Lactobacillus Species Isolates and Vaginal Pro-Inflammatory Cytokine Levels in Women of Reproductive Age Attending Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi

Abstract

The association between vaginal Lactobacillus spp and regulation of pro-inflammatory cytokines have been reviewed. This study was done to evaluate the relationship between the presence of Lactobacillus spp isolated in the vagina of women of reproductive age resident in Nnewi and vaginal tissue pro-inflammatory cytokines (TNF-α and IFN-ᵞ) levels. A total of 220 women of reproductive age (pregnant and non-pregnant women) aged between 18-45 years who attended Obstetrics and Gynaecology clinics at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi and had been classified according to their clinical Bacterial Vaginosis (BV)- status, were enrolled for the study. Two vaginal swabs samples were obtained from each woman. The first swab was used for cultivation and isolation of Lactobacillus spp, while the second swab used for evaluation of pro-inflammatory cytokines (TNF-α and IFN-ᵞ). Within the study population, women who were noted to be non-pregnant and clinically BV-positive had significantly higher mean levels of Pro-inflammatory cytokines (PC); TNF-α (57.90±27.26 pg/ml) and IFN-ᵞ (168.98±100 pg/ml) compared non-pregnant women who were BV-negative with TNF-α (13.48±4.67 pg/ml) and IFN-ᵞ (29.56 pg/ml). Comparison between both groups showed statistically significant difference (p < 0.05). Generally, pregnant women had lower mean levels of PC; TNF-α (24.68±21.69 pg/ml) and IFN-ᵞ (82.35±35.74 pg/ml) compared to non-pregnant women with TNF-α (36.79±29.90) and IFN-ᵞ (102.71±100.86) regardless of their BV-status (p > 0.05). Non-pregnant participants in which Lactobacillus iners were isolated had the highest up-regulation of PC; TNF-α (55.80 pg/ml) and IFN-ᵞ (149.9 pg/ml) compared with other women in the same group who had Lactobacillus crispatus and Lactobacillus acidophilus isolated from their vaginal samples. In pregnant women, subjects with Lactobacillus plantarum isolated had the highest up-regulation of PC; TNF-α (75.63 pg/ml) and IFN-ᵞ (163.63 pg/ml) compared to women who had other Lactobacillus spp isolated from their vaginal swabs. It is inferred by this study the presence of L.iners has a remarkable association with the up-regulation of pro-inflammatory cytokines which promote pathological process in the vaginal disease states. The potential for the deployment of L.iners as a promising potential algorithm and biomarker in the detection of vaginosis and vaginitis is noted in this study