Local immunity in Indian women with bacterial vaginosis

Objectives: To determine the immunoglobulin (Ig) and cytokine levels and degradation of Igs in the cervico-vaginal secretions (CVS) of non-pregnant Indian women of low socio economic status (LSES), with/without bacterial vaginosis (BV) and to assess the interactions among nutritional status, BV and local immunity. Methods: A descriptive study in non-pregnant women of LSES attending the gynecology out patient clinic at a local government hospital, Hyderabad, India. Two hundred non-pregnant women underwent clinical, anthropometrical and gynecological examination and were screened for BV. In a sub-sample of 80 with/without BV, levels of IL-10 and IL-12, IgA, IgM and IgG were determined in the CVS by ELISA and degradation of IgA and IgM by Western blotting. Statistical significance among the groups was tested using the non-parametric Mann-Whitney U-test. Results: Fifty seven percent of the women tested positive for BV. Women with BMI < 16.0 had the highest BV positivity and the lowest IgA levels in CVS. Higher levels of IgA were observed in women with BMI > 18.5. There was significant degradation of IgA and IgM in women with BV. IL-12 was undetectable while IL-10 was detected with higher means in CVS of women with B V. Conclusions: Severe under-nutrition appears to be relevant to BV positivity and local immunity in these women. Greater degradation of IgA and IgM in BV suggests impaired local immunity. (c) 2005 Elsevier Ireland Ltd. All rights reserved.