Abstract
Annotation. The stress objective marker is the neuro-hormonal stress-implementing system stress and the increase the cortisol and prolactin levels in the blood, leading to the “distress syndrome” formation. Aim – to establish the stress effect, revealed according to the level of stress- implementing hormones, in particular cortisol and prolactin, on the progression of vaginal bacterial dysbiosis and the bacterial vaginosis (BV) development. During the study there were used the data taken from 298 women, who were divided into the following groups according to the Opportunistic pathogenic microflora index (OPMI) and normobiota index (NBI): normocenosis (n=53), dysbiosis I (n=128) and II degree (n=117) among the latter 83 patients with NBI>1 lg GE/sample were identified, in which BV was established. Molecular genetic studies of the epithelium scraping from the vagina posterolateral wall were carried out by Polymerase chain reaction (“DNK-Technologiia” LLC, RF). Facultative and obligate anaerobes, myco- and ureplasmas, and yeast-like fungi were quantified. The cortisol and prolactin blood levels were identified. For statistical analysis, the Statistica 10 software (StatSoft, Inc., USA) was used. Catch out that the blood cortisol content with dysbiosis progression compared with the normocenosis has changed in two-phase: it was increased with I degree dysbiosis (1.2–1.4 times; p<0.01) and decreased with II degree dysbiosis and BV (1.5 times; p<0.001). So, with respect to the classical concept of the General adaptive syndrome of G. Selye, the first dysbiosis development stages can be considered as reaction of “anxiety”, while the development of BV is a reaction of “exhaustion”. The blood prolactin content compared with normocenosis with dysbiosis was increased, which was most expressed in BV (1.5 times; p <0.001). It also reflected the stress response development with increased central nervous system stress. The blood hormones content has relation with BV-associated microbiota indexes: prolactin was positively related with NBI, and cortisol was negatively related to the number of Atopobium vaginalis. Thus, according to the data obtained, BV can be attributed to the stress pathology with the "distress syndrome" development and the content of cortisol and prolactin in the blood can be considered as marker factors for hormonal regulation disorder.
Highlights
Bacterial vaginosis (BV) is the most common lower genital tract infection in women of reproductive age [3, 21]
Since the basis of BV is the uncontrolled growth of anaerobic bacteria [19] and the reduction of vaginal colonization resistance [10], the authors [11] hypothesized the suppression of immune function by stress, which increases the risk of BV
The obtained results showed that the content of cortisol in the blood as the dysbiosis progressed changed in two phases: - was increased in the 1st (1.2 times; p=0.005) and in the 2nd subgroup (1.4 times; p
Summary
Bacterial vaginosis (BV) is the most common lower genital tract infection in women of reproductive age [3, 21]. Especially BV during pregnancy, is one of the main causes of adverse perinatal consequences: it was found that women with moderate and high levels of stress were 2.3 times and 2.2 times, respectively, more likely to have BV [5]. Since the basis of BV is the uncontrolled growth of anaerobic bacteria [19] and the reduction of vaginal colonization resistance [10], the authors [11] hypothesized the suppression of immune function by stress, which increases the risk of BV. A higher prevalence of BV has been found in women with high levels of general stress. A close relationship between stress levels, immune suppression, and changes in vaginal microbiota has been shown in a retrospective cohort study (n=2439; OR 1.015; 95 % CI 1.005-1.026) [25]
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