EFFECT OF HORMONAL REGULATION ON VAGINAL COLONIZATION RESISTANCE IN BACTERIAL DYSBIOSIS

The vaginal microbiota and the vaginal colonization resistance are considerably driven by hormonal changes; therefore, the relevance of investigating hormonal regulation indices in female individuals in health (normocenosis) and with dysbiosis of varying degrees is of undoubted clinical significance. The purpose of the study is to determine the effect of hormonal regulation on the microbiota and vaginal colonization resistance in bacterial dysbiosis. 298 women were selected for the study; they were divided into the groups according to the opportunistic microflora index (OMI): OMI in the women with normocenosis was below -3 lg GE/sample (n = 53), OMI in the women with І-st degree dysbiosis ranged from -3 to -1 lg GE/sample (n = 128) and with ІІ-d degree dysbiosis exceeded -1 lg GE/sample (n = 117). The molecular genetic tests of epithelium scrapings from the posterolateral vaginal wall were performed by polymerase chain reaction (“DNA technology”, RF). Lactobacilli, facultative and obligate anaerobes, myco- and urepalasmas, and yeast-like fungi were quantified. By applying the enzyme-linked immunosorbent assay there was determined the content of hormones in the blood serum: luteotropic, follicle-stimulating, prolactin, cortisol, progesterone (PG), estradiol (E2), testosterone (TS). The relationship of microbial biocenosis with the studied parameters was studied using the regression analysis (Statistica 10, StatSoft, Inc., USA). The hormonal indices in normocenosis had no relationship with the number of microorganisms, excluding the level of TS, which demonstrated negative correlation with CPMI. With the progression of dysbiosis, the E2 and PG content in the blood decreased and showed a reverse correlation with the growth of pathogenic microbiota, which reflected the insufficiency of hormonal mechanisms to maintain a constant normocenosis. Hyperprolactinemia and hypertestosteronemia were also found to have pathogenic values, which directly correlated with the growth of pathogenic microbiota. The decrease in blood cortisol level with II degree dysbiosis was associated with anaerobic growth of Atopobium vaginalis. The hormonal disorders correlated with a decrease in colonization resistance factors in the vaginal secretion, lysozyme and IL10, while increase in the pathogenic factor with the content of TGF-1β. Conclusions. The obtained results on the effects of hormonal regulation system on the microbial biocenosis indicators and local colonial resistance reflected the development of hormonal insufficiency with the progression of vaginal dysbiosis.