Vaginal biocenosis in pregnant women with recurrent bacterial vaginosis after treatment with recombinant human interferon alpha-2b

Abstract

Introduction. Preventing recurrent bacterial vaginosis (BV) during pregnancy is an important issue in current obstetrics.Aim: to assess the effect of recombinant human interferon alpha-2b on the incidence of recurrent BV during pregnancy and on the bacterial, cytokine, and antimicrobial components of the nonspecific vaginal immunity.Materials and methods. The study included 80 pregnant women with recurrent BV, 40 of whom (the main group) were treated with recombinant human interferon alpha-2b in the first half of pregnancy and after 30 weeks of pregnancy in addition to standard therapy (metronidazole or clindamycin). The other 40 women (control group) did not receive this interferon drug. Patients of the both groups were examined for the rate of BV recurrence and also tested for their vaginal bacteria and levels of β-defensin-2 (HBD-2), interleukin-1β (IL-1β), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and interferon-γ (INF-γ) in the third trimester of pregnancy.Results. Treatment with recombinant human interferon alfa-2b led to a 3-fold reduction in the occurrence of repeated episodes of BV and an increase in the content of lactobacilli (7.24 ± 0.33 and 7.03 ± 0.40 in patients with interferon therapy and without it, respectively; p = 0.013) mainly due to Lactobacillus crispatus (7.14 ± 0.69 in women who received interferon alfa-2b, compared with 6.36 ± 0.95 in patients on standard therapy; p = 0.003) and a decrease in the number of some types of anaerobes. Also, the use of interferon alpha-2b in pregnant women with recurrent BV led to an increase in the content of IL-1β by 2.5 times, IL-6 by 3.5 times, IL-10 by 1.5 times, INF-γ by 2 times, and HBD-2 by 4 times.Conclusion. Treatment of recurrent BV during pregnancy with recombinant human interferon alfa-2b, aimed at boosting the nonspecific vaginal immunity helps reduce the incidence of recurrent BV.

Results of Complex Immunopharmacological Analysis of the Mechanisms of Action of Bioregulation Agents

“…In light of this, identification of pharmacological agents capable of modulating activity of mediator-producing immune cells and showing no drug-drug interactions with NSAIDs, without strict restriction of the duration of application and with a wide spectrum of indication seems important [7][8][9]. Such immunomodulatory drugs are suggested to act synergistically with NSAIDs and improve their effectiveness [10,11].…”