Introduction Bacterial vaginosis (BV), characterized by Lactobacillus depletion and replacement by facultative or anaerobic bacteria, impacts up to 30% of women and associates with negative reproductive health outcomes. We used a systems immunology approach to investigate cellular and molecular inflammation associated with BV. Methods Matched cervical cytobrush and cervicovaginal lavage were collected from BV− (n=16) and BV+ (n=11) women. Cytobrushes were immunophenotyped by flow cytometry and lavages were analyzed by tandem mass spectrometry. Differences in immune cell levels were evaluated with Mann-Whitney U tests, and assessed against host and bacterial proteins using Spearman’s Rank correlations. Results There were no clinical or demographic differences between BV+ and BV− women, including age (range 22–49), birth control use and STI history. Proteomic analysis identified 1085 human proteins and 516 bacterial proteins from 14 genera, including Lactobacillus, Gardnerella, and Mobiluncus. Long living neutrophils (CD49d+) were significantly increased in BV+ women (p=0.0005), and associated with cell adhesion (p=4.04E-5), T cell mediated immunity (p=0.004), and regulation of myeloid differentiation (p=8.63E-16) pathways. CD49+ neutrophils correlated positively with Mobiluncus (p=0.040, R2=0.49) and negatively with Lactobacillus (p=0.035, R2=−0.498). Discussion This data indicates that cervical neutrophil survival is increased in women with BV. These cells associated with anaerobic bacteria and molecular pathways of immune activation. Studies are ongoing to delineate the relationship between BV-associated bacteria and neutrophil functionality, which may have implications for BV treatment.

Introduction The spleen is an intra‐abdominal organ that increases in size (splenomegaly) due to a variety of hepatic and haematological pathologies. The measurement of its size is crucial for patient treatment and monitoring. This project sought to determine a standard technique for the sonographic measurement of the spleen through a retrospective clinical audit. Methods Serial splenic measurements from 250 patients were retrospectively assessed for caliper placement and visualisation/technique. The measurements were graded according to caliper placement and splenic visualisation on ultrasound. Patients included had serial abdominal ultrasounds over the 3 years prior to audit. Results A literature review was performed to establish a benchmark for splenic measurement. This uncovered a wide variation in reported normal splenic length measurement values. The key point from the data collected along with the literature review is that a normal measurement of the spleen is 10–12 cm. Consistent results were found regarding the method sonographers used to measure the spleen. Discussion To standardise measurement method, the spleen should be imaged with the patient in the right posterior oblique position in the optimal respiratory phase for individual patient habitus.

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