CD4 and bacterial vaginosis: Specifically, the vaginal microbiota stimulates the PRRs in and on epithelial cells lining the vagina and upper genital tract and initializes cytokine signaling cascades.119 For example, the release of interleukin (IL)-1β/6/8 and Tumour Necrosis Factor alpha (TNF-α) recruits or activates immune cells like Natural killer (NK) cells, macrophages, CD4 + helper T-cells, CD8 + cytotoxic T-lymphocytes and B-lymphocytes.120 Bacterial vaginosis (BV) is one of the most common vaginal dysbiosis due to the displacement of Lactobacillus spp and the increased concentration of BVAB.