Avaliação de citocinas em secreção endocervical de mulheres com candidíase, tricomoníase ou vaginite bacteriana

Abstract

Infectious processes in the vagina due to infectious micro-organisms are very common. Vulvovaginitis is commonly caused by protozoa, yeasts, bacteria and/or viruses and their eradication or containment are usually mediated by cytokines of the vaginal mucosa. In this study, the intention was to measure the concentration of cytokines IL-2, IL-6, IL-10, IL-12, IFN-γ and TNF-α and their relationship with some of the infections. One-hundred and seventy three women were included, with ages between 16 and 48 years (mean=31.4 ± 6.5 years). They were distributed into four groups: control, candidiasis, trichomoniasis and bacterial vaginitis group. The samples were subsequently submitted to culture and identification of micro-organism, followed by cytokine measurements. The data was submitted to statistical analysis. Median, interquartile range and the Mann-Whitney test was employed and considered significant when p<0.05. The levels of cytokines in the lower genital-tract of women with candidiasis, trichomoniasis, bacterial vaginitis were higher than those with normal flora. Sixty (34.7%) women were in the control group, 19 (11.0%) presented only candidiasis, three (1.7%) presented trichomoniasis, and only ten presented (5.8%) bacterial vaginosis. The remaining participants had comorbidities such as HPV or bacterial vaginosis, although the study of these last two or association with other conditions was not performed. IL-2 and IL-12 were significantly elevated in the presence of candidiasis, compared with the control group p=0.01 and p=0.07, respectively. Patients with bacterial vaginitis also had statistically significant increased levels for IL-2 (p=0.03) and for IL-12 (p=0.04). TNF-α was elevated only in the presence of trichomoniasis p=0.04. We concluded that patients with vaginal infections had an increase in the concentrations of some cytokines.