , cultured from either a HIV-positive or a HIV-negative MSM stool. H. porcielevated the frequency of both CCR5+CD4+T cells and the ratio of TNF-α/IL-10 Genomic comparisons of the 3 Holdemanellaisolates revealed unique cell wall and capsular components, which may be responsible for their differences in immunogenicity. These findings describe a novel mechanism potentially linking intestinal dysbiosis in MSM to HIV transmission and mucosal pathogenesis.