title: Vulvodynia: What We Know and Where We Should Be Going.
abstract: OBJECTIVE
  The aim of the study was to review the current nomenclature and literature examining microbiome cytokine, genomic, proteomic, and glycomic molecular biomarkers in identifying markers related to the understanding of the pathophysiology and diagnosis of vulvodynia (VVD).
  
  
  METHODS
  Computerized searches of MEDLINE and PubMed were conducted focused on terminology, classification, and "omics" variations of VVD. Specific MESH terms used were VVD, vestibulodynia, metagenomics, vaginal fungi, cytokines, gene, protein, inflammation, glycomic, proteomic, secretomic, and genomic from 2001 to 2016. Using combined VVD and vestibulodynia MESH terms, 7 references were identified related to vaginal fungi, 15 to cytokines, 18 to gene, 43 to protein, 38 to inflammation, and 2 to genomic. References from identified publications were manually searched and cross-referenced to identify additional relevant articles. A narrative synthesis of the articles was conducted; however, meta-analysis was not conducted because of substantial heterogeneity in the studies and limited numbers of control-matched studies.
  
  
  RESULTS
  Varying definitions of VVD complicate a meta-analysis, and standard definitions will better allow for comparisons of studies and enhance the applicability of evidence to patient populations. Although data are still limited, genomic and molecular diagnostic testings continue to be investigated as potential tools for the diagnosis of VVD.
  
  
  CONCLUSIONS
  Standardized nomenclature will allow for comparability of studies and progress in research related to the pathophysiology of VVD and to facilitate clinical decision making and treatment choices. Although the current understanding of the pathogenesis of VVD is limited, there are new opportunities to explore potential diagnostic markers differences in women with VVD, which may lead to targeted therapy.
authors.affiliation: 1Department of Obstetrics and Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, OH; 2Department of Pharmacology and Toxicology, Wright State University, Boonshoft School of Medicine, Dayton, OH; 3Department of Pathology, University of California San Diego, San Diego, CA; and 4Department of Biochemistry and Molecular Biology, Wright State University, Boonshoft School of Medicine, Dayton, OH.
authors.forename: Logan M
authors.initials: LM
authors.lastname: Havemann
authors.forename: David R
authors.initials: DR
authors.lastname: Cool
authors.forename: Pascal
authors.initials: P
authors.lastname: Gagneux
authors.forename: Michael P
authors.initials: MP
authors.lastname: Markey
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Yaklic
authors.forename: Rose A
authors.initials: RA
authors.lastname: Maxwell
authors.forename: Ashvin
authors.initials: A
authors.lastname: Iyer
authors.forename: Steven R
authors.initials: SR
authors.lastname: Lindheim
mesh_terms: D005260:Female; D006801:Humans; D009626:Terminology as Topic; D056650:Vulvodynia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*