title: Cervicovaginal inflammatory cytokines and sphingomyelinase in women with and without bacterial vaginosis.
abstract: BACKGROUND
  The objective is to analyze proinflammatory cytokines [interleukin-1β (IL-1β), interleukin-6 and tumor necrosis factor-α] and sphingomyelinase in women with bacterial vaginosis (BV), cervicitis and vaginitis.
  
  
  METHODS
  From January 2009 to June 2010, human immunodeficiency virus (HIV)-negative, nonpregnant, married women, living with husband, aged 20 to 40 years were recruited from a slum at Hyderabad, India, after taking written consent. One hundred forty-six women including 61 women with BV, 47 women with intermediate flora and 38 women with normal vaginal flora were evaluated for local proinflammatory cytokines and sphingomyelinase. Cervicitis and vaginitis were also analyzed by scoring white blood cells in the cervix and vaginal smears, respectively.
  
  
  RESULTS
  Of the 146 women, 50.7% had cervicitis and 19.5% had vaginitis. IL-1β, tumor necrosis factor-α and interleukin-6 levels were significantly high in women with cervicitis (P < 0.001) and vaginitis (P < 0.001) and IL-1β in BV (P < 0.005), intermediate flora (P < 0.05) when compared with normal women. High vaginal pH was associated with IL-1β. Neutral sphingomelinase showed an inverse association (P < 0.05) with cervicitis. Acid sphingomelinase directly correlated with IL-1β although not significantly.
  
  
  CONCLUSIONS
  This study shows proinflammatory response not only in BV but also in women with vaginitis and cervicitis. These conditions are likely to be important in promoting the transmission of HIV-1 and should be the focus of HIV prevention strategies.
authors.affiliation: Department of Health Research, Ministry of Health and Family Welfare, Indian Council of Medical Research, National Institute of Nutrition, Hyderabad, India. rhemalathanin@yahoo.com
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Hemalatha
authors.forename: Baru Anantha
authors.initials: BA
authors.lastname: Ramalaxmi
authors.forename: Gummuluri
authors.initials: G
authors.lastname: KrishnaSwetha
authors.forename: Putcha Uday
authors.initials: PU
authors.lastname: Kumar
authors.forename: Dasari Madusudhan
authors.initials: DM
authors.lastname: Rao
authors.forename: Nagalla
authors.initials: N
authors.lastname: Balakrishna
authors.forename: Vure
authors.initials: V
authors.lastname: Annapurna
mesh_terms: D000328:Adult; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D002584:Cervix Uteri / Q000276:immunology / Q000378:metabolism* / Q000382:microbiology; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007194:India / Q000453:epidemiology; D053583:Interleukin-1beta / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007378:Interleukins / Q000378:metabolism*; D013108:Sphingomyelin Phosphodiesterase / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D002575:Uterine Cervicitis / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism / Q000382:microbiology; D014621:Vagina / Q000276:immunology / Q000378:metabolism* / Q000382:microbiology; D044364:Vaginal Douching; D014627:Vaginitis / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism* / Q000382:microbiology; D055815:Young Adult
chemical_list: D053583:Interleukin-1beta; D015850:Interleukin-6; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D013108:Sphingomyelin Phosphodiesterase