A Study On The Correlated Pathogenetic Factors And The Vaginal Local Antibiotic Peptides Of The Vulvovaginal Candidiasis (VVC)

Objective:According to comparing vulvovaginal candidiasis (VVC) patients、 recurrent vulvovaginal candidiasis (RVVC) patients with normal woman, to investigate the correlated pathogenetic factors of VVC and RVVC. To analyze the relationship between vaginal local antibiotic peptides and pathogenetic of VVC and RVVC by measuring the level of LL-37and human defensin5(HD5) in vaginal lavage fluid, so that to provide theoretical reference to disease prevention and immunologic mechanism.Method:Total of180women were enrolled in the research who attended gynecology division of outpatient to the second hospital of Tianjin medical university from May2010to December2010.Total of them,60persons were VVC group,60persons were RVVC group,60persons were normal group. The questionnaire content mainly includes the age、ethnicity、cultural degree、personal hygiene habits (using protective pad during non-menstruation frequency of changing underwear、using cotton underwear、using tight trousers or underwear and frequency of cleaning vulva)、 sexual life、oral contraception、personal habits (smoking、preference sweets) and so on. The data was analyzed by logistic statistics. Routine examination and fungal culture (CHROMagar) were done on the vaginal discharge. Human vaginal lavage fluid was collected respectively. Enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of antibiotic peptide LL-37and HD5which were infected by candida albicans that were found by culturing in the CHROMagar.Results:(1) Univariate logistic regression analysis showed that using protective pad during non-menstruation (P=0.01, OR=6.368) and cotton underwear (B=-1.299, P=0.019, OR=0.273) had a certain statistical relationship with the occurrence of VVC, but had no statistical relationship with the occurrence of RVCC. The other factors for example personal hygiene habits (frequency of cleaning vulva, frequency of changing underwear、sexual life、oral contraception and personal habits (smoking, preference sweets) had no statistical relationship with the occurrence of VVC and RVCC. Multivariate logistic regression analysis showed that using protective pad during non-menstruation (B=1.847, P=0.001, OR=6.339) was a risk factor of VVC. Using cotton underwear (B=-1.291, P=0.026, OR=0.275) was a protective factor of VVC.(2) Both the LL-37and HD5were found in the VVC group, RVVC group and the control group; the levels of LL-37and HD5of VVC group were higher than the control group, the difference was statistically significant (P<0.05); the level of LL-37of RVVC group was higher than the control group, the difference was statistically significant (P <0.05); the levels of LL-37and HD5had no difference between the RVVC group and the VVC group, the difference was statistically significant (P<0.05); the level of HD5had no difference between the RVVC group and the control group, the difference was statistically significant (P<0.05).Conclusions:The women who using protective pad during non-menstruation were liable to VVC and who using cotton underwear could reduce the incidence of VVC. There was on significant correlation between incidence of RVVC and personal hygiene habits、sexual life、oral contraception and personal habits. The level of LL-37may play an important role in the pathogenesis of VVC and RVVC. The level of HD5may play an important role in the pathogenesis of VVC, while may had no relationship with RVVC.