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Cervicovaginal Levels of Proinflammatory Cytokines Are Increased During Chlamydial Infection in Bacterial Vaginosis But Not in Lactobacilli-Dominated Flora

Marconi, Camila PhD1; Santos-Greatti, Mariana M.V. MSc1; Parada, Cristina M.G.L. PhD2; Pontes, Anagloria PhD3; Pontes, Ana G. PhD3; Giraldo, Paulo C. PhD4; Donders, Gilbert G.G. PhD5; da Silva, Márcia Guimarães PhD1

Journal of Lower Genital Tract Disease: July 2014 - Volume 18 - Issue 3 - p 261–265
doi: 10.1097/LGT.0000000000000003
Basic Science

Objective The purpose of this study was to assess the cervicovaginal levels of proinflammatory cytokines in women with Chlamydia trachomatis (CT) infection in the presence of bacterial vaginosis (BV) and normal flora and to compare with those negative for CT.

Materials and Methods In this cross-sectional study, nonpregnant women were enrolled at 2 outpatient clinics and at 1 primary medical care unit in São Paulo State, Brazil. Cervicovaginal samples from 256 women with BV, of which 68 (26.6%) had concomitant CT infection and 188 (73.4%) were CT-negative, were measured for interleukin-1β (IL-1β), IL-6, and IL-8 by enzyme-linked immunosorbent assay. A matching number of samples from women with normal flora, CT-positive (n = 68) and negative (n = 188), were evaluated as control. Cytokine levels were compared by Mann-Whitney test and differences were considered significant at p < .05.

Results In CT-negative women, IL-1β was increased in BV (p < .001) when compared to normal flora, while the levels of IL-6 and IL8 were unchanged. The presence of CT infection was not associated with differences on cytokine levels in women with normal flora. However, women with BV had higher levels of IL-1β (p = .02), IL-6 (p = .02), and IL-8 (p = .03) in the presence of CT when compared to those who tested negative for CT.

Conclusions Detection of endocervical CT is associated with increased cervicovaginal IL-1β, IL-6, and IL-8 levels in women with concomitant BV but not in those with normal flora.

Cervicovaginal levels of proinflammatory cytokines are increased in the presence of chlamydial infection and bacterial vaginosis but remain unchanged in Chlamydia-positive women presenting lactobacilli-dominated flora.

Departments of 1Pathology, 2Nursing, and 3Gynecology and Obstetrics, Botucatu Medical School, UNESP – Univ Estadual Paulista; 4Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Campinas University, Campinas, Brazil; and 5University Hospital Gasthuisberg, Leuven, Belgium

Reprint requests to: Márcia Guimarães da Silva, PhD, Department of Pathology, Botucatu Medical School, Distrito de Rubião Junior, s/n, Botucatu, São Paulo, Brazil, 18618-970. E-mail:

This study was supported by Fundação de Amparo a Pesquisa do Estado de São Paulo-FAPESP (grants 2008/55420-6 and 2009/50560-7) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES (grant 1179-09-8).

The authors have declared they have no conflicts of interest.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology