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Neutrophil Gelatinase-Associated Lipocalin Concentration in Vaginal Fluid

Relation to Bacterial Vaginosis and Vulvovaginal Candidiasis

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Abstract

Objective

Neutrophil gelatinase-associated lipocalin (NGAL) is a component of innate immunity that prevents iron uptake by microorganisms. We evaluated whether NGAL was present in vaginal fluid and whether concentrations were altered in women with bacterial vaginosis (BV) or vulvovaginal candidiasis (VVC).

Methods

Vaginal secretions from 52 women with VVC, 43 with BV, and 77 healthy controls were assayed by enzyme-linked immunosorbent assay for NGAL and for concentrations of l-lactic acid.

Results

The median concentration of NGAL in vaginal fluid was significantly higher in control women (561 pg/mL) than in women with BV (402 pg/mL; P = .0116) and lower in women with VVC (741 pg/mL; P = .0017). Median lactic acid levels were similar in controls (0.11 mmol/L) and women with VVC (0.13 mmol/L) and were lower in women with BV (0.02 mmol/L; P < .0001). The NGAL and lactic acid concentrations were highly correlated (P < .0001).

Conclusion

A decrease in Lactobacilli and/or lactic acid plus the absence of leukocytes results in lower vaginal NGAL levels that might facilitate the growth of bacteria associated with BV.

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References

  1. Schmidt-Ott KM, Mori K, Li JY, et al. Dual action of neutrophil gelatinase-associated lipocalin. J Am Soc Nephrol. 2007;18(2):407–413.

    Article  CAS  PubMed  Google Scholar 

  2. D’Anna R, Baviera G, Corrado F, Giordano D, Recupero S, Di Benedetto A. First trimester serum neutrophil gelatinase-associated lipocalin in gestational diabetes. Diabetic Med. 2009;26(12):1293–1295.

    Article  PubMed  Google Scholar 

  3. Flo TH, Smith KD, Sato S, et al. Lipocalin 2 mediates an innate immune response to bacterial infection by sequestering iron. Nature. 2004;432(7019):917–921.

    Article  CAS  PubMed  Google Scholar 

  4. Cowland JB, Sorensen OE, Schested M, Borregaard N. Neutrophil gelatinase-associated lipocalin is up-regulated in human epithelial cells by IL-1β, but not by TNF-α. J Immunol. 2003;171(12):6630–6639.

    Article  CAS  PubMed  Google Scholar 

  5. Bolignano D, Donato V, Lacquaniti A, et al. Neutrophil gelatinase-associated lipocalin (NGAL) in human neoplasias: a new protein enters the scene. Cancer Lett. 2012;288(1):10–16.

    Article  Google Scholar 

  6. Haase M, Bellomo R, Haase-Fielitz A. Neutrophil gelatinase-associated lipocalin. Curr Opin Crit Care. 2010;16(6):526–532.

    Article  PubMed  Google Scholar 

  7. Donders G. Diagnosis and management of bacterial vaginosis and other types of abnormal vaginal bacterial flora: a review. Obstet Gynecol Surv. 2010;65(7):462–473.

    Article  PubMed  Google Scholar 

  8. Amsel R, Totten PA, Speigel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74(1):14–22.

    Article  CAS  PubMed  Google Scholar 

  9. Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis isimproved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297–301.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Sobel JD, Faro S, Force RW, et al. Vulvovaginal candidiasis: Epidemiologic, diagnostic, and therapeutic considerations. Am J Obstet Gynecol. 1998;178(2):203–211.

    Article  CAS  PubMed  Google Scholar 

  11. Zhou X, Westman R, Hickey R, et al. Vaginal microbiota of women with frequent vulvovaginal candidiasis. Infect Immun. 2009;77(9):4130–4135.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Tadesse S, Luo G, Park JS, et al. Intra-amniotic infection upregulates neutrophil gelatinase-associated lipocalin (NGAL) expression at the maternal-fetal interface at term: implications for infection-related preterm birth. Reprod Sci. 2011;18(8):713–722.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Fichorova RN, Cronin AO, Lien E, Anderson DJ, Ingalls RR. Response to Neisseria gonorrhoeae by cervicovaginal epithelial cells occurs in the absence of toll-like receptor 4-mediated signaling. J Immunol. 2002;168(5):2424–2432.

    Article  CAS  PubMed  Google Scholar 

  14. Biagi E, Vitali B, Pugliese C, et al. Quantitative variations in the vaginal bacterial population associated with asymptomatic infections: a real-time polymerase chain reaction study. Eur J Clin Microbiol Infect. 2009;28(3):281–285.

    Article  CAS  Google Scholar 

  15. Jarosik GP, Land CB, Duhon P, Chandler R Jr, Mercer T. Acquisition of iron by Gardnerella vaginalis. Infect Immun. 1998;66(10):5041–5047.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ferreira MC, Whibley N, Mamo AJ, Siebenlist U, Chan YR, Gaffen SL. Interleukin-17-induced protein lipocalin 2 is dispensible for immunity to oral candidiasis. Infect Immun. 2014;82(3):1030–1035.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Witkin SS, Alvi S, Bongiovanni AM, Linhares IM, Ledger WJ. Lactic acid stimulates interleukin-23 production by peripheral blood mononuclear cells exposed to bacterial lipopolysaccharide. FEMS Immunol Med Microbiol. 2011;61(2):153–158.

    Article  CAS  PubMed  Google Scholar 

  18. Shime H, Yabu M, Akazawa T, et al. Tumor-secreted lactic acid promotes IL-23/IL-17 proinflammatory pathway. J Immunol. 2008;180(11):7175–7183.

    Article  CAS  PubMed  Google Scholar 

  19. Mossop H, Linhares IM, Bongiovanni AM, Ledger WJ, Witkin SS. Influence of lactic acid on endogenous and viral RNA-induced immune mediator production by vaginal epithelial cells. Obstet Gynecol. 2011;118(4):840–846.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Cornell Medical College, 525 East 68th Street, 10065, NY, New York, USA

    Joziani Beghini MD, Iara M. Linhares MD, PhD, William J. Ledger MD & Steven S. Witkin PhD

  2. Department of Gynecology and Obstetrics, University of Campinas, Campinas, Sao Paulo, Brazil

    Joziani Beghini MD & Paulo C. Giraldo MD, PhD

  3. Department of Gynecology and Obstetrics, University of Sao Paulo Medical School, Sao Paulo, Brazil

    Iara M. Linhares MD, PhD

Authors
  1. Joziani Beghini MD
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  2. Paulo C. Giraldo MD, PhD
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  3. Iara M. Linhares MD, PhD
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  4. William J. Ledger MD
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  5. Steven S. Witkin PhD
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Corresponding author

Correspondence to Steven S. Witkin PhD.

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Beghini, J., Giraldo, P.C., Linhares, I.M. et al. Neutrophil Gelatinase-Associated Lipocalin Concentration in Vaginal Fluid. Reprod. Sci. 22, 964–968 (2015). https://doi.org/10.1177/1933719115570914

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  • DOI: https://doi.org/10.1177/1933719115570914

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