title: Differences in inflammatory cytokine and Toll-like receptor genes and bacterial vaginosis in pregnancy.
abstract: OBJECTIVE
  This study was undertaken to estimate the frequency of inflammatory cytokine and Toll-like receptor gene polymorphisms in women with and without bacterial vaginosis (BV) in pregnancy.
  
  
  METHODS
  A secondary analysis was performed of pregnant women at less than 30 weeks' gestation enrolled as part of 2 multicenter studies. Eight hundred eighty-five women were assessed for BV (defined as Nugent's vaginal Gram stain score 7-10 and a pH > 4.5). Comparisons were made between women with or without BV. Extracted maternal DNA was analyzed for 7 cytokine (interleukin [IL] 1beta-511, IL1beta Exon 5 +3954, IL6-174, IL8-845, IL10-1082, tumor necrosis factor alpha-238 [TNFalpha-238], TNFalpha-308) and 2 Toll-like receptor (TLR-4 299, TLR-4 399) gene polymorphisms.
  
  
  RESULTS
  BV was diagnosed in 497 women and 388 did not have BV. Genotype and allele frequency analyses revealed associations with BV and polymorphisms at the IL1beta Exon 5 +3954, IL6-174, IL10-1082, and TLR-4 399 loci. Women with BV were less likely to be homozygous (C/C) for IL1beta Exon 5 +3954 (P = .04). Women with BV were also less likely to have polymorphisms at the IL10-1082 (P = .03) and TLR-4 399 (P = .04) loci in the univariate analysis. Women with BV were more likely to be heterozygous (G/C) for the IL6-174 genotype (P < .0001). Multivariate analysis, controlling for maternal race, confirmed the following associations with BV: IL1beta Exon 5 +3954 (odds Ratio [OR] 0.5, 95% CI 0.3-0.9) and IL6-174 (OR 2.2, 95% CI 1.6-3.1). In addition, polymorphism at the IL8-845 locus was associated with a decreased risk for BV (OR 0.6, 95% CI 0.4-1.0).
  
  
  CONCLUSIONS
  After controlling for race, polymorphisms at the IL1beta Exon 5 +3954, IL6-174, and IL8-845 loci were associated with an altered rate of BV in pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Alabama, Birmingham, AL, USA.
authors.forename: Alice R
authors.initials: AR
authors.lastname: Goepfert
authors.forename: Michael
authors.initials: M
authors.lastname: Varner
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ward
authors.forename: Cora
authors.initials: C
authors.lastname: Macpherson
authors.forename: Mark
authors.initials: M
authors.lastname: Klebanoff
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
authors.forename: Brian
authors.initials: B
authors.lastname: Mercer
authors.forename: Paul
authors.initials: P
authors.lastname: Meis
authors.forename: Jay
authors.initials: J
authors.lastname: Iams
authors.forename: Atef
authors.initials: A
authors.lastname: Moawad
authors.forename: J Chris
authors.initials: JC
authors.lastname: Carey
authors.forename: Kenneth
authors.initials: K
authors.lastname: Leveno
authors.forename: Ronald
authors.initials: R
authors.lastname: Wapner
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: J Peter
authors.initials: JP
authors.lastname: Van Dorsten
authors.forename: Oded
authors.initials: O
authors.lastname: Langer
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications* / Q000276:immunology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D018121:Receptors, Cytokine / Q000235:genetics*; D051193:Toll-Like Receptors / Q000235:genetics*; D014621:Vagina / Q000166:cytology / Q000276:immunology*; D014623:Vaginal Diseases / Q000276:immunology / Q000382:microbiology*
chemical_list: D018121:Receptors, Cytokine; D051193:Toll-Like Receptors