OBJECTIVE: Cytokines are potential biomarkers of immune response in the lower female genital tract. This study compares cytokines between the vagina and endometrium, two portals of entry for infectious organisms.DESIGN: Randomized, assessor-blinded cross-over trial. MATERIALS AND METHODS: Eighteen reproductive-aged women underwent follicular phase vaginal lavage (VL) and endometrial lavage (EL) as part of a clinical trial examining the impact of vaginal gels on the vagina and endometrium. Eight pro-inflammatory cytokines (Il-1b, Il-6, Il-8, MCP-1, MIP-1a, MIP-1b, RANTES, and TNF-a and three anti-inflammatory cytokines (Il-1ra, Il-10, Slp-1) were assayed in baseline VL and EL specimens (RayBio Human Cytokines Array). Absolute cytokine levels were compared between VL and EL by signrank tests.RESULTS: Multiple cytokines differed between the vagina and endometrium. Of pro-inflammatory cytokines, Il-1b (p¼0.001) was significantly higher, while RANTES (p<0.001) was significantly lower in the vagina. Of anti-inflammatory markers, Il-1ra (p<0.001) was higher, while Il-10 (p<0.001) and Slp-1 (p<0.001) were significantly lower in the vagina than in the endometrium.CONCLUSIONS: This is the first study to compare immune response between the human vagina and endometrium using inflammatory cytokines. Our findings suggest that immune response varies by different sites of the lower reproductive tract. However, we see no common trend in regard to pro-and anti-inflammatory cytokines between these sites. It is unknown whether these differences reflect independent immune responses at the two sites, or, alternatively, vaginal immune responses are a product of mixed vaginal and endometrial immune response.

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