title: Vestibular Mast Cell Density in Vulvodynia: A Case-Controlled Study.
abstract: OBJECTIVE
  To identify whether mast cell densities in vulvar biopsies from the vestibule are associated with vulvodynia.
  
  
  METHODS
  We enrolled 100 women aged 19 to 59 years with confirmed vulvodynia cases, 100 racially matched controls, and 100 black control women. All had vulvar biopsies performed at the 7 o'clock position of the vestibule, which were then immunostained to detect c-KIT protein. The numbers of c-KIT positive mast cells per ×400 magnification field were manually counted, and t tests and logistic regression were used to assess the association with case-control status.
  
  
  RESULTS
  Of the biopsies, 235 were adequate samples for c-KIT testing for mast cells. The mast cell density was substantially lower in black control women (13.9 ± 10.9) in comparison to white control women (22.5 ± 13.2 p < 0.001): hence the analysis was confined to white cases and racially matched control women. Compared with racially matched controls, cases were younger, more likely to be married, and reported a higher household income. The average number of mast cells per ×400 magnification field overall was 19.1 ± 13.2 (range, 0-62). There was no difference in the mast cell count between racially matched cases (22.4 ± 13.9 per ×400 field) and controls (22.5 ± 13.2) in either the univariate or multivariable analyses. Within the group of cases, there was no difference in mast cell density based on the presence or absence of a variety of urogenital symptoms.
  
  
  CONCLUSIONS
  No difference in mast cell density in biopsies of the vestibule was found between white cases and racially matched controls. Black control women have a lower mast cell density compared with white control women.
authors.affiliation: 1Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK.; 2Center for Vulvar Diseases, Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI, USA; 3Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA; and 4Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papoutsis
authors.forename: Hope K
authors.initials: HK
authors.lastname: Haefner
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Crum
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Opipari
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Reed
mesh_terms: D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D007958:Leukocyte Count; D008407:Mast Cells / Q000276:immunology*; D008853:Microscopy; D008875:Middle Aged; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D014844:Vulva / Q000473:pathology*; D056650:Vulvodynia / Q000473:pathology*; D055815:Young Adult
chemical_list: D019009:Proto-Oncogene Proteins c-kit