ABSTRACT
OBJECTIVE: To compare the levels of interleukin (IL)-1beta, IL-6, and matrix metalloproteinase (MMP)-8 in the vaginal secretions of pregnant women with a positive fetal fibronectin (fFN) test result with or without asymptomatic bacterial vaginosis (BV) before and after treatment with oral clindamycin. METHODS: A prospective cohort study was conducted among 43 pregnant women with a positive fFN test result. All patients were treated with clindamycin, and the pre- and post-treatment levels of IL-1beta, IL-6, and MMP-8 were compared. RESULTS: Before treatment, levels of IL-1beta and MMP-8 were significantly higher in women with BV compared with women without BV (P<0.05). Vaginal levels of IL-1beta and IL-6, but not MMP-8, decreased after treatment in pregnant women with BV. CONCLUSIONS: The inability of clindamycin to decrease MMP-8 vaginal levels may explain why it is ineffective in reducing preterm birth in pregnant women with positive fFN and BV.
Subject(s)
Anti-Bacterial Agents/pharmacology , Clindamycin/pharmacology , Matrix Metalloproteinase 8/drug effects , Vaginosis, Bacterial/drug therapy , Adult , Anti-Bacterial Agents/therapeutic use , Clindamycin/therapeutic use , Cohort Studies , Female , Fibronectins/analysis , Humans , Inflammation/drug therapy , Inflammation/etiology , Inflammation/metabolism , Interleukin-1beta/drug effects , Interleukin-1beta/metabolism , Interleukin-6/metabolism , Matrix Metalloproteinase 8/metabolism , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/physiopathology , Premature Birth/etiology , Premature Birth/prevention & control , Prospective Studies , Vagina/metabolism , Vagina/microbiology , Vaginosis, Bacterial/complications , Vaginosis, Bacterial/physiopathology , Young AdultABSTRACT
OBJECTIVE: To compare matrix metalloproteinase (MMP)-8 and MMP-9 levels in the vaginal secretions of pregnant women with or without asymptomatic bacterial vaginosis (BV). METHODS: In this study, vaginal levels and molecular forms of MMP-8 and MMP-9 were studied in 36 pregnant women between 28 and 34 weeks of gestation with asymptomatic BV and 41 pregnant women, matched for gestational age, without BV. RESULTS: Vaginal MMP-8 concentrations were significantly higher (P = .023) in BV-positive women. There was no significant difference in MMP-9 levels between healthy pregnant controls and BV-positive pregnant women. The presence of MMP-8 was confirmed by a 38-kd band on Western blots. CONCLUSIONS: Our findings show that BV is associated with increased levels of MMP-8 in vaginal fluid. Increased production of collagen-degrading enzymes such as MMP-8 is a possible cause of spontaneous preterm delivery in pregnant women with asymptomatic BV.
Subject(s)
Matrix Metalloproteinases/analysis , Pregnancy Complications, Infectious/enzymology , Vagina/enzymology , Vaginosis, Bacterial/enzymology , Adult , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Female , Gestational Age , Humans , Matrix Metalloproteinase 8/analysis , Matrix Metalloproteinase 9/analysis , Obstetric Labor, Premature/enzymology , Parity , PregnancyABSTRACT
Los tuberculomas del sistema nervioso central son lesiones intracraneanos poco frecuentes, aparecen en cualquier sitio del tejido nervioso, sus características clínicas son: cefalea, parálisis espontánea del VI par, crisis convulsivas o hemorragia subaracnoidea espontanea. Otras enfermedades que pueden simular el mismo cuadro son: toxoplasmosis, cisticercosis, infección por VIH o gliomas. Por ser lesiones muy pequeñas y únicas, su identificación por tomografía axial computada tiene baja sensibilidad, no así la resonancia magnética nuclear, con alta especificidad y sensibilidad en el diagnóstico temprano. El tratamiento a base de esteroides y antifímico mejorar notablemente los efectos de masa intracraneana