Vulvodynia and fungal association: A preliminary report

Ventolini, Gary; Gygax, Scott E.; Adelson, Martin E.; Cool, David R.

doi:10.1016/j.mehy.2013.04.043

Cited by 35 publications

(43 citation statements)

References 6 publications

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“…These observations further align our findings in Ox-CHS hyperalgesia with clinical evidence for a role for these inflammatory cytokines associated with allergies and vulvar pain. Recent studies of vaginal secretions in vulvodynia patients vs. controls have shown an increase in IL-4 levels in patients [33]. After 3 Ox challenges, we found a very slight upregulation in IL-4 transcripts in the labiar tissue and are continuing to monitor the levels of this cytokine in the context of >3 Ox challenges in studies ongoing in our laboratory.…”

Section: Discussionsupporting

confidence: 59%

“…IL-1β transcript levels were 15-fold and ~30-fold increased over ethanol-challenge controls following 1 and 3 Ox challenges respectively. These inflammatory cytokines are also increased in vulvar biopsies from vulvar vestibulitis patients [32] but not in vaginal lavages from patients vs. controls [33]. Genetic differences in the production of IL-1β and IL-1Ra in vulvodynia patients vs. controls [34] and enhanced IL-6 production in vulvar fibroblasts obtained from vulvodynia patients have been reported [35].…”

Section: Discussionmentioning

confidence: 99%

“…We found only a slight upregulation in IL-13 mRNA levels in experimental vs. control mice, and little to no change in IL-5 and CCL11 transcripts (Figure S5B). Interestingly, no increases in levels of IL-5, IL-13 and CCL11 have been reported in vaginal secretions of vulvodynia patients compared to controls [33]. …”

Section: Discussionmentioning

confidence: 99%

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Contact Hypersensitivity to Oxazolone Provokes Vulvar Mechanical Hyperalgesia in Mice

et al. 2013

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The interplay among pain, allergy and dysregulated inflammation promises to yield significant conceptual advances in immunology and chronic pain. Hapten-mediated contact hypersensitivity reactions are used to model skin allergies in rodents but have not been utilized to study associated changes in pain perception in the affected skin. Here we characterized changes in mechanical hyperalgesia in oxazolone-sensitized female mice challenged with single and repeated labiar skin exposure to oxazolone. Female mice were sensitized with topical oxazolone on their flanks and challenged 1-3 times on the labia. We then measured mechanical sensitivity of the vulvar region with an electronic pressure meter and evaluated expression of inflammatory genes, leukocyte influx and levels of innervation in the labiar tissue. Oxazolone-sensitized mice developed vulvar mechanical hyperalgesia after a single labiar oxazolone challenge. Hyperalgesia lasted up to 24 hours along with local influx of neutrophils, upregulation of inflammatory cytokine gene expression, and increased density of cutaneous labiar nerve fibers. Three daily oxazolone challenges produced vulvar mechanical hyperalgesic responses and increases in nerve density that were detectable up to 5 days post-challenge even after overt inflammation resolved. This persistent vulvar hyperalgesia is resonant with vulvodynia, an understudied chronic pain condition that is remarkably prevalent in 18-60 year-old women. An elevated risk for vulvodynia has been associated with a history of environmental allergies. Our pre-clinical model can be readily adapted to regimens of chronic exposures and long-term assessment of vulvar pain with and without concurrent inflammation to improve our understanding of mechanisms underlying subsets of vulvodynia and to develop new therapeutics for this condition.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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Contact Hypersensitivity to Oxazolone Provokes Vulvar Mechanical Hyperalgesia in Mice

et al. 2013

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“…This results in repetitive stimulation of pain receptors and ultimately receptor or nerve damage (nociceptive pain) 17. Allergic contact dermatitis18 and yeast19,20 or other urogenital infections21 have all been proposed as causes for inflammation. Women may identify trauma as precipitating their pain.…”

Section: Etiologymentioning

confidence: 99%

Etiology, diagnosis, and clinical management of vulvodynia

Sadownik¹

2014

IJWH

106

154

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Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. It may affect girls and women across all age groups and ethnicities. Vulvodynia is a significant burden to society, the health care system, the affected woman, and her intimate partner. The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. An approach to the diagnosis and management of a woman presenting with chronic vulvar pain should address the biological, psychological, and social/interpersonal factors that contribute to her illness. The gynecologist has a key role in excluding other causes for vulvar pain, screening for psychosexual and pelvic floor dysfunction, and collaborating with other health care providers to manage a woman’s pain. An important component of treatment is patient education regarding the pathogenesis of the pain and the negative impact of experiencing pain on a woman’s overall quality of life. An individualized, holistic, and often multidisciplinary approach is needed to effectively manage the woman’s pain and pain-related distress.

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“…Infections, such as those with Candida albicans, may perpetuate an immunological response increasing the risk of vulvodynia [79].…”

Section: Vulvar Pain Disordersmentioning

confidence: 99%

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

Shah

Ginzburg

Morrissey

et al. 2015

Curr Bladder Dysfunct Rep

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The diagnosis and treatment of chronic pelvic pain have shifted from organ-specific to multifactorial, multidisciplinary, and individualized approach. While many organizations have had diverse outlooks on classification and treatment plans, new research has identified varied clinical phenotypes and updated classification systems. These phenotypes are based on pain, gender, symptomatology, and comorbid pain syndromes. These new classification systems allow a multimodal therapeutic approach and evaluation of patients. Multidisciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy, and pain medicine, is also further recognized for adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies.

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Vulvodynia and fungal association: A preliminary report

Cited by 35 publications

References 6 publications

Contact Hypersensitivity to Oxazolone Provokes Vulvar Mechanical Hyperalgesia in Mice

Contact Hypersensitivity to Oxazolone Provokes Vulvar Mechanical Hyperalgesia in Mice

Etiology, diagnosis, and clinical management of vulvodynia

Update in Diagnosis and Treatment of Chronic Pelvic Pain Syndromes

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