Candida albicans vaginitis in a murine model is reduced by polypeptide-enriched Gastrodia elata extracts.

Aim: The primary objective of this study was to evaluate the effects of polypeptide-enriched Gastrodia elata extracts (GE) on vulvovaginal candidiasis (VVC). Materials & methods: A VVC model induced by Candida albicans (C. albicans) infection was successfully developed in BALB/c mice. After treatment, the colony-forming unit (CFU) of vaginal lavage was measured by plating. The extent of the inflammatory response was assessed by hematoxylin-eosin (H&E) staining and enzyme-linked immunosorbent assay (ELISA). Results: GE had an inhibitory effect on the proliferation of C. albicans and inflammatory reaction. Meanwhile, it had a potentially beneficial effect on the growth of Lactobacillus. Conclusion: These results showed the potential application of GE as an antifungal agent in VVC treatment.

Impaired Th17 cell proliferation and decreased pro-inflammatory cytokine production in CXCR3/CXCR4 double-deficient mice of vulvovaginal candidiasis.

Vulvovaginal candidiasis (VVC) is a common observed infection, affecting approximately 75% of women of reproductive age. Drug resistance represents a troublesome stumbling block associated with VVC therapy. Thus the aim of the present study was to provide information regarding the selection of potential drug targets for VVC. CXCR3-, CXCR4-, or CXCR/CXCR4 double-deficient mouse models of VVC were subsequently established, with changes to the load of Candida Albicans evaluated accordingly. The biological behaviors of the vaginal epithelial cells were characterized in response to the CXCR3-, CXCR4-, or CXCR3/CXCR4 double-knockout in vivo. Our initial observations revealed that in mice with VVC, CXCR3-, CXCR4-, or CXCR3 - CXCR4 double-knockout resulted in a decreased load of C. Albicans as well as reduced levels and proportion of Th17 cells. Proinflammatory cytokine production was found to be inhibited by CXCR3-, CXCR4-, or CXCR3/CXCR4 double-knockout whereby the mRNA and protein expressions CXCR3, CXCR4, IL-17, IL-6, and TNF-α exhibited decreased levels. CXCR3-, CXCR4-, or CXCR3/CXCR4 double-knockout appeared to function as positive proliferation factors, while playing a negative role in the processes of apoptosis and the cell cycle of vaginal epithelial cells. Taken together, the key findings of the study suggested that CXCR3/CXCR4 double-knockout could act to hinder the progression of VVC, highlighting its promise as a novel therapeutic target in the treatment of VVC. CXCR3 and CXCR4 genes may regulate Th17/IL-17 immune inflammatory pathways to participate in antifungal immunity.

Eosinofilia no sangue periférico de mulheres com candidiase vaginal recorrente / Eosinophilia in peripheral blood of women with recurrent vaginal candidiasis

OBJETIVO: Quantificar o número de células de defesa e os níveis de imunoglobulina E (IgE) no sangue periférico em amostra de mulheres com candidíase vaginal recorrente. MÉTODOS: Estudo de corte transversal com 60 mulheres, 40 com candidíase vulvovaginal e 20 do grupo controle (sem doença). As células de defesa foram identificadas utilizando um sistema de impedância combinada com a citometria de fluxo, os níveis de IgE total e específica foram medidos por meio de técnicas de quimiluminescência, o teste de Mann-Whitney foi utilizado para variáveis nominais e do teste de Spearman para correlações das concentrações de IgE e de eosinófilos no sangue periférico. RESULTADOS: O número de eosinófilos no sangue periférico de pacientes com candidíase vulvovaginal, 302,60 (±253,07), foi significativamente maior do que o grupo controle, 175,75 (±109,24) (p=0,037). Os níveis séricos de IgE total e específica foram semelhantes em ambos os grupos de mulheres com e sem candidíase vulvovaginal recorrente (p=0,361). Entretanto, observou-se uma correlação positiva moderada entre eosinofilia e níveis de IgE total no sangue periférico de mulheres com candidíase vaginal recorrente (r=0,25). CONCLUSÃO: Mulheres com candidíase vaginal recorrente parecem ter maior concentração de eosinófilos no sangue periférico que as assintomáticas.

PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were identified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (±253.07), was significantly higher compared to control, 175.75 (±109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.

Clinical aspects and luteal phase assessment in patients with recurrent vulvovaginal candidiasis.

OBJECTIVE: This study was undertaken to characterize the patients with recurrent vulvovaginal candidiasis. STUDY DESIGN: Basic data of personal history and history of recurrent vulvovaginal candidiasis, lower genital tract symptoms and signs in 50 patients were analyzed in this longitudinal follow-up study including the determination of midluteal serum progesterone and urinary pregnanediol levels during the luteal phase in 84 cycles (recurrent vulvovaginal candidiasis) and 60 cycles (healthy controls). RESULTS: All patients suffered primary idiopathic form of recurrent vulvovaginal candidiasis. Frequently, there was a striking discrepancy between severe symptoms and clinical finding, which was often negligible or normal. There was no redness and no or minimum discharge in 52% of culture documented attacks. In contrast to the healthy controls, the patients had significantly lower levels of progesterone (p<0.01) as well as those of urinary pregnanediol (p<0.05). CONCLUSION: Culture positive attacks in patients with recurrent vulvovaginal candidiasis represented rather a form of vulvovaginal discomfort than attacks of vulvovaginal candidiasis with typical inflammatory changes. Significantly lower progesterone levels in the RVVC patients as compared to the healthy controls suggest a link between an altered hormonal status and one of possible causes of RVVC in these women.

The serum levels of calcium, magnesium, iron and zinc in patients with recurrent vulvovaginal candidosis during attack, remission and in healthy controls.

The real cause of recurrent vulvovaginal candidosis (RVVC) is concealed and the etiopathogenesis of this disease remains to be determined. In a cohort study, concentrations of metals in 44 patients with RVVC and 30 healthy age-matched women were measured and compared. The concentrations of serum calcium (Ca), magnesium (Mg) and iron (Fe) were measured photometrically, the zinc (Zn) levels were determined using flame atomic absorption spectrometry. For statistical analysis were used the Student's t-tests (paired analysis for attack vs. remission; non-paired analysis for patient vs. control). Although all measured metals were within normal ranges the patients with RVVC had in contrast to the healthy controls significantly lower levels of serum Ca, Mg and Zn and insignificantly higher levels of Fe. These relative changes may contribute to the development of attacks in patients with RVVC.

Partial protection against experimental vaginal candidiasis after mucosal vaccination with heat-killed Candida albicans and the mucosal adjuvant LT(R192G).

The effectiveness of a mucosal vaccine composed of heat-killed Candida albicans (HK-CA) or C. albicans culture filtrate (CaCF) in conjunction with the mucosal adjuvant LT(R192G) against vulvovaginal candidiasis was examined in an estrogen-dependent murine model. Mice vaccinated intranasally with HK-CA + LT(R192G) exhibited a significant but short-lived protection accompanied by a vigorous delayed-type hypersensitivity response as well as high titers of circulating C. albicans-specific antibodies. Surprisingly, the levels of antigen-specific antibodies in the vaginal secretions of protected mice were negligible and no correlates of vaginal-associated Type 1 or Type 2 cytokines were observed. Vaginal priming with C. albicans before vaccination did not alter the protective outcome. Immunization with CaCF + LT(R192G) induced a discrete level of protection when administered intrarectally but not intranasally. These results suggest that mucosal vaccination can afford partial protection against vulvovaginal candidiasis, but the precise immune mechanisms responsible for protection are complex and as yet, not well understood.

Association of recurrent vaginal candidiasis and secretory ABO and Lewis phenotype.

The relationship between ABO-Le secretor phenotype and susceptibility to recurrent idiopathic vulvovaginal candidiasis (RVVC) was investigated. ABO and Lewis blood typing was done for 38 women with RVVC (case-patients) and for women in 2 control groups, consisting of 58 healthy women, who were friends identified by case-patients, and 38 race-matched, healthy hospital employees. The 3 groups were similar with regard to age and race. There was no difference in the distribution of ABO phenotype between case-patients and controls. Case-patients were more likely than members of either control group to have Le(a+ b-) (nonsecretor) rather than Le(a- b+) (secretor) blood type. With combined nonsecretor Le(a+ b-) phenotype and absence of the Lewis gene Le(a- b-), the relative risk of chronic recurring vulvovaginal candidiasis was 2.41-4.39, depending on the analysis technique and control group. In conclusion, there is an increased frequency of ABO-Le nonsecretor status among women with RVVC.

[Benign increase of tumor marker Ca 12-5 in pelvic peritonitis with ascites]. / Nichtkarzinombedingte Erhöhung des Tumormarkers Ca 12-5 bei Pelveoperitonitis mit Aszites.

Two patients suffering from pelveoperitonitis had ascites and elevated CA 12-5 serum level mimicking epithelial ovarian cancer. Both were treated successfully with antibiotics, after laparoscopic confirmation.

Association of recurrent candidal vaginitis with inheritance of Lewis blood group antigens.

A subset of women with candidal vulvovaginitis have no known risk factors for recurrent episodes. Although there are reports of an association of blood group antigens with various infections, no such association has been described with candidal vulvovaginitis. The ABO, P1, and Lewis group phenotypes of 35 women with recurrent vulvovaginitis but without other chronic infections were determined. These were compared with those of a control group of 40 women without a history of candidal vulvovaginitis. The distribution of ABO blood types and P blood group phenotype did not differ from those in controls. However, vulvovaginitis patients were more likely than controls to be classified as Lea-b- (chi 2 = 6.4, 1 df, P = .011). Women without known predisposing factors may have a genetic predisposition to recurrent vulvovaginitis, as evidenced by a higher frequency of Lea-b- phenotype profiles compared with controls.

Effect of Candida albicans plus histamine on prostaglandin E2 production by peripheral blood mononuclear cells from healthy women and women with recurrent candidal vaginitis.

The in vitro production of prostaglandin E2 (PGE2) by peripheral blood mononuclear cells (PBMC) in response to viable Candida albicans, histamine, and C. albicans plus histamine was examined. With PBMC from 10 healthy women, C. albicans but not histamine induced PGE2 at a low level (100 pg/ml). However, C. albicans plus histamine acted synergistically to stimulate PGE2 production (448 pg/ml). PBMC from 8 of 10 women with recurrent candidal vaginitis also produced maximal levels of PGE2 in the presence of C. albicans plus histamine. Production of tumor necrosis factor by PBMC from patients and controls was unaffected by histamine in both the presence and absence of C. albicans. However, unlike the controls, PBMC from six of the patients who were atopic and from two nonatopic patients spontaneously released PGE2 in vitro. Addition of 4 or 10 units/ml interferon-gamma inhibited spontaneous and C. albicans-induced PGE2 production by PBMC. These data reinforce the evidence that immediate hypersensitivity responses may be involved in the etiology of recurrent candidal vaginitis.

High spontaneous premature labor rate in insulin-dependent diabetic pregnant women: an association with poor glycemic control and urogenital infection.

The incidence of spontaneously occurring premature labor in insulin-dependent diabetic pregnancies is unclear, because previous studies have been confounded by a high rate of iatrogenic prematurity. The purpose of this study was to determine, in a large population of insulin-dependent diabetic pregnant women, the rate of spontaneous occurrence of premature labor and the various factors that may affect it. We hypothesized a priori that spontaneously occurring premature labor occurs at a high rate in insulin-dependent diabetic pregnant women, mainly because of poor control of diabetes during pregnancy, and is related to the presence of polyhydramnios and hypomagnesemia. One hundred forty-five insulin-dependent diabetic women undergoing 181 pregnancies were recruited since 1978 in an interdisciplinary prospective study. The goals of glucose control were a fasting blood glucose less than 100 mg/dL and a 90-minute postprandial glucose less than 140 mg/dL. The rate of spontaneous premature labor, 31.1%, was significantly higher (P less than .01) than that in a control population managed by the same obstetricians in similar clinical settings (20.2%). The following variables were not significantly associated with the onset of premature labor: maternal age, parity, gravidity, diabetic class according to White, presence of renal disease or retinopathy, previous elective abortion, chronic hypertension or pregnancy-induced hypertension, cigarette smoking, first-trimester or post-20 weeks' gestation vaginal bleeding, maternal serum magnesium concentration, or polyhydramnios.(ABSTRACT TRUNCATED AT 250 WORDS)