Vaginal heat shock protein expression in symptom-free women with a historyof recurrent vulvovaginitis

OBJECTIVES: The cause of recurrent vulvovaginitis remains unexplained in mo st cases. Heat shock protein synthesis is induced under conditions of stres s; its presence in vaginal samples from women who were between episodes of recurrent vulvovaginitis thus might reflect a persistent perturbation in th e local milieu. STUDY DESIGN: We undertook an evaluation by means of enzyme-linked immunoso rbent assay of 60-kd heat shack protein and inducible 70-kd heat shock prot ein expressions in vaginal wash samples from 24 symptom-free women with a h istory of recurrent vulvovaginitis and 19 matched control subjects. The sam ples were also tested for Candida albicans, Chlamydia trachomatis, Ureaplas ma urealyticum, Mycoplasma hominis, and human papillomavirus by polymerase chain reaction; for bacterial vaginosis by clinical and microbiologic evalu ation; and for interleukin 10, interleukin 1, interleukin 8, RANTES, and eo taxin by enzyme-linked immunosorbent assay. RESULTS: The presence of 60-kd heat shock protein was detected in 11 women with recurrent vulvovaginitis (45.8%) and 1 control subject (5.3%, P=.005). Similarly 70-kd heat shock protein was present in 8 patients with recurren t vulvovaginitis (33.3%) and no control subjects (P =.005). The presence of 60-kd heat shock protein and the presence of 70-kd heat shock protein were correlated with each other (P=.02), as were both 60-kd heat shock protein (P =.006) and 70-kd heat shock protein (P =.01) correlated with IL-10. Ther e was no relation between the presence of 60-kd heat shock protein or 70-kd heat shock protein and detection of IL-l, IL-8, or any microorganism. CONCLUSION: The expression of heat shock proteins and IL-10 in the vaginas of women with a history of recurrent vulvovaginitis but not in the vaginas of control subjects suggests the existence of differences in the vaginal mi lieu between the 2 groups, even when both are without vaginal symptoms.