THE PROFILES OF LACTOBACILLLUS MICROFLORA AND LOCAL IMMUNE RESPONSE OF THE VAGINAL MUCOSA IN THE DIAGNOSIS OF VAGINAL INFECTIONS

DOI: https://doi.org/10.29296/24999490-2020-03-07

O.V. Budilovskaya(1, 2), A.A. Krysanova(1, 2), E.V. Shipitsyna(1), N.A. Pereverzeva(1), N.E. Vorobyova(1), E.N. Gerasimova(1), A.N. Grigoryev(1), A.M. Savicheva(1, 2) 1-D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Mendeleevskaya Line, 3, St. Petersburg, 199034, Russian Federation; 2-St. Petersburg State Pediatric Medical University, Litovskaya Street, 2, St. Petersburg, 194100, Russian Federation E-mail: [email protected]

Introduction. In vaginal infections, both microbial factor and the state of local (mucosal) immunity, determined by the immunological reactivity of the macroorganism, play an important role in the pathogenesis of an infectious process. Aim of the studying. To determine the profiles of lactobacillus microflora and local immune response of the vaginal mucosa specific for various vaginal infections – aerobic vaginitis (AV), bacterial vaginosis (BV), candida vulvovaginitis (CVV). Material and methods. The study involved 223 women with complaints of the discharge from the genital tract. To determine the species and quantitative composition of the vaginal microbiota and assess local inflammation, the vaginal discharge was examined using microscopy and real-time polymerase chain reaction. Results. Vaginal infections were detected in 71 women (31,8%). AV was diagnosed in 15,2% (34 of 223) of women, BV – 16,1% (36 of 223) of women, and СVV – in 10,3% (23 of 223) of women. The most characteristic predictors of normocenosis were the dominance of 56 2020, т. 18, №3 Молекулярная медицина Диагностика вагинальных инфекций с учетом профилей лактобациллярной микрофлоры... Lactobacillus crispatus and increased levels of mRNA expression of the IL18, GATA3 and CD68 genes. AB and BV were characterized by a significant decrease in L. crispatus, L. jensenii and L. vaginalis levels, with AB being associated with an increased level of the expression of IL1b and IL10, and BV being associated with a reduced level of expression of IL18 and GATA3. Increased levels of L. gasseri and L. vaginalis IL1b and TLR4 were characteristic of CVV. Conclusions. Along with the assessment of the vaginal microbiocenosis, including the determination of lactobacilllus profiles, the evaluation of local immunity of the vaginal mucosa might increase the information content of the diagnosis of vaginal infections and be useful in predicting relapsing of vaginal dysbiosis and monitoring treatment efficacy.
Keywords: 
vaginal infections, lactobacillus microflora, markers of local immune response
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