Modulation of vaginal immune response among pregnant women with bacterial vaginosis by Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and yeast.
OBJECTIVE
This study was undertaken to examine the influence of coinfections on vaginal innate and adaptive immunity, and microbial enzyme activities of pregnant women with bacterial vaginosis (BV).


METHODS
The population consisted of 265 singleton pregnant women in early gestation (<20 weeks) with BV (Nugent 7-10) who had vaginal fluid collected for measurement of interleukin-1beta (IL-1beta) and IL-8 concentrations, number of neutrophils, immunoglobulin A against Gardnerella vaginalis (anti-Gvh IgA), and activities of microbial sialidase and prolidase.


RESULTS
Among women with BV, median levels of vaginal IL-1beta (4-fold, P = .005), IL-8 (4-fold, P < .001), and neutrophils (6-fold, P = .013) were greatly increased in women with T vaginalis with respect to women without any coinfection. Yeast increased the level of IL-8 (5-fold, P < .001), but not IL-1beta (P = .239) and neutrophils (P = .060). Chlamydia trachomatis and Neisseria gonorrhoeae had no effect on vaginal cytokines. None of the coinfections influenced vaginal anti-Gvh IgA, sialidase and prolidase activities.


CONCLUSIONS
The strong proinflammatory cytokine induction by T. vaginalis may contribute to the observed increase in preterm birth among BV positive women coinfected with T. vaginalis treated with metronidazole.
Cauci
Sabina
S
Department of Biomedical Sciences and Technologies, School of Medicine, University of Udine, Italy. scauci@mail.dstb.uniud.it
Culhane
Jennifer Flatow
JF
D000328:Adult; D000818:Animals; D002690:Chlamydia Infections / Q000276:immunology; D002692:Chlamydia trachomatis; D004150:Dipeptidases / Q000032:analysis; D005260:Female; D006069:Gonorrhea / Q000276:immunology; D006801:Humans; D007109:Immunity; D007113:Immunity, Innate; D007070:Immunoglobulin A / Q000276:immunology; D053583:Interleukin-1beta / Q000032:analysis / Q000276:immunology; D016209:Interleukin-8 / Q000032:analysis / Q000276:immunology; D007958:Leukocyte Count; D009181:Mycoses / Q000276:immunology; D009439:Neuraminidase / Q000032:analysis; D009504:Neutrophils / Q000276:immunology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000201:enzymology / Q000276:immunology*; D014245:Trichomonas Infections / Q000276:immunology; D014246:Trichomonas vaginalis; D014621:Vagina / Q000276:immunology*; D016585:Vaginosis, Bacterial / Q000201:enzymology / Q000276:immunology*
D007070:Immunoglobulin A; D053583:Interleukin-1beta; D016209:Interleukin-8; D009439:Neuraminidase; D004150:Dipeptidases; C022449:proline dipeptidase