Abstract
Objective: The cause of vulvar vestibulitis syndrome is unknown. To determine a possible role
for defective immune regulation in this chronic condition, proinflammatory and anti-inflammatory
immune responses to the 70-kd heat shock protein and to lipopolysaccharide were compared
in women with and without vulvar vestibulitis syndrome. Study design: Whole blood cultures from 62 women with vulvar vestibulitis syndrome and 48 control
subjects were incubated in the presence or absence of 5 μg/mL human recombinant 70-kd
heat shock protein or 0.1 ng/mL lipopolysaccharide for 18 hours. The culture supernatants
were then assayed for interleukin-1β and interleukin-1 receptor antagonist by enzyme-linked
immunosorbent assay. Results: Median levels of interleukin-1β were higher in response to heat shock protein in
cultures from patients with vulvar vestibulitis syndrome (median, 1.07 ng/mL) as opposed
to control subjects (median, 0.40 ng/mL; P = .006). Conversely, levels of interleukin-1 receptor antagonist were higher in response
to heat shock protein in control subjects (median, 39.21 ng/mL) than in patients (median,
29.25 ng/mL; P = .009).In response to lipopolysaccharide, median levels of interleukin-1β were similar
in patients (1.00 ng/mL) and control subjects (1.15 ng/mL); median interleukin-1 receptor
antagonist concentrations were higher in control subjects (70.0 ng/mL) than in patients
(44.3 ng/mL; P < .0001). The ratio of interleukin-1 receptor antagonist to interleukin-1β was higher
in control subjects than in women with vulvar vestibulitis syndrome in response to
both heat shock protein (P = .0002) and lipopolysaccharide (P = .01). In uninduced cultures, interleukin-1 receptor antagonist levels were also
higher in control subjects (median, 1.60 ng/mL) than in patients with vulvar vestibulitis
syndrome (median, 0.62 ng/mL; P < .0001). Conclusion: A relative inability to down-regulate proinflammatory interleukin-1β activity by
interleukin-1 receptor antagonist may contribute to the pathophysiologic features
of vulvar vestibulitis syndrome. (Am J Obstet Gynecol 2002;186:696-700.)
Keywords
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Article Info
Publication History
Accepted:
November 19,
2001
Received in revised form:
October 15,
2001
Received:
June 21,
2001
Footnotes
☆Reprint requests: Steven S. Witkin, PhD, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 515 E 71st St, New York, NY 10021. E-mail: [email protected]
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
