Vulvovaginal candidiasis in women of reproductive age: immunological aspects of modern algorithms for examination and treatment

Abstract

immunological defense complex is involved: the role of complement, T-lymphocytes, NK-cells is noted. Of particular importance among immune factors is interferon-γ, which is able to limit the reproduction of Candida fungi in the early stages of infection by stimulating the immune response. This is due to the fact that interferon-γ is the strongest stimulator of effector functions of macrophages (microbicidal activity, cytokine production), increases the expression of histocompatibility molecules MHCI and MHCII, as well as adhesion molecules on endothelial cells, increasing endothelial permeability. Thus, the rate of development and severity of the pathological process depend on the state of the body’s defenses. The use of antibiotics, glucocorticoids and cytostatics, as well as radiation therapy can enhance the adhesive properties of yeast fungi. The choice of treatment for VVC should be based on the results of a comprehensive diagnosis, taking into account the form and risk factors of the disease. Local immunity impairment due to the innate quality of the vaginal epitheliocytes is currently one of the most significant risk factors for the development of VVC. This also explains the availability of sufficient drugs for etiotropic therapy, which does not affect its recurrence rate. The use of topical immunomodulators is a very promising method of overcoming the therapeutic failures in the complex treatment of genital candidiasis.