Chlamydial endocervicitis in reproductive aged women: aspects of the inate immune response

Abstract

Chlamydia trachomatis is the most common sexually transmitted agent in the world and, according to the World Health Organization, affects more than 90 million people per year. A C. trachomatis infection in women has the most common manifestation mucopurulent cervicitis, and most often asymptomatic. The development of cervicitis depends on many factors such as the activity of the immune system, microorganisms and production of virulence factors which inhibit the growth of pathogens associated with these infections. In this scenario, besides the production of innate immune system cytokines as Interleukin (IL) -1², IL-6 and Tumor Necrosis Factor (TNF-±) there is the production of natural antimicrobials such as human ² defensin (HBDs), which exhibit antibacterial activity and can play an important role in the host immune response.Objective: To determine the levels of HBD-1, HBD-2, HBD-3, HBD-4 and IL-1 ², IL-10 and TNF-± factor in cervicovaginal content of women with Chlamydia endocervicitis.Patients and Methods: This is a ambispectivo study which is going to include 80 women who participated in the campaign "Taking care of Women's Intimate Health" held in 2012. During the speculum examination, it was collected vaginal content for pattern analysis of vaginal microbiota following Nugent et al. (1991) and Donders et al. (2002) criteria. Next, the cervical secretion was collected with cytobrush for C. trachomatis search by Polymerase Chain Reaction (PCR).Finally, the cervicovaginal lavage fluid was collected to determine the levels of HBD-1, HBD-2, HBD-3 and HBD-4 and IL-1², IL-10 and TNF-± by ELISA. The study group will consist of 40 women diagnosed with C. trachomatis cervicitis and normal vaginal flora and the control group of 40 women with no C. trachomatis cervicitis and normal vaginal flora. All women had, at enrollment, ages between 18 and 50 years and met the following eligibility criteria: non-pregnant, non-menopausal, HIV negative without urinary tract infection, infection treatment absence of the genital tract less in 30 period days and at least 72 hours of sexual abstinence. Statistical analysis and the choice of comparison tests between the variables of interest in this study is going to be implemented in accordance with the conditions determined by the results. For all the tests used, it is going to be adopted the 5% significance level.