Mannose-binding lectin and vulvovaginal candidiasis

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.