Hyaluronan in vaginal secretions: association with recurrent vulvovaginal candidiasis.
OBJECTIVE
We evaluated whether vaginal concentrations of hyaluronan were altered in women with recurrent vulvovaginal candidiasis (RVVC).


METHODS
Lavage samples from 17 women with acute RVVC, 27 women who were receiving a maintenance antifungal regimen, and 24 control women were tested for hyaluronan and interleukin (IL)-6, IL-12, and IL-23 by enzyme-linked immunosorbent assay.


RESULTS
Median vaginal hyaluronan concentrations were 33.8 ng/mL (range, 21.6-66.3 ng/mL) in women with acute RVVC, 15.0 ng/mL (range, 11.2-50.6 ng/mL) in women who were receiving maintenance therapy, and 4.2 ng/mL (range, 3.6-12.0 ng/mL) in control subjects (P </= .02). The vaginal hyaluronan concentration was 27.4 ng/mL (range, 15.4-37.7 ng/mL) when Candida was detected by microscopy and 9.5 ng/mL (range, 7.7-14.6 ng/mL) in microscopy-negative cases (P = .0354). Elevated hyaluronan levels were associated with itching plus burning (40.7 ng/mL) or itching plus discharge (42.1 ng/mL), as opposed to itching only (6.2 ng/mL; P = .0152). Hyaluronan and IL-6 levels were correlated (P = .0009).


CONCLUSIONS
Hyaluronan release is a component of the host response to a candidal infection and may contribute to symptoms.
Lev-Sagie
Ahinoam
A
Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY 10065, USA.
Nyirjesy
Paul
P
Tarangelo
Nicholas
N
Bongiovanni
Ann Marie
AM
Bayer
Cynthia
C
Linhares
Iara M
IM
Giraldo
Paulo C
PC
Ledger
William J
WJ
Witkin
Steven S
SS
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001826:Body Fluids / Q000276:immunology / Q000378:metabolism*; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism*; D018664:Interleukin-12 / Q000378:metabolism; D053759:Interleukin-23 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008875:Middle Aged; D012008:Recurrence; D007507:Therapeutic Irrigation; D014621:Vagina / Q000276:immunology / Q000378:metabolism*
D000935:Antifungal Agents; C508600:IL6 protein, human; D053759:Interleukin-23; D015850:Interleukin-6; D018664:Interleukin-12; D006820:Hyaluronic Acid