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Protein Content of Cervicovaginal Fluid Is Altered During Bacterial Vaginosis

Ferreira, Carolina Sanitá Tafner MSc1; da Silva, Márcia Guimarães PhD1; de Pontes, Letícia Gomes MSc2; dos Santos, Lucilene Delazari PhD2; Marconi, Camila PhD1,3

Journal of Lower Genital Tract Disease: April 2018 - Volume 22 - Issue 2 - p 147–151
doi: 10.1097/LGT.0000000000000367
Original Research Articles: Vagina and Vulva

Objectives The aim of the study was to compare, using a proteomic approach, cervicovaginal fluid (CVF) proteins of women with bacterial vaginosis (BV) with those presenting normal microbiota.

Materials and Methods A total of 309 reproductive-aged women were cross-sectionally enrolled. Participants were tested for vaginal candidosis, Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae and excluded if positive. Vaginal microbiota was classified microscopically according to Nugent criteria in normal, intermediate, and BV. Randomly selected CVF samples of 29 women with BV and an equal number with normal microbiota were subjected to proteomic analysis. Thus, a total of 58 CVF samples were evaluated using shotgun liquid chromatography-tandem mass spectrometry in a Q-Tof PREMIER API mass spectrometer (MicroMass/Waters) for peptide detection and relative quantification.

Results Of the 309 women enrolled, 63 (20.4%) were excluded after testing positive for at least one of the tested co-infections or because of low-quality samples. Microscopic classification of vaginal microbiota on the remaining 246 samples revealed that 132 women (53.6%) had normal microbiota, 33 (13.4%) had intermediate microbiota, and 81 (33.0%) had BV. Proteomic analysis of CVF of 58 randomly selected women with normal microbiota (n = 29) or BV (n = 29) successfully identified 74 proteins. In addition, the comparison of abundance of those proteins between the groups showed that the following five (6.7%) were enriched in BV: neutrophil elastase, kaliocin-1, neutrophil defensin-1, Ig lambda-2 chain C regions, and protein S100-A7. All of which have a recognized role in host's immunity.

Conclusions Exclusive finding of BV affects immunity-related CVF components of reproductive-aged women.

1Department of Pathology from Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil; 2Center for the Studies of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil and Graduate Program in Tropical Diseases from Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil; and 3Department of Basic Pathology, Setor de Ciências Biológicas, UFPR – Univ. Federal do Paraná, Curitiba, Paraná, Brazil

Reprint requests to: Camila Marconi, PhD, Department of Basic Pathology, Federal University of Paraná Avenida Cel. Francisco H. dos Santos, 100. Curitiba, Paraná, Brasil 80050-540. E-mail:

The authors have declared they have no conflicts of interest.

This study is supported by São Paulo Research Foundation (FAPESP) (Grants #2012/16800-3 and #2012/10403-2).

The study is approved by the ethics committee of Botucatu Medical School/UNESP (Approval Number 478.483).

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Copyright © 2018 by the American Society for Colposcopy and Cervical Pathology