Among pregnant women with bacterial vaginosis, the hydrolytic enzymes sialidase and prolidase are positively associated with interleukin-1beta

OBJECTIVE: The objective of the study was to explore the mechanisms of local innate immunity induction and modulation in pregnant women with bacterial vaginosis (BV). STUDY DESIGN: A total of 200 singleton pregnant women in early gestation (12 4 weeks) with BV (Nugent 7-10) without concurrent vaginal infections with Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, and yeast. Concentrations of vaginal interleukin (IL)-1 and IL-8, the number of neutrophils, and the levels of sialidase and prolidase hydrolytic enzymes were determined in vaginal fluid. RESULTS: Concentrations of vaginal IL-1 had a strong positive correlation with levels of sialidase (P .001) and prolidase (P .001). Conversely, such enzymes were negatively correlated with the ratio of IL-8/IL-1 (both P .001) and were not significantly associated with concentrations of IL-8. Notably, the number of vaginal neutrophils had a negative correlation with sialidase (P .007). CONCLUSION: The strong induction of IL-1 in BV-positive women appears to be associated with the production of the hydrolytic enzymes sialidase and prolidase by BV-associated bacteria. However, these 2 enzymes may inhibit the expected amplification of the proinflammatory IL-1 cascade as evaluated by the down-regulation of the IL-8/IL-1 ratio. A blunted response to IL-1 signals may cause the poor rise of neutrophils, which is peculiar to BV. This impairment of local defense may contribute to increased susceptibility to adverse outcomes in BVpositive pregnant women.