Mannose‐binding lectin and vulvovaginal candidiasis

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Abstract
Objective: To investigate the effect of mannose‐binding lectin (MBL) gene polymorphism on the immune system and the significance of vaginal MBL concentration in the pathogenesis of vulvovaginal candidiasis (VVC) and recurrent VVC (rVVC). Patients and methods: Mannose‐binding lectin concentrations in CVL samples from 111 women were collected between August 2004 and November 2004, 51 with VVC, 6 with rVVC patients, and 54 healthy women. CVL MBL concentrations were determined by enzyme‐linked immunosorbent assay, and MBL gene polymorphism was analyzed by polymerase chain reaction and the restriction fragment length polymorphism method. Results: Cervicovaginal lavage MBL concentration (17.80 ng/mL) and gene mutation frequency (33.33%) were both significantly higher in women with VVC (P < 0.01) than in controls (odds ratio [OR], 2.93; 95% confidence interval [CI], 1.14–7.57; P < 0.05). On the other hand, MBL concentration was lower in women with rVVC (0.30 ng/mL) than in controls (1.28 ng/mL) (P < 0.05), although MBL gene mutation frequency (83.33%) was significantly higher in women with rVVC than in controls (OR, 26.87; 95% CI, 2.76–261.65; P < 0.01). Conclusions: The presence of VVC can increase vaginal MBL level, which may be an immune response against Candida albicans infection; in women with rVVC, the low level of MBL in the vagina caused by mutation in the MBL gene may play a role in the recurrence of the infection.