Local immunity in Indian women with bacterial vaginosis

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.

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.

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 BV.

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.