LOCAL IMMUNITY DURING THERAPY FOR CANDIDA VAGINITIS DURING PREGNANCY
- Authors: TYUTYUNNIK V.L1, KAN N.E1, BALUSHKINA A.A1, KARAPETYAN T.E1
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Affiliations:
- Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
- Issue: No 6 (2015)
- Pages: 71-78
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/247407
- ID: 247407
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Abstract
Objective. To study the local immunity of pregnant women with Candida vaginitis (CV) and to evaluate the efficiency of etiotropic therapy. Subjects and methods. A prospective cohort study of 125 women was conducted. A study group comprised 54 patients with CV; a comparison group consisted of 71 patients with vaginal normocenosis. Enzyme immunoassay was used to determine the concentrations of proinflammatory (TNF-α, IFN-γ, IL-1α, IL-2, and IL-6) and anti-inflammatory (IL-4, IL-10) cytokines in the cervical canal of women with the second and third trimesters of pregnancy; the mRNA gene expression of the above cytokines was estimated. The clinical and microbiological efficiency of topical therapy for CV was evaluated. Results. The study group, unlike the comparison one, was found to have significantly high pretreatment concentrations of the following cytokines: TNF-α, IFN-γ, IL-6, IL-1α, and IL-2. With their significant posttreatment reductions, the mean second-trimester levels of IFN-y and IL-1α were higher than those in the vaginal normocenosis group. The study group showed a strong inverse correlation in the production of IL-6 and IL-10 (r = -0.858) and no correlation between the concentrations of IL-6 and IL-4 (r = -0.02). In the pregnant women with CV, there was a statistically significantly higher pretreatment mRNA gene expression of both proinflammatory (IL-6, LIF) and anti-inflammatory (IL-10) cytokines. The clinical and microbiological efficiency of CV treatment was 92.6%; a disease recurrence was detected in 3 (5.6%) patients in the third trimester. Conclusion. In the pregnant women with CV, pretreatment local immunity is characterized by a significant increase in the higher levels of pro- and anti-inflammatory cytokines in reference with their production in those with normocenosis. The use of topical agents is pathogenetically sound as an inflammatory response becomes normal, by lowering the expression of the proinflammatory cytokines.
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About the authors
V. L TYUTYUNNIK
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: tioutiounnik@mail.ru
PhD, MD, the head of the obstetric physiological department Moscow 117997, Ac. Oparina str. 4, Russia
N. E KAN
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: n_kan@oparina4.ru
PhD, MD, the head of the obstetric observation department Moscow 117997, Ac. Oparina str. 4, Russia
A. A BALUSHKINA
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: ann.balushkina@gmail.com
obstetrician-gynecologist of the obstetric observation department Moscow 117997, Ac. Oparina str. 4, Russia
T. E KARAPETYAN
Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: t_karapetyan@oparina4.ru
PhD, MD, senior research scientist of the obstetric observation department Moscow 117997, Ac. Oparina str. 4, Russia
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