Local immune responsiveness following intravaginal challenge with Candida antigen in adult women at different stages of the menstrual cycle
Local immune responsiveness following intravaginal challenge with Candida antigen in adult women at different stages of the menstrual cycle
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DOI：
10.1080/714043904
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发表时间：
2003-04-01
期刊：
影响因子：
2.9
通讯作者：
Dunlap, K
中科院分区：
文献类型：
--
作者：
Fidel, PL;Barousse, M;Dunlap, K
复发性外阴阴道念珠菌病 (RVVC) 是育龄妇女的一个严重问题，最常见的是无症状定植于粘膜组织的白色念珠菌引起的。尽管推测某种形式的局部免疫功能障碍会引发 RVVC 发作，但阴道宿主对白色念珠菌的正常保护性反应仍知之甚少。为了刺激没有 VVC 病史的健康女性对酵母的自然适应性反应，在阴道内引入商业念珠菌皮试抗原，并在抗原攻击前后监测阴道灌洗液中细胞因子/免疫调节剂的变化。在一项早期的试点研究中，使用少量女性而不控制月经周期的各个阶段，我们报告了抗原攻击女性阴道分泌物中细胞因子的升高。然而，本研究在月经周期的每个阶段对大量女性采用了类似的设计，但没有显示局部免疫刺激的证据，包括 Th 和促炎细胞因子、IgE、组胺和前列腺素的变化，尽管阴道细胞因子在月经周期过程中存在自然调节。总而言之，这些结果表明，要么对酵母菌有明显的某种形式的阴道免疫调节/耐受性反应，要么需要更先进的临床设计来检测对白色念珠菌的正常保护性阴道反应。
Recurrent vulvovaginal candidiasis ( RVVC) is a significant problem in women of childbearing age and is most often caused by Candida albicans that asymptomatically colonizes mucosal tissues. Although some form of local immune dysfunction is postulated to precipitate bouts of RVVC, the normal protective vaginal host response to C. albicans is poorly understood. In an effort to stimulate the natural adaptive response to yeast in healthy women without a history of VVC, commercial Candida skin test antigen was introduced intravaginally and changes in cytokines/ immunomodulators were monitored in vaginal lavage fluid pre- and post- antigen challenge. In an earlier pilot study using small numbers of women without controlling for stages of the menstrual cycle, we reported elevated cytokines in vaginal secretions of antigen challenged women. The present study, however, that employed a similar design in a large number of women during each stage of the menstrual cycle showed no evidence of local immune stimulation, including changes in Th and proinflammatory cytokines, IgE, histamine, and prostaglandin, despite a natural modulation of vaginal cytokines over the course of the menstrual cycle. Taken together, these results suggest that either some form of vaginal immunoregulation/ tolerance is evident in response to yeast or that more advanced clinical designs are required to detect the normal protective vaginal response to C. albicans.