Comparison of methods for assessing the inflammatory response of the lower parts of the female reproductive tract

Hypothesis/aims of study. A lack of timely diagnosis and treatment of inflammatory diseases of the lower genital tract in a woman can lead to serious reproductive disorders. The detection of inflammation is an important component of the diagnosis of these diseases. This study was undertaken to compare methods for detection of local inflammation in women with complaints of vaginal discharge. Study design, materials, and methods. A total of 87 women having vaginal discharge were enrolled in the study. For the detection of inflammation, vaginal discharge was examined using microscopy and reverse transcriptase polymerase chain reaction (the ImmunoQuantex® test, DNA-Technology Ltd., Moscow, Russia). Results. Vaginal infections caused by opportunistic microorganisms were detected in 27 women (31%), as follows: candidal vulvovaginitis (CVV) in 10 patients (11.5%), aerobic vaginitis (AV) in 14 patients (16.1%), and bacterial vaginosis (BV) in 14 patients (16.1%), with 8 (9.2%) of them having BV combined with CVV, AV or both infections. The results of the two methods fully agreed in the analysis of samples from women with CVV and AV as vaginal infections characterized by local inflammation. Testing samples from women with BV, which is a non-inflammatory syndrome, as well as women without vaginal infections resulted in significant discrepancies between the two methods. The sensitivity and specificity of the ImmunoQuantex® test compared to the microscopic method were 85.7% and 48.9%, respectively. Conclusion. The new reverse transcriptase polymerase chain reaction based test for the evaluation of expression profiles of selected genes of immune response enables to assess the local immune status in the vagina. Determination of the presence or absence of inflammatory reaction in the vagina can be used as a diagnostic criterion for resolving discrepancies between laboratory data and clinical manifestations, as well as for choosing effective therapy.