Highlights Regarding Host Predisposing Factors to Recurrent Vulvovaginal Candidiasis: Chronic Stress and Reduced Antioxidant Capacity
نویسندگان
چکیده
We studied host factors that could predispose women to develop recurrent vulvovaginal candidiasis (RVVC), including glycemia, insulin resistance, chronic stress, antioxidant capacity, overall immune status, local inflammation and vaginal microbiota. The presence of yeasts in vaginal culture was screened in 277 women, with or without signs and symptoms of VVC and RVVC. The presence of an inflammatory process and microbiota were analyzed through vaginal bacterioscopy and cervical-vaginal cytology, respectively. Fasting-blood samples were collected by standard venipuncture for biochemical analyses. Flow cytometry was employed to obtain the T helper/T cytotoxic lymphocyte ratio, and insulin resistance was assessed by the HOMA index (HI). Yeasts were isolated from 71 (26%) women: 23 (32.4%) with a positive culture but without symptoms (COL), 22 (31%) in an acute episode (VVC), and 26 (36.6%) with RVVC. C. albicans was the main yeast isolated in all clinical profiles. The control group (negative culture) comprised 206 women. Diabetes mellitus and insulin resistance were more associated with the positive-culture groups (COL, VVC and RVVC) than with negative ones. The RVVC group showed lower mean levels of cortisol than the control group and lower antioxidant capacity than all other groups. The T Helper/T cytotoxic lymphocyte ratio was similar in all groups. The RVVC group showed a similar level of vaginal inflammation to the control group, and lower than in the COL and VVC groups. Only the CVV group showed a reduction in vaginal lactobacillus microbiota. Our data suggest that both chronic stress (decreased early-morning cortisol levels) and reduced antioxidant capacity can be host predisposing factors to RVVC.
منابع مشابه
Chronic vulvovaginal candidiasis.
Frequently ignored by the medical community, chronic vulvovaginal symptoms are relatively common and can frustrating for patients and physicians. Establishing a proper diagnosis will lay the foundation for an effective therapeutic therapeutic plan. Fungal cultures are an important component of the work-up. The most common causes of chronic vaginal symptoms are recurrent vulvovaginal candidiasis...
متن کاملمقایسه پاسخ کلینیکی ولو واژینیت کاندیدایی عود کننده به کرم واژینال اویشن و بوریک اسید
Background and Objective: Since long-term therapy of recurrent vulvovaginal candidiasis patients with azol is accompanied with drug resistance and systemic toxicity, thus, researches have returned to non-azole drugs. This research compared clinical response of these patients to boric acid and leukorex (Zataria multiflora). Materials and Methods: This study was performed as a blind clinic...
متن کاملWhat to do with the patient with recurrent vulvovaginal candidiasis.
The problem Genital infection with candida species is common in women, 75% of whom will have had at least one episode during their lives. Indeed, there is a 15–20% point prevalence of asymptomatic candida carriage in young, nonpregnant, premenopausal women. While acute episodes of candidal vulvovaginitis usually respond rapidly to treatment, some women suVer frequent recurrences or chronic infe...
متن کاملImmune Deviation in Recurrent Vulvovaginal Candidiasis: Correlation with Iron Deficiency Anemia
Background: Iron Deficiency Anemia (IDA) has been controversially linked to IL-4 production in previous studies. A predominant Th1 response leads to resistance against recurrent vulvovaginal candidiasis (RVVC), whereas a Th2 response exacerbates the disease. Objective: To investigate the possible effect of iron deficiency on the host’s susceptibility to RVVC as a result of the Th1/Th2 cytokine ...
متن کاملRecurrent Vulvovaginal Candidiasis: Could It Be Related to Cell-Mediated Immunity Defect in Response to Candida Antigen?
Objective Recurrent vulvovaginal candidiasis (RVVC) is a common cause of morbidity affecting millions of women worldwide. Patients with RVVC are thought to have an underlying immunologic defect. This study has been established to evaluate cell mediated immunity defect in response to candida antigen in RVVC cases. MaterialsAndMethods Our cross sectional study was performed in 3 groups of RVVC pa...
متن کامل