Semen contains potent soluble proteins, bacteria, viruses, activated immune cells as well as anti- and pro-inflammatory cytokines that may influence the inflammatory response and alter microbial composition of the female genital tract. The presence of semen in the female genital mucosa may be a significant confounder that most studies have failed to control for in their analysis. Prostate-specific antigen (PSA), a protein secreted by the prostate into the urethra during ejaculation, is a well-established biomarker of semen exposure. Several studies have demonstrated discordance between self-reports of sexual behavior and the presence of PSA. Recent semen exposure has been shown to promote pro-inflammatory responses, stimulate the recruitment of activated immune cells and decrease Lactobacilli abundance in the female genital mucosa. As a result, it is important to understand the concordance between self-reported consistent condom use and the presence of semen biomarkers. Furthermore, to ensure that the interpretation of data in clinical studies of the immunological and microbial environment in the female genital mucosa are accurate, it is essential to establish whether semen is present in the vaginal fluid. This review explores the impact of semen exposure on the mucosal microenvironment and assesses the use of the PSA as an objective biomarker of semen exposure to reduce reliance on self-reported sexual intercourse.

精液含有有效的可溶性蛋白质、细菌、病毒、激活的免疫细胞以及抗炎和促炎细胞因子，这些细胞因子可能会影响炎症反应并改变女性生殖道的微生物组成。女性生殖器黏膜中精液的存在可能是一个重要的混杂因素，大多数研究在他们的分析中未能控制。前列腺特异性抗原 (PSA) 是前列腺在射精过程中分泌到尿道中的一种蛋白质，是公认的精液暴露生物标志物。几项研究表明，性行为的自我报告与 PSA 的存在之间存在不一致。最近的精液暴露已被证明可促进促炎反应，刺激活化免疫细胞的募集并降低女性生殖器粘膜中的乳酸杆菌丰度。因此，重要的是要了解自我报告的一致使用安全套与精液生物标志物存在之间的一致性。此外，为了确保对女性生殖器黏膜免疫学和微生物环境临床研究数据的解释准确，必须确定精液是否存在于阴道液中。本综述探讨了精液暴露对黏膜微环境的影响，并评估了使用 PSA 作为精液暴露的客观生物标志物，以减少对自我报告的性交的依赖。为确保对女性生殖器黏膜免疫和微生物环境临床研究数据的解读准确无误，必须确定精液是否存在于阴道液中。本综述探讨了精液暴露对黏膜微环境的影响，并评估了使用 PSA 作为精液暴露的客观生物标志物，以减少对自我报告的性交的依赖。为确保对女性生殖器黏膜免疫和微生物环境临床研究数据的解读准确无误，必须确定精液是否存在于阴道液中。本综述探讨了精液暴露对黏膜微环境的影响，并评估了使用 PSA 作为精液暴露的客观生物标志物，以减少对自我报告的性交的依赖。