RVVC患者阴道分泌物中SP-A的表达及意义
|
摘要
外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)是一种由假丝酵母菌引起的常见的育龄期妇科疾病。流行病学研究估计大约有75%妇女患过1次此症,其中大多数为育龄期妇女,而且约有5%的成年妇女曾患复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidosis,RVVC)。RVVC是指一年中复发4次或者4次以上,并反复出现感染。随着RVVC发病机制研究的进展,目前认为RVVC的复发可能与阴道局部免疫功能异常有关,并且阴道宿主防御机制中的天然免疫因子近来受到关注。肺表面活性物质相关蛋白A (Pulmonary surfactant-associated protein A,SP-A)是阴道局部细胞分泌的一种具有多种免疫调节功能的蛋白质,其在阴道局部分泌物中的表达对于RVVC的发生发展具有一定作用。
目的:探讨肺表面活性物质相关蛋白A(SP-A)在复发性外阴阴道假丝酵母菌病(RVVC)患者阴道分泌物中的表达及意义。
方法:收集RVVC患者阴道分泌物28例,外阴阴道假丝酵母菌患者(VVC)及健康体检者(对照组)阴道分泌物各30例,采用酶联免疫吸附测定方法(enzyme-linked immunosorbent assay,ELISA)测定各组中SP-A蛋白的含量,用逆转录聚合酶链式反应(reverse transcription–polymerase chain reaction,RT–PCR)方法检测各组中SP-A的基因表达情况。
结果:用ELISA方法检测各组中SP-A蛋白的含量发现:VVC组的SP-A明显高于对照组(P<0.05), RVVC组的SP-A高于对照组及VVC组(P<0.05)。RT-PCR方法发现:VVC组的SP-A mRNA的表达水平高于对照组(P<0.05),RVVC组的SP-A mRNA的表达水平明显高于对照组及VVC组(P<0.05)。
结论:SP-A可能是RVVC患者抗假丝酵母菌的重要物质,其性质或数量的改变可能在RVVC的发病机制中发挥重要作用。
Vulvovaginal candidiasis(vvc) is a kind of vulvovaginal inflammation caused by candida infection,which is a a common disorder in women of childbearing age. The infection affects approximately 75% of women at least once during their lives, most frequently young women of childbearing age. 5–8% of adult women have recurrent vulvovaginal candidosis. Patients,suffering of at least four episodes of candida infection during 1 year,have a recurrent infection and are therefore recognized and classified as recurring vulvovaginal candidosis (RVVC) patients.With the developments of the researches in pathogenic mechanisms, now it is believed that the recurrence have obvious relevance to the deficiency of vaginal-associated immunity.Recent studies have focused on the importance of the innate immune factors in the vaginal host defense mechanism against mucosal candidal infections.Research shows pulmonary surfactant-associated protein A(SP-A) is a protein produced by squamous epithelium,namely the vaginal mucosa,which have important immunoregulation function.The expression of SP-A in the vaginal fluid might contribute to the recurrence of RVVC.
Objective:It was to study the expression and signification of pulmonary surfactant-associated protein-A in the vaginal fluid of recurrent vulvovaginal candidiasis(RVVC).
Methods:Human vaginal fluid from 28 RVVC patients,30 VVC patients and 30 healthy women(the control group)were collected, respectively.Enzyme-linked immunosorbent assay(ELISA) was applied to detect the levels of SP-A protein.The expression of SP-A gene was detected by reverse transcription–polymerase chain reaction (RT–PCR).
Results:The levels and of SP-A of VVC group were higher than that of the control group ( P < 0. 05).The levels of SP-A of recurrent vulvovaginal candidiasis (RVVC) group were higher than those of VVC group and control group.The expression of SP-A mRNA in VVC was higher than that in the control group.The expression of SP-A mRNA in RVVC was significantly higher than those of VVC group and control group.
Conclusion:SP-A might be an essential component in RVVC resistance. The qualitative and quantitative alterations of normal SP-A may play a role in the pathogenesis of RVVC.
目的:探讨肺表面活性物质相关蛋白A(SP-A)在复发性外阴阴道假丝酵母菌病(RVVC)患者阴道分泌物中的表达及意义。
方法:收集RVVC患者阴道分泌物28例,外阴阴道假丝酵母菌患者(VVC)及健康体检者(对照组)阴道分泌物各30例,采用酶联免疫吸附测定方法(enzyme-linked immunosorbent assay,ELISA)测定各组中SP-A蛋白的含量,用逆转录聚合酶链式反应(reverse transcription–polymerase chain reaction,RT–PCR)方法检测各组中SP-A的基因表达情况。
结果:用ELISA方法检测各组中SP-A蛋白的含量发现:VVC组的SP-A明显高于对照组(P<0.05), RVVC组的SP-A高于对照组及VVC组(P<0.05)。RT-PCR方法发现:VVC组的SP-A mRNA的表达水平高于对照组(P<0.05),RVVC组的SP-A mRNA的表达水平明显高于对照组及VVC组(P<0.05)。
结论:SP-A可能是RVVC患者抗假丝酵母菌的重要物质,其性质或数量的改变可能在RVVC的发病机制中发挥重要作用。
Vulvovaginal candidiasis(vvc) is a kind of vulvovaginal inflammation caused by candida infection,which is a a common disorder in women of childbearing age. The infection affects approximately 75% of women at least once during their lives, most frequently young women of childbearing age. 5–8% of adult women have recurrent vulvovaginal candidosis. Patients,suffering of at least four episodes of candida infection during 1 year,have a recurrent infection and are therefore recognized and classified as recurring vulvovaginal candidosis (RVVC) patients.With the developments of the researches in pathogenic mechanisms, now it is believed that the recurrence have obvious relevance to the deficiency of vaginal-associated immunity.Recent studies have focused on the importance of the innate immune factors in the vaginal host defense mechanism against mucosal candidal infections.Research shows pulmonary surfactant-associated protein A(SP-A) is a protein produced by squamous epithelium,namely the vaginal mucosa,which have important immunoregulation function.The expression of SP-A in the vaginal fluid might contribute to the recurrence of RVVC.
Objective:It was to study the expression and signification of pulmonary surfactant-associated protein-A in the vaginal fluid of recurrent vulvovaginal candidiasis(RVVC).
Methods:Human vaginal fluid from 28 RVVC patients,30 VVC patients and 30 healthy women(the control group)were collected, respectively.Enzyme-linked immunosorbent assay(ELISA) was applied to detect the levels of SP-A protein.The expression of SP-A gene was detected by reverse transcription–polymerase chain reaction (RT–PCR).
Results:The levels and of SP-A of VVC group were higher than that of the control group ( P < 0. 05).The levels of SP-A of recurrent vulvovaginal candidiasis (RVVC) group were higher than those of VVC group and control group.The expression of SP-A mRNA in VVC was higher than that in the control group.The expression of SP-A mRNA in RVVC was significantly higher than those of VVC group and control group.
Conclusion:SP-A might be an essential component in RVVC resistance. The qualitative and quantitative alterations of normal SP-A may play a role in the pathogenesis of RVVC.
引文
[1] Jack D Sobel. Vulvovaginal candidosis[J]. Lancet 2007,369: 1961-71.
[2] Colin Macneill,Todd M.Umstead,David S.Pheles, et a1. Surfactant protein A,an innate immune factor,is expressed in the vaginal mucosa and is present in vaginal lavage fluid[J]. Immunology,2004,111:91-99.
[3] Melissa M.Barousse,Terri Espinosa,Kathleen Dunlap, et a1.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J]. Infect Immun, 2005,73(11):7765-7767.
[4] Melissa M. Barousse, Chad Steele, Kathleen Dunlap,et al.Growth Inhibition of Candida albicans by Human Vaginal Epithelial Cells[J]. JID,2001,184 (1 December):1489-1493.
[5] S.R.Fan,Q.P.Liao, X.P.Liu,et al. Vaginal allergic response in women with vulvovaginal candidiasis[J].International Journal of Gynecology and Obstetrics,2008, 101: 27-30.
[6] Tobias M. Weissenbacher, Steven S. Witkin , Andrea Gingelmaier ,et al.Relationship between recurrent vulvovaginal candidosis and immune mediators in vaginal fluid[J]. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009,144:59–63.
[7] Chad Steele ,Paul L. Fidel, Jr. Cytokine and Chemokine Production by Human Oral and Vaginal Epithelial Cells in Response to Candida albicans[J]. Infection and immunity,2002,70(2):577-583.
[8] Haagsman H P,Diemel R V.Surfactant-associated proteins:functions and structural variation[J].Comp Biochem Physiol A Mol Inter Physio1.2001,129(1):91-108.
[9] Pikaar JC,Voorhout WF,Van Golde LM,et al.Opsonic activities of surfactant proteins A and D in phagocytosis of gram-negative bacteria by alveolar macrophages[J].J Infect Dis, 1995, 172(2): 481-489.
[10] Hiroki Takahashi, Hitomi Sano, Hirofumi Chiba,et al. Pulmonary Surfactant Proteins A and D: Innate Immune Functions and Biomarkers for Lung Diseases[J].Current Pharmaceutical Design,2006, 12(5); 589-598.
[11] Sengelov H.Complement receptors in neutrophils[J].Crit Rev Immunol,1995,15(2):107-131.
[12] LeVine AM,Kurak KE,Bruno MD,etal.Surfactant protein-A-deficient mice are susceptible to Pseudomonas aeruginosa infection[J]. Am J Respir Cell Mol Biol,1998, 19(4):700-708.
[13] Wu H,KuzmenkoA,Wan S,et a1.Sufactant proteins A and D inhibit the growth of Gram-negative bacteria by increasing membrane permeability[J].Clin Invest,2003,l11(10):1589-1602.
[1]赵敬军,童华,张正华,等.念珠菌性外阴阴道炎患者阴道分泌物中白介素4和白介素12水平测定[J].中华皮肤科杂志,2005,38(3):178-179.
[2]刘朝晖,王晓莉,廖秦平.外阴阴道假丝酵母菌患者阴道局部环境状态研究[J].中华妇产科杂志,2006,41(12):843-844.
[3]刘朝晖,陈磊.阴道上皮细胞先天性抗假丝酵母菌的作用研究[J].北京大学学报(医学版),2008,40(2):174-177.
[4]崔纪云,刘会娟,龙成凤,等.肺表面活性物质相关蛋白A、D的研究进展[J].山东医药,2008,48(28):112-113.
[5]孙雨.肺表面活性物质相关蛋白A的免疫调节功能[J].国外医学免疫学分册,2001,24(3):126-128.
[6] Melissa M.Barousse,Terri Espinosa,Kathleen Dunlap,et al.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J].Infect Immun,2005,73(11):7765-7767.
[7] Tobias M .Weissenbacher,Steven S.Witkin,Andrea Gingelmaier,et al.Relationship between recurrent vulvovaginal candidosis and immune mediators in Vaginal fluid[J].European Jouranl of Obstetrics&Gynecology and Reproductive Biology,2009,144(1):59-63.
[8] MacNeill C , Umstead TM , Phelp sDS , et al. Surfactant protein A , an innate immune factor ,is expressed in the vaginal mucosa and is p resent in vaginal lavage fluid [J].Immunology,2004,111(1): 91 - 99.
[9] Orhan Kankavi,Ayhan Ata,Orsan Gungor,et al.Surfactant proteins A and D in the genital tract of mares[J].Animal Reproduction Science,2007,98(3-4):259-270.
[10] Haagsman H P,Diemel R V.Surfactant-associated proteins:functions and structural variation[J].Comp Biochem Physiol A Mol Inter Physio1.2001,129(1):91-108.
[1] Jack D Sobel. Vulvovaginal candidosis[J]. Lancet 2007,369: 1961-71.
[2] Colin Macneill,Todd M.Umstead,David S.Pheles, et a1. Surfactant protein A,an innate immune factor,is expressed in the vaginal mucosa and is present in vaginal lavage fluid[J]. Immunology,2004,111:91-99.
[3] Melissa M.Barousse,Terri Espinosa,Kathleen Dunlap, et a1.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J]. Infect Immun, 2005,73(11):7765-7767.
[4] Melissa M. Barousse, Chad Steele, Kathleen Dunlap,et al.Growth Inhibition of Candida albicans by Human Vaginal Epithelial Cells[J]. JID,2001,184 (1 December):1489-1493.
[5] S.R.Fan,Q.P.Liao, X.P.Liu,et al. Vaginal allergic response in women with vulvovaginal candidiasis[J].International Journal of Gynecology and Obstetrics,2008, 101: 27-30.
[6] Tobias M. Weissenbacher, Steven S. Witkin , Andrea Gingelmaier ,et al.Relationship between recurrent vulvovaginal candidosis and immune mediators in vaginal fluid[J]. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009,144:59–63.
[7] Chad Steele ,Paul L. Fidel, Jr. Cytokine and Chemokine Production by Human Oral and Vaginal Epithelial Cells in Response to Candida albicans[J]. Infection and immunity,2002,70(2):577-583.
[8] Haagsman H P,Diemel R V.Surfactant-associated proteins:functions and structural variation[J].Comp Biochem Physiol A Mol Inter Physio1.2001,129(1):91-108.
[9]Shweta Saxena,MSc,Ratan Kumar,et al.Association of Polymorphisms in Pulmonary Sufactant Protein A1 and A2 Genes With High Altitu-de Pulmonary Edema[J].Chest,2005,28(3):1611-1619.
[10] Pikaar JC,Voorhout WF,Van Golde LM,et al.Opsonic activities of surfactant proteins A and D in phagocytosis of gram-negative bacteria by alveolar macrophages[J].J Infect Dis, 1995, 172(2): 481-489.
[11] Hiroki Takahashi, Hitomi Sano, Hirofumi Chiba,et al. Pulmonary Surfactant Proteins A and D: Innate Immune Functions and Biomarkers for Lung Diseases[J].Current Pharmaceutical Design,2006,12(5);589-598.
[12] Sengelov H.Complement receptors in neutrophils[J].Crit Rev Immunol, 1995,15(2):107-131.
[13] Morgan BP.Physiology and pathophysiology of complement: progress and trends[J]. Crit Rev Clin Lab Sci,1995,32(3):265-298.
[14] LeVine AM,Kurak KE,Bruno MD,etal.Surfactant protein-A-deficient mice are susceptible to Pseudomonas aeruginosa infection[J]. Am J Respir Cell Mol Biol,1998, 19(4):700-708.
[15]Kremlev SG, Phelps DS. Surfactant protein A stimulation of inflammatory cytokine and immunoglobulin production[J].Am J Physiol,1994,267(6):712-719.
[16] Cheng G, Ueda T, Nakajima H,et al. Suppressive effects of SP-A on ionomycin-induced IL-8 production and release by eosinophils[J]. Int Arch Allergy Immunol,1998,117(1):59-62.
[17] Borron P, Veldhuizen RA, Lewis JF,et al. Surfactant associated protein-A inhibits human lymphocyte proliferation and IL-2 production[J].Am J Respir Cell Mol Biol. 1996,15(1):115-121.
[18] Weikert LF,Lopez JP,Abdolrasulnia R,et al.Surfactant protein A enhances mycobacterial killing by rat macrophages through a nitric oxide-dependent pathway[J]. Am J Physiol Lung Cell Mol Physiol, 2000,279(2): 216-223.
[19] Wu H,KuzmenkoA,Wan S,et a1.Sufactant proteins A and D inhibit the growth of Gram-negative bacteria by increasing membrane permeability[J].Clin Invest,2003,l11(10):1589-1602.
[1] Sobel JD.Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis[J].Am J Obstet Gynecol.1985,152: 924-935.
[2] Sobel JD.Recurrent vulvovaginal candidiasis,a prospective study of the efficacy of maintenance ketoconazole therapy[J]. N Engl J Med.1986,315: 1455-1458.
[3] Landers DV,Wiesenfeld HC,Heine RP,et al.Predictive value of the clinical diagnosis of lower genital tractinfection in women[J]. Am J Obstet Gynecol.2004, 190: 1004-1010.
[4] Corsello S,Spinillo A,Osnengo G,et al.An epidemiological survey of vulvovaginal candidiasis in Italy[J]. Eur J Obstet Gynecol Reprod Biol.2003,110: 66-72.
[5] Okungbowa FI, Isikhuemhen OS, Dede AP. The distribution frequency of Candida species in the genitourinary tract among symptomatic individuals in Nigerian cities[J].Rev Iberoam Micol.2003,20(2): 60-63.
[6] Buscemi L,Arechavala A,Negroni R. Study of acute vulvovaginitis in sexually active adult women, with special reference to candidosis, in patients of the Francisco J Muniz Infectious Diseases Hospital[J].Rev Iberoam Micol.2004,21: 177-181.
[7] Erdem H, Cetin M,Timuroglu T,et al.Identification of yeasts in public hospital primary care patients with or without clinical vaginitis[J].Aust N Z J Obstet Gynaecol. 2003,43:312-316.
[8] Holland J,Young ML,Lee O,et al.Vulvovaginal carriage of yeasts other than Candida albicans[J].Sex Transm Infect.2003,79:249-250.
[9] Bauters TG,Dhont MA,Temmerman MI,et al.Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women[J].Am J Obstet Gynecol. 2002,187:569-574.
[10] Cauwenbergh G.Vaginal candidiasis: evolving trends in the incidence and treatment of non-Candida albicans infection[J].Curr Probl Obstet Gynecol Fertil. 1990, 8:241.
[11] Sobel JD,Brooker D,Stein GE,et al. Single oral dose fluconazole compared with conventional clotrimazole topical therapy of candida vaginitis[J]. Am J Obstet Gynecol.1995,172:1263-1268.
[12] Sobel JD,Wiesenfeld HC,Martens M,et al.Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis[J].N Engl J Med. 2004,351:876-883.
[13] Lian C,Zhao J,Zhang Z,et al.Genotype of candida species associated with different conditions of vulvovaginal candidosis[J].Mycoses. 2004,47;495-502.
[14] Macura AB,Voss A,Melchers WJ,et al.Characterization of pathogenetic determinants of Candida albicansstrains[J].Zentralbl Bakteriol.1998,287:501-508.
[15] Soll DR,Galask R,Isley S,et al. Switching of Candida albicans during successiveepisodes of recurrent vaginitis[J]. J Clin Microbiol.1989, 27:681-690.
[16] King RD,Lee JC,Morris AL.Adherence of Candida albicans and other candida species to mucosal epithelial cells[J]. Infect Immun 1980, 27:667-674.
[17] Sobel JD,Myers PG,Kaye D,et al.Adherence of Candida albicans to human vaginal and buccal epithelial cells[J].J Infect Dis.1981,143: 76-82.
[18] Trumbore DJ,Sobel JD.Recurrent vulvovaginal candidiasis:vaginal epithelial cell susceptibility to Candida albicans adherence[J].Obstet Gynecol1.1986, 67: 810-812.
[19] Sobel JD,Muller G,Buckley HR.Critical role of germ tube formation in the pathogenesis of candidal vaginitis[J]. Infect Immun.1984, 44: 576-580.
[20] De Bernardis F,Agatensi L,Ross IK,et al.Evidence for a role forsecreted aspartate proteinase of Candida albicans in vulvovaginal candidiasis[J].J Infect Dis.1990,161: 1276-1283.
[21] Al-Hedaithy SS.Spectrum and proteinase production of yeasts causing vaginitis in Saudi Arabian women[J].Med Sci Monit.2002,8:CR498-501.
[22] Merson-Davies LA,Odds FC, Malet R,et al. Quantifi cation of Candida albicans morphology in vaginal smears[J].Eur J Obstet Gynecol Reprod Biol.1991,42: 49-52.
[23] Bertholf ME,Staff ord MJ.Colonization of Candida albicans in vagina,rectum,and mouth[J]. J Fam Pract.1983,16: 919-924.
[24] Beigi RH,Meyn LA,Moore DM,et al.Vaginal yeast colonization in nonpregnant women:a longitudinal study[J].Obstet Gynecol.2004,104: 926-930.
[25] Geiger AM,Foxman B.Risk factors for vulvovaginal candidiasis:a case-control study among university students[J].Epidemiology.1996,7:182-187.
[26] Chaim W,Foxman B,Sobel JD. Association of recurrent vaginal candidiasis and secretory ABO and Lewis phenotype[J].J Infect Dis.1997,176: 828-830.
[27] Babula O,Lazdane G,Kroica J,et al.Frequency of interleukin-4 (IL-4) -589 gene polymorphism and vaginal concentrations of IL-4, nitric oxide, and mannose-binding lectin in women with recurrent vulvovaginal candidiasis[J].Clin Infect Dis.2005,40: 1258-1262.
[28] Calderon L, Williams R,Martinez M,et al.Genetic susceptibility to vaginal candidiasis[J]. Med Mycol. 2003,41:143-147.
[29] Bland PB.Experimental vaginal and cutaneous moniliasis:clinical and laboratorystudies of certain monilias associated with vaginal, oral and cutaneous thrush[J].Arch Dermatol Syphil.1937,36: 760.
[30] Cotch MF,Hillier SL,Gibbs RS,et al. Epidemiology and outcomes associated with moderate to heavy candida colonization during pregnancy[J]. Am J Obstet Gynecol.1998,178: 374-380.
[31] Powell BL.Identifi cation of a 173-estradiol-binding protein in Candida albicans and Candida (Torulopsis) glabrata[J].Exp Mycology.1984,8: 304.
[32] Davidson F,Oates JK.The pill does not cause‘thrush’[J]. BJOG, 1985,92: 1265- 1266.
[33] Foxman B.The epidemiology of vulvovaginal candidiasis:risk factors[J].Am J Public Health.1990, 80: 329-331.
[34] Reed BD,Zazove P,Pierson CL,et al. Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis[J].J Womens Health (Larchmt).2003, 12: 979-989.
[35] Barbone F, Austin H, Louv WC, et al. A follow-up study of methods of contraception,sexual activity,and rates of trichomoniasis,candidiasis,and bacterial vaginosis[J].Am J Obstet Gynecol.1990,163:510-514.
[36] Demirezen S,Dirlik OO,Beksac MS.The association of candida infection with intrauterine contraceptive device[J].Cent Eur J Public Health.2005,13: 32-34.
[37] Fidel PL Jr,Vazquez JA,Sobel JD.Candida glabrata: review of epidemiology,pathogenesis, and clinical disease with comparison to C.albicans[J]. Clin Microbiol Rev.1999, 12: 80-96.
[38] De Leon EM,Jacober SJ,Sobel JD,et al. Prevalence and risk factors for vaginal candida colonization in women with type 1 and type 2 diabetes[J]. BMC Infect Dis. 2002, 2: 1-4.
[39] Goswami R,Dadhwal V,Tejaswi S,et al.Species-specific prevalence of vaginal candidiasis among patients with diabetes mellitus and its relation to their glycaemic status[J]. J Infect. 2000,41: 162-166.
[40] Spinillo A,Capuzzo E,Acciano S,et al.Effect of antibiotic use on the prevalence of symptomatic vulvovaginal candidiasis[J].Am J Obstet Gynecol.1999,180: 14-17.
[41] Wilton L, Kollarova M,Heeley E, et al. Relative risk of vaginal candidiasis after use of antibiotics compared with antidepressants in women: postmarketing surveillance data in England[J].Drug Saf.2003,26: 589-597.
[42] Pirotta MV,Gunn JM,Chondros P.“Not thrush again!”Women’s experience of post-antibiotic vulvovaginitis[J].Med J Aust. 2003,179:43-46.
[43] Bluestein D,Rutledge C,Lumsden L.Predicting the occurrence of antibiotic-induced candidal vaginitis (AICV) [J].Fam Pract Res J.1991,11:319-326.
[44] Oriel JD,Waterworth PM.Eff ects of minocycline and tetracycline on the vaginal yeast flora[J].J Clin Pathol.1975, 28: 403-406.
[45] Pultz NJ,Stiefel U, Ghannoum M, et al. Effect of parenteral antibiotic administration on establishment of intestinal colonization by Candida glabrata in adult mice[J].Antimicrob Agents Chemother.2005, 49:438-440.
[46] Miles MR,Olsen L,Rogers A.Recurrent vaginal candidiasis[J].JAMA.1977,238: 1836-1887.
[47] Thin RN,Leighton M,Dixon MJ.How often is genital yeast infection sexually transmitted? [J].BMJ.1977,2: 93-94.
[48] Garcia-Tamayo J,Castillo G, Martinez AJ. Human genital candidiasis: histochemistry,scanning and transmission electron microscopy[J].Acta Cytol.1982,26: 7-14.
[49] Chong PP,Lee YL,Tan BC,et al.Genetic relatedness of candida strains isolated from women with vaginal candidiasis in Malaysia[J].J Med Microbiol.2003, 52: 657-666.
[2] Colin Macneill,Todd M.Umstead,David S.Pheles, et a1. Surfactant protein A,an innate immune factor,is expressed in the vaginal mucosa and is present in vaginal lavage fluid[J]. Immunology,2004,111:91-99.
[3] Melissa M.Barousse,Terri Espinosa,Kathleen Dunlap, et a1.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J]. Infect Immun, 2005,73(11):7765-7767.
[4] Melissa M. Barousse, Chad Steele, Kathleen Dunlap,et al.Growth Inhibition of Candida albicans by Human Vaginal Epithelial Cells[J]. JID,2001,184 (1 December):1489-1493.
[5] S.R.Fan,Q.P.Liao, X.P.Liu,et al. Vaginal allergic response in women with vulvovaginal candidiasis[J].International Journal of Gynecology and Obstetrics,2008, 101: 27-30.
[6] Tobias M. Weissenbacher, Steven S. Witkin , Andrea Gingelmaier ,et al.Relationship between recurrent vulvovaginal candidosis and immune mediators in vaginal fluid[J]. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009,144:59–63.
[7] Chad Steele ,Paul L. Fidel, Jr. Cytokine and Chemokine Production by Human Oral and Vaginal Epithelial Cells in Response to Candida albicans[J]. Infection and immunity,2002,70(2):577-583.
[8] Haagsman H P,Diemel R V.Surfactant-associated proteins:functions and structural variation[J].Comp Biochem Physiol A Mol Inter Physio1.2001,129(1):91-108.
[9] Pikaar JC,Voorhout WF,Van Golde LM,et al.Opsonic activities of surfactant proteins A and D in phagocytosis of gram-negative bacteria by alveolar macrophages[J].J Infect Dis, 1995, 172(2): 481-489.
[10] Hiroki Takahashi, Hitomi Sano, Hirofumi Chiba,et al. Pulmonary Surfactant Proteins A and D: Innate Immune Functions and Biomarkers for Lung Diseases[J].Current Pharmaceutical Design,2006, 12(5); 589-598.
[11] Sengelov H.Complement receptors in neutrophils[J].Crit Rev Immunol,1995,15(2):107-131.
[12] LeVine AM,Kurak KE,Bruno MD,etal.Surfactant protein-A-deficient mice are susceptible to Pseudomonas aeruginosa infection[J]. Am J Respir Cell Mol Biol,1998, 19(4):700-708.
[13] Wu H,KuzmenkoA,Wan S,et a1.Sufactant proteins A and D inhibit the growth of Gram-negative bacteria by increasing membrane permeability[J].Clin Invest,2003,l11(10):1589-1602.
[1]赵敬军,童华,张正华,等.念珠菌性外阴阴道炎患者阴道分泌物中白介素4和白介素12水平测定[J].中华皮肤科杂志,2005,38(3):178-179.
[2]刘朝晖,王晓莉,廖秦平.外阴阴道假丝酵母菌患者阴道局部环境状态研究[J].中华妇产科杂志,2006,41(12):843-844.
[3]刘朝晖,陈磊.阴道上皮细胞先天性抗假丝酵母菌的作用研究[J].北京大学学报(医学版),2008,40(2):174-177.
[4]崔纪云,刘会娟,龙成凤,等.肺表面活性物质相关蛋白A、D的研究进展[J].山东医药,2008,48(28):112-113.
[5]孙雨.肺表面活性物质相关蛋白A的免疫调节功能[J].国外医学免疫学分册,2001,24(3):126-128.
[6] Melissa M.Barousse,Terri Espinosa,Kathleen Dunlap,et al.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J].Infect Immun,2005,73(11):7765-7767.
[7] Tobias M .Weissenbacher,Steven S.Witkin,Andrea Gingelmaier,et al.Relationship between recurrent vulvovaginal candidosis and immune mediators in Vaginal fluid[J].European Jouranl of Obstetrics&Gynecology and Reproductive Biology,2009,144(1):59-63.
[8] MacNeill C , Umstead TM , Phelp sDS , et al. Surfactant protein A , an innate immune factor ,is expressed in the vaginal mucosa and is p resent in vaginal lavage fluid [J].Immunology,2004,111(1): 91 - 99.
[9] Orhan Kankavi,Ayhan Ata,Orsan Gungor,et al.Surfactant proteins A and D in the genital tract of mares[J].Animal Reproduction Science,2007,98(3-4):259-270.
[10] Haagsman H P,Diemel R V.Surfactant-associated proteins:functions and structural variation[J].Comp Biochem Physiol A Mol Inter Physio1.2001,129(1):91-108.
[1] Jack D Sobel. Vulvovaginal candidosis[J]. Lancet 2007,369: 1961-71.
[2] Colin Macneill,Todd M.Umstead,David S.Pheles, et a1. Surfactant protein A,an innate immune factor,is expressed in the vaginal mucosa and is present in vaginal lavage fluid[J]. Immunology,2004,111:91-99.
[3] Melissa M.Barousse,Terri Espinosa,Kathleen Dunlap, et a1.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J]. Infect Immun, 2005,73(11):7765-7767.
[4] Melissa M. Barousse, Chad Steele, Kathleen Dunlap,et al.Growth Inhibition of Candida albicans by Human Vaginal Epithelial Cells[J]. JID,2001,184 (1 December):1489-1493.
[5] S.R.Fan,Q.P.Liao, X.P.Liu,et al. Vaginal allergic response in women with vulvovaginal candidiasis[J].International Journal of Gynecology and Obstetrics,2008, 101: 27-30.
[6] Tobias M. Weissenbacher, Steven S. Witkin , Andrea Gingelmaier ,et al.Relationship between recurrent vulvovaginal candidosis and immune mediators in vaginal fluid[J]. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009,144:59–63.
[7] Chad Steele ,Paul L. Fidel, Jr. Cytokine and Chemokine Production by Human Oral and Vaginal Epithelial Cells in Response to Candida albicans[J]. Infection and immunity,2002,70(2):577-583.
[8] Haagsman H P,Diemel R V.Surfactant-associated proteins:functions and structural variation[J].Comp Biochem Physiol A Mol Inter Physio1.2001,129(1):91-108.
[9]Shweta Saxena,MSc,Ratan Kumar,et al.Association of Polymorphisms in Pulmonary Sufactant Protein A1 and A2 Genes With High Altitu-de Pulmonary Edema[J].Chest,2005,28(3):1611-1619.
[10] Pikaar JC,Voorhout WF,Van Golde LM,et al.Opsonic activities of surfactant proteins A and D in phagocytosis of gram-negative bacteria by alveolar macrophages[J].J Infect Dis, 1995, 172(2): 481-489.
[11] Hiroki Takahashi, Hitomi Sano, Hirofumi Chiba,et al. Pulmonary Surfactant Proteins A and D: Innate Immune Functions and Biomarkers for Lung Diseases[J].Current Pharmaceutical Design,2006,12(5);589-598.
[12] Sengelov H.Complement receptors in neutrophils[J].Crit Rev Immunol, 1995,15(2):107-131.
[13] Morgan BP.Physiology and pathophysiology of complement: progress and trends[J]. Crit Rev Clin Lab Sci,1995,32(3):265-298.
[14] LeVine AM,Kurak KE,Bruno MD,etal.Surfactant protein-A-deficient mice are susceptible to Pseudomonas aeruginosa infection[J]. Am J Respir Cell Mol Biol,1998, 19(4):700-708.
[15]Kremlev SG, Phelps DS. Surfactant protein A stimulation of inflammatory cytokine and immunoglobulin production[J].Am J Physiol,1994,267(6):712-719.
[16] Cheng G, Ueda T, Nakajima H,et al. Suppressive effects of SP-A on ionomycin-induced IL-8 production and release by eosinophils[J]. Int Arch Allergy Immunol,1998,117(1):59-62.
[17] Borron P, Veldhuizen RA, Lewis JF,et al. Surfactant associated protein-A inhibits human lymphocyte proliferation and IL-2 production[J].Am J Respir Cell Mol Biol. 1996,15(1):115-121.
[18] Weikert LF,Lopez JP,Abdolrasulnia R,et al.Surfactant protein A enhances mycobacterial killing by rat macrophages through a nitric oxide-dependent pathway[J]. Am J Physiol Lung Cell Mol Physiol, 2000,279(2): 216-223.
[19] Wu H,KuzmenkoA,Wan S,et a1.Sufactant proteins A and D inhibit the growth of Gram-negative bacteria by increasing membrane permeability[J].Clin Invest,2003,l11(10):1589-1602.
[1] Sobel JD.Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis[J].Am J Obstet Gynecol.1985,152: 924-935.
[2] Sobel JD.Recurrent vulvovaginal candidiasis,a prospective study of the efficacy of maintenance ketoconazole therapy[J]. N Engl J Med.1986,315: 1455-1458.
[3] Landers DV,Wiesenfeld HC,Heine RP,et al.Predictive value of the clinical diagnosis of lower genital tractinfection in women[J]. Am J Obstet Gynecol.2004, 190: 1004-1010.
[4] Corsello S,Spinillo A,Osnengo G,et al.An epidemiological survey of vulvovaginal candidiasis in Italy[J]. Eur J Obstet Gynecol Reprod Biol.2003,110: 66-72.
[5] Okungbowa FI, Isikhuemhen OS, Dede AP. The distribution frequency of Candida species in the genitourinary tract among symptomatic individuals in Nigerian cities[J].Rev Iberoam Micol.2003,20(2): 60-63.
[6] Buscemi L,Arechavala A,Negroni R. Study of acute vulvovaginitis in sexually active adult women, with special reference to candidosis, in patients of the Francisco J Muniz Infectious Diseases Hospital[J].Rev Iberoam Micol.2004,21: 177-181.
[7] Erdem H, Cetin M,Timuroglu T,et al.Identification of yeasts in public hospital primary care patients with or without clinical vaginitis[J].Aust N Z J Obstet Gynaecol. 2003,43:312-316.
[8] Holland J,Young ML,Lee O,et al.Vulvovaginal carriage of yeasts other than Candida albicans[J].Sex Transm Infect.2003,79:249-250.
[9] Bauters TG,Dhont MA,Temmerman MI,et al.Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women[J].Am J Obstet Gynecol. 2002,187:569-574.
[10] Cauwenbergh G.Vaginal candidiasis: evolving trends in the incidence and treatment of non-Candida albicans infection[J].Curr Probl Obstet Gynecol Fertil. 1990, 8:241.
[11] Sobel JD,Brooker D,Stein GE,et al. Single oral dose fluconazole compared with conventional clotrimazole topical therapy of candida vaginitis[J]. Am J Obstet Gynecol.1995,172:1263-1268.
[12] Sobel JD,Wiesenfeld HC,Martens M,et al.Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis[J].N Engl J Med. 2004,351:876-883.
[13] Lian C,Zhao J,Zhang Z,et al.Genotype of candida species associated with different conditions of vulvovaginal candidosis[J].Mycoses. 2004,47;495-502.
[14] Macura AB,Voss A,Melchers WJ,et al.Characterization of pathogenetic determinants of Candida albicansstrains[J].Zentralbl Bakteriol.1998,287:501-508.
[15] Soll DR,Galask R,Isley S,et al. Switching of Candida albicans during successiveepisodes of recurrent vaginitis[J]. J Clin Microbiol.1989, 27:681-690.
[16] King RD,Lee JC,Morris AL.Adherence of Candida albicans and other candida species to mucosal epithelial cells[J]. Infect Immun 1980, 27:667-674.
[17] Sobel JD,Myers PG,Kaye D,et al.Adherence of Candida albicans to human vaginal and buccal epithelial cells[J].J Infect Dis.1981,143: 76-82.
[18] Trumbore DJ,Sobel JD.Recurrent vulvovaginal candidiasis:vaginal epithelial cell susceptibility to Candida albicans adherence[J].Obstet Gynecol1.1986, 67: 810-812.
[19] Sobel JD,Muller G,Buckley HR.Critical role of germ tube formation in the pathogenesis of candidal vaginitis[J]. Infect Immun.1984, 44: 576-580.
[20] De Bernardis F,Agatensi L,Ross IK,et al.Evidence for a role forsecreted aspartate proteinase of Candida albicans in vulvovaginal candidiasis[J].J Infect Dis.1990,161: 1276-1283.
[21] Al-Hedaithy SS.Spectrum and proteinase production of yeasts causing vaginitis in Saudi Arabian women[J].Med Sci Monit.2002,8:CR498-501.
[22] Merson-Davies LA,Odds FC, Malet R,et al. Quantifi cation of Candida albicans morphology in vaginal smears[J].Eur J Obstet Gynecol Reprod Biol.1991,42: 49-52.
[23] Bertholf ME,Staff ord MJ.Colonization of Candida albicans in vagina,rectum,and mouth[J]. J Fam Pract.1983,16: 919-924.
[24] Beigi RH,Meyn LA,Moore DM,et al.Vaginal yeast colonization in nonpregnant women:a longitudinal study[J].Obstet Gynecol.2004,104: 926-930.
[25] Geiger AM,Foxman B.Risk factors for vulvovaginal candidiasis:a case-control study among university students[J].Epidemiology.1996,7:182-187.
[26] Chaim W,Foxman B,Sobel JD. Association of recurrent vaginal candidiasis and secretory ABO and Lewis phenotype[J].J Infect Dis.1997,176: 828-830.
[27] Babula O,Lazdane G,Kroica J,et al.Frequency of interleukin-4 (IL-4) -589 gene polymorphism and vaginal concentrations of IL-4, nitric oxide, and mannose-binding lectin in women with recurrent vulvovaginal candidiasis[J].Clin Infect Dis.2005,40: 1258-1262.
[28] Calderon L, Williams R,Martinez M,et al.Genetic susceptibility to vaginal candidiasis[J]. Med Mycol. 2003,41:143-147.
[29] Bland PB.Experimental vaginal and cutaneous moniliasis:clinical and laboratorystudies of certain monilias associated with vaginal, oral and cutaneous thrush[J].Arch Dermatol Syphil.1937,36: 760.
[30] Cotch MF,Hillier SL,Gibbs RS,et al. Epidemiology and outcomes associated with moderate to heavy candida colonization during pregnancy[J]. Am J Obstet Gynecol.1998,178: 374-380.
[31] Powell BL.Identifi cation of a 173-estradiol-binding protein in Candida albicans and Candida (Torulopsis) glabrata[J].Exp Mycology.1984,8: 304.
[32] Davidson F,Oates JK.The pill does not cause‘thrush’[J]. BJOG, 1985,92: 1265- 1266.
[33] Foxman B.The epidemiology of vulvovaginal candidiasis:risk factors[J].Am J Public Health.1990, 80: 329-331.
[34] Reed BD,Zazove P,Pierson CL,et al. Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis[J].J Womens Health (Larchmt).2003, 12: 979-989.
[35] Barbone F, Austin H, Louv WC, et al. A follow-up study of methods of contraception,sexual activity,and rates of trichomoniasis,candidiasis,and bacterial vaginosis[J].Am J Obstet Gynecol.1990,163:510-514.
[36] Demirezen S,Dirlik OO,Beksac MS.The association of candida infection with intrauterine contraceptive device[J].Cent Eur J Public Health.2005,13: 32-34.
[37] Fidel PL Jr,Vazquez JA,Sobel JD.Candida glabrata: review of epidemiology,pathogenesis, and clinical disease with comparison to C.albicans[J]. Clin Microbiol Rev.1999, 12: 80-96.
[38] De Leon EM,Jacober SJ,Sobel JD,et al. Prevalence and risk factors for vaginal candida colonization in women with type 1 and type 2 diabetes[J]. BMC Infect Dis. 2002, 2: 1-4.
[39] Goswami R,Dadhwal V,Tejaswi S,et al.Species-specific prevalence of vaginal candidiasis among patients with diabetes mellitus and its relation to their glycaemic status[J]. J Infect. 2000,41: 162-166.
[40] Spinillo A,Capuzzo E,Acciano S,et al.Effect of antibiotic use on the prevalence of symptomatic vulvovaginal candidiasis[J].Am J Obstet Gynecol.1999,180: 14-17.
[41] Wilton L, Kollarova M,Heeley E, et al. Relative risk of vaginal candidiasis after use of antibiotics compared with antidepressants in women: postmarketing surveillance data in England[J].Drug Saf.2003,26: 589-597.
[42] Pirotta MV,Gunn JM,Chondros P.“Not thrush again!”Women’s experience of post-antibiotic vulvovaginitis[J].Med J Aust. 2003,179:43-46.
[43] Bluestein D,Rutledge C,Lumsden L.Predicting the occurrence of antibiotic-induced candidal vaginitis (AICV) [J].Fam Pract Res J.1991,11:319-326.
[44] Oriel JD,Waterworth PM.Eff ects of minocycline and tetracycline on the vaginal yeast flora[J].J Clin Pathol.1975, 28: 403-406.
[45] Pultz NJ,Stiefel U, Ghannoum M, et al. Effect of parenteral antibiotic administration on establishment of intestinal colonization by Candida glabrata in adult mice[J].Antimicrob Agents Chemother.2005, 49:438-440.
[46] Miles MR,Olsen L,Rogers A.Recurrent vaginal candidiasis[J].JAMA.1977,238: 1836-1887.
[47] Thin RN,Leighton M,Dixon MJ.How often is genital yeast infection sexually transmitted? [J].BMJ.1977,2: 93-94.
[48] Garcia-Tamayo J,Castillo G, Martinez AJ. Human genital candidiasis: histochemistry,scanning and transmission electron microscopy[J].Acta Cytol.1982,26: 7-14.
[49] Chong PP,Lee YL,Tan BC,et al.Genetic relatedness of candida strains isolated from women with vaginal candidiasis in Malaysia[J].J Med Microbiol.2003, 52: 657-666.