Mannose-Binding Lectin Gene Polymorphism, Vulvovaginal Candidiasis, and Bacterial Vaginosis

Giraldo, Paulo César; Babula, Oksana; Gonçalves, Ana Katherine; Linhares, Iara M.; Amaral, Rose Luce Gomes do; Ledger, William J.; Witkin, Steven S.

doi:10.1097/01.aog.0000260386.17555.a5

Cited by 97 publications

(99 citation statements)

References 20 publications

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“…Those authors also reported that the presence of the B allele was associated with significantly fewer recurrences among women who were placed on chronic fluconazole maintenance therapy. Carriage of MBL allele B was also more frequent in Brazilian women with recurrent vulvovaginal candidiasis (25.0%) than in women with acute vulvovaginal candidiasis (17.9%) or controls (10.6%) (160). MBL concentrations in cervicovaginal lavage fluid specimens from Chinese (257) and Latvian (17,18) women with recurrent vulvovaginal candidiasis were lower than those in a control population.…”

Section: Inherited Deficiencies Of Complement Activationmentioning

confidence: 85%

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

2010

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SUMMARY The complement system comprises several fluid-phase and membrane-associated proteins. Under physiological conditions, activation of the fluid-phase components of complement is maintained under tight control and complement activation occurs primarily on surfaces recognized as “nonself” in an attempt to minimize damage to bystander host cells. Membrane complement components act to limit complement activation on host cells or to facilitate uptake of antigens or microbes “tagged” with complement fragments. While this review focuses on the role of complement in infectious diseases, work over the past couple of decades has defined several important functions of complement distinct from that of combating infections. Activation of complement in the fluid phase can occur through the classical, lectin, or alternative pathway. Deficiencies of components of the classical pathway lead to the development of autoimmune disorders and predispose individuals to recurrent respiratory infections and infections caused by encapsulated organisms, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. While no individual with complete mannan-binding lectin (MBL) deficiency has been identified, low MBL levels have been linked to predisposition to, or severity of, several diseases. It appears that MBL may play an important role in children, who have a relatively immature adaptive immune response. C3 is the point at which all complement pathways converge, and complete deficiency of C3 invariably leads to severe infections, including those caused by meningococci and pneumococci. Deficiencies of the alternative and terminal complement pathways result in an almost exclusive predisposition to invasive meningococcal disease. The spleen plays an important role in antigen processing and the production of antibodies. Splenic macrophages are critical in clearing opsonized encapsulated bacteria (such as pneumococci, meningococci, and Escherichia coli) and intraerythrocytic parasites such as those causing malaria and babesiosis, which explains the fulminant nature of these infections in persons with anatomic or functional asplenia. Paramount to the management of patients with complement deficiencies and asplenia is educating patients about their predisposition to infection and the importance of preventive immunizations and seeking prompt medical attention.

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Section: Inherited Deficiencies Of Complement Activationmentioning

confidence: 85%

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

2010

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“…Mannose-binding lectin (MBL) is an epithelial cell-associated host protein, binds to Candida mannan, activates complement, and thus inhibits Candida growth. Reduced levels of MBL and genetic polymorphism in the MBL gene were found in Chinese and Latvian women with RVVC (18,104,155).…”

Section: Innate Immune Responses To Vvcmentioning

confidence: 93%

“…An increased incidence of VVC was found in African-American compared to white American women in two different population-based studies (97,102). Furthermore, increased incidence of blood group ABO-Lewis nonsecretor phenotype was found in women with RVVC compared to controls (48), and more recently, polymorphism in the mannose-binding lectin gene was found to be associated with RVVC (18,104). HIV ϩ women have higher rates of vaginal colonization with Candida, often non-C. albicans species, than HIV Ϫ women (76,94,223,249).…”

Section: Risk Factors For Vvcmentioning

confidence: 98%

Candida Infections of the Genitourinary Tract

2010

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SUMMARYAll humans are colonized withCandidaspecies, mostlyCandida albicans, yet some develop diseases due toCandida, among which genitourinary manifestations are extremely common. The forms of genitourinary candidiasis are distinct from each other and affect different populations. While vulvovaginal candidiasis affects mostly healthy women, candiduria occurs typically in elderly, hospitalized, or immunocompromised patients and in neonates. Despite its high incidence and clinical relevance, genitourinary candidiasis is understudied, and therefore, important questions about pathogenesis and treatment guidelines remain to be resolved. In this review, we summarize the current knowledge about genitourinary candidiasis.

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“…24 Giraldo et al demonstrated that the incidence of vulvovaginitis differed according to race among Brazilian women, and MBL2 codon 54 gene polymorphism was associated with both recurrent vulvovaginal candidiasis and bacterial vaginosis. 25 Furthermore, other factors may be involved. A recent study showed a higher number of stressful life events (such as socioeconomic status and psychosocial stress) was significantly associated with higher bacterial vaginosis prevalence, among both African-American and white American women.…”

Section: Discussionmentioning

confidence: 99%

Relationship between infectious agents for vulvovaginitis and skin color

et al. 2010

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CONTEXT AND Objective: Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis. DESIGN AND SETTING:Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba). METHODS:Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X 2 test, logistic regression and odds ratios. RESULTS:The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (P < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (P < 0.0001 and P < 0.05, respectively). CONCLUSIONS: There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.RESUMO CONTEXTO E OBJETIVO: Muitos fatores influenciam a ocorrência de vulvovaginites. Os objetivos foram avaliar diferenças relacionadas à cor da pele e idade na flora vaginal e vulvovaginites. TIPO DE ESTUDO E LOCAL: Estudo transversal; hospital de referência terciário (Universidade Federal do Triângulo Mineiro, Uberaba).MÉTODOS: Mulheres saudáveis em atendimento de rotina para exames ginecológicos foram divididas em brancas (n = 13.881) e não brancas (n = 5.295) e avaliadas quanto a vulvovaginites e flora vaginal. Para análise estatística, foram utilizados teste X 2 , regressão logística e odds ratio.RESULTADOS: Microflora vaginal foi dependente da cor da pele, com maior ocorrência de "clue cells", Trichomonas vaginalis e bacilos cocoides em não brancas (P < 0,0001); bacilos de Döderlein e flora citolítica foram mais prevalentes em brancas (P < 0,0001 e P < 0,05, respectivamente CONCLUSÕES: Há diferenças na ocorrência de vulvovaginites relacionadas com a cor da pele, podendo haver associação com variações na flora vaginal.

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Mannose-Binding Lectin Gene Polymorphism, Vulvovaginal Candidiasis, and Bacterial Vaginosis

Abstract: The incidence of vulvovaginal candidiasis and bacterial vaginosis differs by ethnicity in Brazilian women. The MBL2 codon 54 gene polymorphism is associated with both recurrent vulvovaginal candidiasis and recurrent bacterial vaginosis.

Cited by 97 publications

References 20 publications

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

Candida Infections of the Genitourinary Tract

Relationship between infectious agents for vulvovaginitis and skin color

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