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Obstetrics & Gynecology 2007;109:1123-1128
© 2007 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Mannose-Binding Lectin Gene Polymorphism, Vulvovaginal Candidiasis, and Bacterial Vaginosis

Paulo C. Giraldo, MD, PhD1, Oksana Babula, MD2, Ana Katherine S. Gonçalves, MD3, Iara M. Linhares, MD, PhD2,4, Rose Luce Amaral, MD1, William J. Ledger, MD2 and Steven S. Witkin, PhD2

From the 1Department of Gynecology and Obstetrics, The State University of Campinas, School of Medical Sciences, São Paulo, Brazil; 2Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, New York; 3Department of Gynecology, School of Medical Science, The Federal University of Rio Grande do Norte, Natal, Brazil; and 4Department of Gynecology, University of Sao Paulo Medical School and Hospital das Clinicas, Sao Paulo, Brazil.

OBJECTIVE: To evaluate associations between polymorphisms in the gene coding for mannose-binding lectin (MBL) and the diagnosis of acute or recurrent vulvovaginal candidiasis and bacterial vaginosis

METHODS: Women at two outpatient clinics in Brazil filled out a questionnaire and were examined for the presence of vulvovaginal candidiasis or bacterial vaginosis. A buccal swab was blindly tested for codons 54 and 57 MBL2 gene polymorphisms by polymerase chain reaction and endonuclease digestion.

RESULTS: A total of 177 women were enrolled. Vulvovaginal candidiasis was identified in 78 (44.1%) women, 33 (18.6%) had bacterial vaginosis, and 66 (37.3%) were normal controls. Recurrent vulvovaginal candidiasis was present in 50 (64.1%) of the women with vulvovaginal candidiasis; 20 (60.6%) of the bacterial vaginosis patients had recurrent disease. Vulvovaginal candidiasis was associated with white race (P=.007), bacterial vaginosis was associated with nonwhite race (P=.05), and both were associated with a history of allergy (P≤.02) and having sexual intercourse at least three times a week (P<.001). Carriage of the variant MBL2 codon 54 allele B was more frequent in women with recurrent vulvovaginal candidiasis (25.0%) than in the women with acute vulvovaginal candidiasis (17.9%) or controls (10.6%) (P=.004). Allele B was also more prevalent in women with recurrent bacterial vaginosis (22.5%) than in those with acute bacterial vaginosis (0%) (P=.009). The MBL2 codon 57 polymorphism was infrequent and not associated with vulvovaginal candidiasis or bacterial vaginosis.

CONCLUSION: The incidence of vulvovaginal candidiasis and bacterial vaginosis differs by ethnicity in Brazilian women. The MBL2 codon 54 gene polymorphism is associated with both recurrent vulvovaginal candidiasis and recurrent bacterial vaginosis.

LEVEL OF EVIDENCE: III






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