ELEVATED TISSUE-LEVELS OF INTERLEUKIN-1-BETA AND TUMOR-NECROSIS-FACTOR-ALPHA IN VULVAR VESTIBULITIS

Objective: To compare levels of two inflammatory cytokines, interleuki n-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha), in s elected regions of the vulva, vestibule, and vagina in women with vulv ar vestibulitis and in asymptomatic controls. Methods: Selective sampl ings of surgical specimens from 12 women undergoing perineoplasty for vulvar vestibulitis and ten pain-free subjects undergoing posterior va ginal repair were prepared into tissue homogenates and analyzed for co ncentrations of IL-1 beta and TNF-alpha. Interleukin-1 beta and TNF-al pha concentrations were measured by sandwich enzyme-linked immunosorbe nt assay. The results were reported after adjustment for total tissue protein concentration. Results: Median tissue levels of IL-1 beta and TNF-alpha were elevated 2.3-fold and 1.8-fold, respectively, in women with vulvar vestibulitis relative to pain-free women. Median IL-beta t issue levels were increased significantly from 1.3 pg/mg to 3.0 pg/mg total protein in women with vulvar vestibulitis compared to pain-free women. Median TNF-alpha tissue levels were increased from 83 pg/mg to 148 pg/mg total protein in women with vulvar vestibulitis compared to pain-free women. Analysis by selected anatomic site of women with vulv ar vestibulitis revealed a significant 2.2-fold higher median level of TNF-alpha at the vulvar site compared to the vestibule. Conclusion: C oncentrations of IL-1 beta and TNF-alpha were elevated in women with v ulvar vestibulitis relative to those in asymptomatic controls. This el evation in inflammatory cytokines with vulvar vestibulitis varied acco rding to anatomic site and was, paradoxically, lowest in the area of h ighest hyperalgesia, the vulvar vestibule. Inflammatory cytokine eleva tion may contribute to the pathophysiology of mucocutaneous hyperalges ia. Copyright (C) 1997 by The American College of Obstetricians and Gy necologists.