Eculiarities of systemic and local immunity in patients with recurrent vulvovaginal candidiasis
DOI:
https://doi.org/10.15574/PP.2024.98.48Keywords:
recurrent vulvovaginal candidiasis, general immunity, local immunity, pro-inflammatory cytokines, anti-inflammatory cytokinesAbstract
Aim - to study the state of general and local immunity in women with recurrent vulvovaginal candidiasis (RVVC); to determine the role of immunity in the pathogenesis and prognosis of disease recurrence.
Materials and methods. A prospective study of systemic and local immunity was carried out - the level of immunocompetent peripheral blood cells (CD3, CD4, CD8, CD16, CD19, CD56) in patients with RVVC and a wide range of cytokines (IL-4, IL-5, IL-6, IL-10, IFN-γ, TNF-α and secretory IgA) in the cells of the vaginal mucosa. The main group (МG) consisted of 70 women of reproductive age with RVVC and 40 healthy women of reproductive age, who made up the control group (CG). Statistical analysis of the obtained data was performed using the "SPSS Statistics" software. Differences at p<0.05 are considered statistically significant.
Results. Average values of the main proinflammatory cytokines IL-6 (135±15 mg/ml vs. 92±12 mg/ml), TNF-α (10±2 mg/ml vs. 5±1 mg/ml), lFN-γ (90±11 mg/ml vs. 20±5 mg/ml) in patients with RVVC significantly exceeded similar indicators in healthy women (p<0.05). The level of the anti-inflammatory cytokine IL-10 was almost twice as low as in CG patients (7±1 pg/ml vs. 11±2 pg/ml, p<0.05). The most pronounced changes are found in patients with RVVK occurring on the bacterial vaginosis - so the level of IL-6 pg/ml in patients was 236±55 pg/ml against 94±12 pg/ml in CG, p<0.001; IL-10 - 5±2 pg/ml versus 11±2 pg/ml, respectively, p<0.05; IFN-γ - 104±3 pg/ml versus 20±5 pg/ml in CG and TNF-α 12±3 pg/ml versus 5±1 pg/ml in CG; p<0.001. In the case of chronic RVVC caused by fungi C. albicans and C. non-albicans species, a significant increase in the content of only IFN-γ was found (90±11 pg/ml vs. 20±5 pg/ml in CG, p<0.001; and 52±11 pg/ml vs. 20±5 pg/ml in CG, p<0.05) and TNF-α (10±2 pg/ml vs. 5±1 pg/ml in CG, p<0.05).
Conclusions. Changes in local immunity play a significant role in the development of RVVC: an increase in the levels of pro-inflammatory cytokines (IL-6, IFN-γ, TNF-α) and a decrease in the level of the anti-inflammatory cytokine IL-l0. The ratio of IFN-γ/IL-l0 is a marker of the severity of the course of RVVC and the frequency of disease relapses.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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