title: Vaginal cytokines do not differ between postmenopausal women with and without symptoms of vulvovaginal irritation.
abstract: OBJECTIVE
  The aim of this exploratory pilot study was to determine if there are differences in vaginal cytokine levels between postmenopausal women with and without vulvovaginal irritative symptoms (itching, burning, or pain).
  
  
  METHODS
  Postmenopausal women (n = 34) not using hormone therapy and presenting with or without symptoms of vulvovaginal irritation were asked to volunteer for this study. Each participant underwent a vaginal examination and screening for vaginitis using Amsel criteria, pH, and light microscopy. A vaginal lavage with 5.0 mL of sterile saline was carried out, and a peripheral blood sample was obtained. The vaginal lavage and serum samples were assayed for interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α by specific enzyme-linked immunosorbent assays. Results were adjusted for total protein concentration and presented as the amount of cytokines per protein (pg/μg protein). Statistical analysis was performed using SAS version 9.3 (SAS Institute, Cary, NC). The means and SDs of all variables among women with and without vulvovaginal irritation were compared using independent-samples Student's t test.
  
  
  RESULTS
  A total of 26 postmenopausal women were enrolled into the study (symptomatic, n = 15; asymptomatic, n = 11). The mean (SD) vaginal pH for all participants was 5.9 (1.2). There were no significant differences (P > 0.05) in age, age at menopause, vaginal pH, and vaginal and serum cytokines and chemokines (IL-1β, IL-6, IL-8, and tumor necrosis factor-α) among symptomatic versus asymptomatic women. IL-8 was the most abundant vaginal cytokine, with mean (SD) vaginal IL-8 levels being 4.1 (3.4) and 3.1 (3.9) pg/μg protein in the symptomatic versus asymptomatic groups, respectively (P = 0.55). There were no significant linear correlations (P > 0.05) between serum and vaginal cytokine levels for all endpoints.
  
  
  CONCLUSIONS
  The presence or absence of postmenopausal vulvovaginal symptoms does not significantly differentiate vaginal inflammatory markers. Serum and vaginal cytokines are not significantly linearly correlated among postmenopausal women with and without symptoms commonly associated with vaginal atrophy, implying that this is a local reaction.
authors.affiliation: From the 1Department of Obstetrics and Gynecology, University of Berne, Berne, Switzerland; and 2The Clinical Research Center, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.
authors.forename: Petra
authors.initials: P
authors.lastname: Stute
authors.forename: Zahraa
authors.initials: Z
authors.lastname: Kollmann
authors.forename: Nick
authors.initials: N
authors.lastname: Bersinger
authors.forename: Michael
authors.initials: M
authors.lastname: von Wolff
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Thurman
authors.forename: David F
authors.initials: DF
authors.lastname: Archer
mesh_terms: D000328:Adult; D001284:Atrophy; D016207:Cytokines / Q000032:analysis* / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood; D016209:Interleukin-8 / Q000032:analysis / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000097:blood; D014621:Vagina / Q000276:immunology*; D014623:Vaginal Diseases / Q000276:immunology* / Q000473:pathology
chemical_list: D016207:Cytokines; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha