Title : TLR gene polymorphisms and susceptibility to recurrent vulvovaginal candidiasis

Abstract:

Introduction: Recurrent vulvovaginal candidiasis (RVVC) is a common cause of significant morbidity in women in all strata of society affecting millions of women worldwide. Considerable progress has been made in understanding risk factors that determine susceptibility to RVVC, particularly genetic factors. Genetic variation in TLRs may significantly enhance susceptibility to RVVC by attenuating host defense mechanisms against Candida.

Methods: We examined the existence of TLR4 Asp299Gly (rs4986790), TLR4 Thr399Ile (rs4986791) and TLR2 Arg753Gln (rs5743708) polymorphisms in 63 patients with Recurrent Vulvovaginal Candidiasis (RVVC), 37 patients with Vulvovaginal Candidiasis (VVC), 36 patients with Gardnerella bacterial vaginosis (GV) and 61 normal women.

Results: We observed a significant association of TLR4 Asp299Gly and Thr399Ile polymorphisms with RVVC as compared to that of normal women (p=0.018 and p=0.031, respectively). The generalized odds ratio (OR_G) was 5.57 for TLR4 Asp299Gly and 4.92 for Thr399Ile polymorphisms with the corresponding 95% confidence interval (CI) of 1.17-26.56 and 1.02-23.77, respectively.  Moreover, the TLR4 allelic frequencies of TLR4 Asp299Gly and Thr399Ile polymorphisms were found to statistically differ from Hardy-Weinberg equilibrium for Europeans in RVVC patients (p=0.003 and 0.021, respectively). No significant associations were found for TLR4 Asp299Gly and Thr399Ile alleles with GV as well as for TLR2 Arg753Gln with any of RVVC, VVC and GV disease groups. The TLR4 and TLR2 allelic frequencies were found to be in Hardy-Weinberg equilibrium in GV patients and in control subjects.

 Conclusion: The results suggest a higher risk of RVVC in individuals carrying TLR4 Asp299Gly and Thr399Ile polymorphisms.

Biography:

John Routsias is a Chemist and a Pathologist - Microbiologist with a PhD in Immunology.  Currently he is Associate Professor of Immunology/Microbiology at the Medical School of the University Athens. His research work is significant (total Impact Factor = 520) and internationally recognized (H-index = 35), having received fifteen Greek and international awards and distinctions. He is editor-reviewer in 18 international journals, has publish 68 articles in international journals with 3355 bibliographic citations. He has submitted 279 sequences of new B- and T-epitopes the "Immune Epitope Database " and he has 183 conference papers (Greek: 67, International: 116).