Cervicovaginal Inflammatory Cytokines and Sphingomyelinase in Women With and Without Bacterial Vaginosis

• Published in: The American journal of the medical sciences 2012-07, Vol.344 (1), p.35-39
• Main Authors: Hemalatha, Rajkumar, MD, Ramalaxmi, Baru Anantha, MBBS, DGO, KrishnaSwetha, Gummuluri, MBBS, Kumar, Putcha Uday, MD, Rao, Dasari Madusudhan, MSc, Balakrishna, Nagalla, PhD, Annapurna, Vure, PhD
• Format: Article
• Language: English
• Subjects: Adult; Bacteria; Bacteria - classification; Bacteria - isolation & purification; Bacterial diseases; Bacterial diseases of the genital system; Bacterial vaginosis; Biological and medical sciences; Cervicitis; Cervix; Cervix Uteri - immunology; Cervix Uteri - metabolism; Cervix Uteri - microbiology; Disease transmission; Female; General aspects; Genital microflora; HIV Seronegativity; Human bacterial diseases; Human immunodeficiency virus 1; Humans; Hydrogen-Ion Concentration; IL-1β; IL-6; India - epidemiology; Infectious diseases; Inflammation; Interleukin 1; Interleukin 6; Interleukin-1beta - metabolism; Interleukin-6 - metabolism; Interleukins - metabolism; Internal Medicine; Leukocytes; Medical sciences; pH effects; Sphingomyelin phosphodiesterase; Sphingomyelin Phosphodiesterase - metabolism; Sphingomyelinase; TNF-α; Tumor necrosis factor- alpha; Tumor Necrosis Factor-alpha - metabolism; Uterine Cervicitis - epidemiology; Uterine Cervicitis - immunology; Uterine Cervicitis - metabolism; Uterine Cervicitis - microbiology; Vagina; Vagina - immunology; Vagina - metabolism; Vagina - microbiology; Vaginal Douching; Vaginitis; Vaginitis - epidemiology; Vaginitis - immunology; Vaginitis - metabolism; Vaginitis - microbiology; Vaginosis; Vaginosis, Bacterial - epidemiology; Vaginosis, Bacterial - immunology; Vaginosis, Bacterial - metabolism; Vaginosis, Bacterial - microbiology; Young Adult
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1097/MAJ.0b013e318235597b

Abstract Introduction The objective is to analyze proinflammatory cytokines [interleukin-1 β (IL-1 β ), 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-1 β , 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-1 β in BV ( P < 0.005), intermediate flora ( P < 0.05) when compared with normal women. High vaginal pH was associated with IL-1 β . Neutral sphingomelinase showed an inverse association ( P < 0.05) with cervicitis. Acid sphingomelinase directly correlated with IL-1 β 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.