Downregulation of IFN-γ production in patients with recurrent vaginal candidiasis

Abstract

Background: Recurrent vaginal candidiasis (RVC) is an important health problem with unknown pathogenesis. Although impairment of the T-cell response is associated with persistent or recurrent candidiasis, data on immunologic responses in patients with RVC are controversial. Objectives: To evaluate the T-cell response in patients with RVC and the ability of cytokines and cytokine antagonists to modulate IFN-γ production in cultures stimulated with Candida albicans antigens. Methods: Participants in the study included 13 patients with RVC and 7 control women with sporadic candidiasis. Cytokines were determined by ELISA in supernatants of mononuclear cells with C albicans , purified protein derivative, or tetanus toxoid antigen. Results: IFN-γ production was absent or low in 11 of 13 women (84.6%) with RVC. Absent or low IFN-γ production was specific to C albicans antigens (189 ± 389 pg/mL), because high IFN-γ levels were found in cultures stimulated with purified protein derivative (739 ± 774 pg/mL) or tetanus toxoid antigens (1085 ± 546 pg/mL). Monoclonal antibody anti-IL-10 enhanced IFN-γ levels (750 ± 753 pg/mL), and IL-10 suppressed this cytokine production in patients with sporadic candidiasis. Conclusions: Mononuclear cells from patients with RVC stimulated with C albicans antigen have low or absent IFN-γ production. IL-10 plays an important role in downregulation of the T-cell response in these patients. (J Allergy Clin Immunol 2002;109:102-5.)