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Differential expression of lactic acid isomers, extracellular matrix metalloproteinase inducer, and matrix metalloproteinase‐8 in vaginal fluid from women with vaginal disorders
Author(s) -
Beghini J,
Linhares IM,
Giraldo PC,
Ledger WJ,
Witkin SS
Publication year - 2015
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.13072
Subject(s) - bacterial vaginosis , lactic acid , medicine , vaginal disease , vagina , chemistry , gynecology , biology , bacteria , surgery , genetics
Objective Do metabolites in vaginal samples vary between women with different vaginal disorders. Design Cross‐sectional study. Setting Campinas, Brazil. Sample Seventy‐seven women (39.9%) with no vaginal disorder, 52 women (26.9%) with vulvovaginal candidiasis ( VVC ), 43 women (22.3%) with bacterial vaginosis ( BV ), and 21 women (10.9%) with cytolytic vaginosis ( CTV ). Method Concentrations of d ‐ and l ‐lactic acid, extracellular matrix metalloproteinase inducer ( EMMPRIN ), and matrix metalloproteinase‐8 ( MMP ‐8), and the influence of C andida albicans on EMMPRIN production by cultured vaginal epithelial cells, were determined by enzyme‐linked immunosorbent assay ( ELISA ). Associations were determined by the Mann–Whitney U ‐test and by Spearman's rank correlation test. Main outcome measures Metabolite levels and their correlation with diagnoses. Results Vaginal concentrations of d ‐ and l ‐lactic acid were reduced from control levels in BV ( P < 0.0001); l ‐lactic acid levels were elevated in CTV ( P = 0.0116). EMMPRIN and MMP ‐8 concentrations were elevated in VVC ( P < 0.0001). EMMPRIN and l ‐lactic acid concentrations ( P ≤ 0.008), but not EMMPRIN and d ‐lactic acid, were correlated in all groups. EMMPRIN also increased in proportion with the ratio of l ‐ to d ‐lactic acid in controls and in women with BV ( P ≤ 0.009). Concentrations of EMMPRIN and MMP ‐8 were correlated in controls and women with VVC ( P ≤ 0.0002). C andida albicans induced EMMPRIN release from vaginal epithelial cells. Conclusions Vaginal secretions from women with BV are deficient in d ‐ and l ‐lactic acid, women with VVC have elevated EMMPRIN and MMP ‐8 levels, and women with CTV have elevated l ‐lactic acid levels. These deviations may contribute to the clinical signs, symptoms, and sequelae that are characteristic of these disorders.