Email this article Comparison of methods for assessing the inflammatory response of the lower parts of the female reproductive tract
- Authors: Budilovskaya O.V.1, Shipitsyna E.V.1, Pereverzeva N.A.2, Vorobyova N.E.1, Spasibova E.V.1, Grigoryev A.N.1, Savicheva A.M.1
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Affiliations:
- Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Microbiomed Ltd
- Issue: Vol 67, No 5 (2018)
- Pages: 13-20
- Section: Articles
- URL: https://journal-vniispk.ru/jowd/article/view/10664
- DOI: https://doi.org/10.17816/JOWD67513-20
- ID: 10664
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Abstract
Hypothesis/aims of study. A lack of timely diagnosis and treatment of inflammatory diseases of the lower genital tract in a woman can lead to serious reproductive disorders. The detection of inflammation is an important component of the diagnosis of these diseases. This study was undertaken to compare methods for detection of local inflammation in women with complaints of vaginal discharge.
Study design, materials, and methods. A total of 87 women having vaginal discharge were enrolled in the study. For the detection of inflammation, vaginal discharge was examined using microscopy and reverse transcriptase polymerase chain reaction (the ImmunoQuantex® test, DNA-Technology Ltd., Moscow, Russia).
Results. Vaginal infections caused by opportunistic microorganisms were detected in 27 women (31%), as follows: candidal vulvovaginitis (CVV) in 10 patients (11.5%), aerobic vaginitis (AV) in 14 patients (16.1%), and bacterial vaginosis (BV) in 14 patients (16.1%), with 8 (9.2%) of them having BV combined with CVV, AV or both infections. The results of the two methods fully agreed in the analysis of samples from women with CVV and AV as vaginal infections characterized by local inflammation. Testing samples from women with BV, which is a non-inflammatory syndrome, as well as women without vaginal infections resulted in significant discrepancies between the two methods. The sensitivity and specificity of the ImmunoQuantex® test compared to the microscopic method were 85.7% and 48.9%, respectively.
Conclusion. The new reverse transcriptase polymerase chain reaction based test for the evaluation of expression profiles of selected genes of immune response enables to assess the local immune status in the vagina. Determination of the presence or absence of inflammatory reaction in the vagina can be used as a diagnostic criterion for resolving discrepancies between laboratory data and clinical manifestations, as well as for choosing effective therapy.
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##article.viewOnOriginalSite##About the authors
Olga V. Budilovskaya
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Author for correspondence.
Email: o.budilovskaya@gmail.com
Researcher. The Laboratory of Microbiology
Russian Federation, Saint PetersburgElena V. Shipitsyna
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: shipitsyna@inbox.ru
PhD, DSci (Biology), Leading Researcher. The Laboratory of Microbiology
Russian Federation, Saint PetersburgNadezhda A. Pereverzeva
Microbiomed Ltd
Email: studentugpi@mail.ru
MD
Russian Federation, Saint PetersburgNadezda E. Vorobyova
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: sergiognezdo@yandex.ru
MD, PhD, Researcher. The Department of Endocrinology of Reproduction
Russian Federation, Saint PetersburgElena V. Spasibova
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: elena.rybina@gmail.com
MD. The Laboratory of Microbiology
Russian Federation, Saint PetersburgAleksey N. Grigoryev
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: galexey08081978@gmail.com
Researcher. The Laboratory of Microbiology
Russian Federation, Saint PetersburgAlevtina M. Savicheva
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: savitcheva@mail.ru
MD, PhD, DSci (Medicine), Professor, Honoured Scholar of the Russian Federation, the Head of the Laboratory of Microbiology
Russian Federation, Saint PetersburgReferences
- Бантьева М.Н., Прилипко Н.С. Возрастные аспекты заболеваемости взрослого населения по обращаемости в амбулаторно-поликлинические учреждения // Социальные аспекты здоровья населения. - 2013. - Т. 32. - № 4. - С. 7-21. [Bantyeva MN, Prilipko NS. Age aspects of the disease incidence rate of adult population. Sotsial’nye aspekty zdorov’ya naseleniya. 2013;32(4):7-21. (In Russ.)]
- Кира Е.Ф. Бактериальный вагиноз. - М.: МИА, 2012. [Kira EF. Bakterial’nyy vaginoz. Moscow: MIA; 2012. (In Russ.)]
- Савичева А.М., Соколовский Е.В., Домейка М. Порядок проведения микроскопического исследования мазков из урогенитального тракта: методические рекомендации для лечащих врачей. - СПб.: Изд-во Н-Л, 2007. [Savicheva AM, Sokolovskiy EV, Domeyka M. Poryadok provedeniya mikroskopicheskogo issledovaniya mazkov iz urogenital’nogo trakta: metodicheskie rekomendatsii dlya lechashchikh vrachey. Saint Petersburg: Izdatel’stvo N-L; 2007. (In Russ.)]
- Bourmenskaya O, Bayramova G, Nepsha O, et al. Vaginal smear TNF-alpha, IL18, TLR4, and GATA3 mRNA levels correlate with local inflammation. International Journal of Biomedicine. 2014;4(4):204-208.
- Донецкова А.Д., Шарова Н.И., Бурменская О.В., и др. Выработка цитокинов эпителиальными клетками тимуса человека // Российский аллергологический журнал. - 2007. - № 3-1. - С. 70. [Donetskova AD, Sharova NI, Burmenskaya OV, et al. Vyrabotka tsitokinov epitelial’nymi kletkami timusa cheloveka. Rossiiskii allergologicheskii zhurnal. 2007;(3-1):70. (In Russ.)]
- Ярилин А.А. Иммунология: учебник. - М.: ГЭОТАР-Медиа, 2010. [Yarilin AA. Immunologiya: uchebnik. Moscow: GEOTAR-Media; 2010. (In Russ.)]
- Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297-301.
- Donders GG. Definition and classification of abnormal vaginal flora. Best Pract Res Clin Obstet Gynaecol. 2007;21(3):355-373. doi: 10.1016/j.bpobgyn.2007.01.002.
- Lamont RF, Taylor-Robinson D. The role of bacterial vaginosis, aerobic vaginitis, abnormal vaginal flora and the risk of preterm birth. BJOG. 2010;117(1):119-120. doi: 10.1111/j.1471-0528.2009.02403.x.
- Бурменская О.В., Байрамова Г.Р., Непша О.С., и др. Состояние локального иммунитета при хроническом рецидивирующем вульвовагинальном кандидозе // Иммунология. - 2011. - Т. 32. - № 3. - С. 154-159. [Burmenskaya OV, Bairamova GR, Nepsha OS, et al. The state of local immunity in patients presenting with chronic recurring vulvovaginal candidosis. Immunologiia. 2011;32(3):154-159. (In Russ.)]
- Савичева А.М., Тапильская Н.И., Шипицына Е.В., Воробьева Н.Е. Бактериальный вагиноз и аэробный вагинит как основные нарушения баланса вагинальной микрофлоры. Особенности диагностики и терапии // Акушерство и гинекология. - 2017. - № 5. - C. 24-31. [Savicheva AM, Tapil’skaya NI, Shipitsyna EV, Vorobyeva NE. Bacterial vaginosis and aerobic vaginitis as major vaginal microflora balance disorders: Diagnostic and therapeutic characteristics. Obstetrics and Gynecology. 2017;(5): 24-31. (In Russ.)]. doi: 10.18565/aig.2017.5.24-31.
- Marrazzo JM, Wiesenfeld HC, Murray PJ, et al. Risk factors for cervicitis among women with bacterial vaginosis. J Infect Dis. 2006;193(5):617-624. doi: 10.1086/500149.
- Taylor BD, Darville T, Haggerty CL. Does bacterial vaginosis cause pelvic inflammatory disease? Sex Transm Dis. 2013;40(2):117-122. doi: 10.1097/OLQ.0b013e31827c5a5b.
- Bautista CT, Wurapa E, Sateren WB, et al. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;3:4. doi: 10.1186/s40779-016-0074-5.
- Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of Bacterial Vaginosis and Associated Risk Factors among Women Complaining of Genital Tract Infection. Int J Microbiol. 2017;2017:4919404. doi: 10.1155/2017/4919404.
- Mastromarino P, Di Pietro M, Schiavoni G, et al. Effects of vaginal lactobacilli in Chlamydia trachomatis infection. Int J Med Microbiol. 2014;304(5-6):654-661. doi: 10.1016/j.ijmm.2014.04.006.
- Breshears LM, Edwards VL, Ravel J, Peterson ML. Lactobacillus crispatus inhibits growth of Gardnerella vaginalis and Neisseria gonorrhoeae on a porcine vaginal mucosa model. BMC Microbiol. 2015;15:276. doi: 10.1186/s12866-015-0608-0.
- Brotman RM, Bradford LL, Conrad M, et al. Association between Trichomonas vaginalis and vaginal bacterial community composition among reproductive-age women. Sex Transm Dis. 2012;39(10):807-812. doi: 10.1097/OLQ.0b013e3182631c79.
- Shukair SA, Allen SA, Cianci GC, et al. Human cervicovaginal mucus contains an activity that hinders HIV-1 movement. Mucosal Immunol. 2013;6(2):427-434. doi: 10.1038/mi.2012.87.
- Cherpes TL, Meyn LA, Krohn MA, et al. Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Clin Infect Dis. 2003;37(3):319-325. doi: 10.1086/375819.
- Kero K, Rautava J, Syrjanen K, et al. Association of asymptomatic bacterial vaginosis with persistence of female genital human papillomavirus infection. Eur J Clin Microbiol Infect Dis. 2017;36(11):2215-2219. doi: 10.1007/s10096-017-3048-y.
- Bretelle F, Rozenberg P, Pascal A, et al. High Atopobium vaginae and Gardnerella vaginalis Vaginal Loads are Associated with Preterm Birth. Clin Infect Dis. 2015;60(6):860-867. doi: 10.1093/cid/ciu966.
- Тютюнник В.Л., Курчакова Т.А., Кан Н.Е., и др. Локальные факторы врожденного иммунитета в прогнозировании преждевременных родов // Акушерство и гинекология. - 2016. - № 10. - С. 59-63. [Tyutyunnik VL, Kurchakova TA, Kan NE, et al. Local factors of innate immunity in the prediction of preterm birth. Obstetrics and Gynecology. 2016;(10):59-63. (In Russ.)]. doi: 10.18565/aig.2016.10.59-63.
- Mirmonsef P, Gilbert D, Zariffard MR, et al. The effects of commensal bacteria on innate immune responses in the female genital tract. Am J Reprod Immunol. 2011;65(3):190-195. doi: 10.1111/j.1600-0897.2010.00943.x.
- Marovt M, Kese D, Kotar T, et al. Ureaplasma parvum and Ureaplasma urealyticum detected with the same frequency among women with and without symptoms of urogenital tract infection. Eur J Clin Microbiol Infect Dis. 2015;34(6):1237-1245. doi: 10.1007/s10096-015-2351-8.
- Glaser K, Silwedel C, Fehrholz M, et al. Ureaplasma isolates stimulate pro-inflammatory CC chemokines and matrix metalloproteinase-9 in neonatal and adult monocytes. PLoS One. 2018;13(3):e0194514. doi: 10.1371/journal.pone.0194514.
- Тютюнник В.Л., Карапетян А.Е., Донников А.Е., и др. Изменения локального и системного иммунитета при оппортунистических инфекциях влагалища у беременных // Акушерство и гинекология. - 2013. - № 8. - С. 25-29. [Tyutyunnik VL, Karapetyan TE, Donnikov AE, et al. Local and systemic immune changes in opportunistic vaginal infections in pregnant women. Obstetrics and Gynecology. 2013;(8):25-29. (In Russ.)]
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