RESUMO
Iron Deficiency Anemia [IDA] has been controversially linked to IL-4 production in previous studies. A predominant Th1 response leads to resistance against recurrent vulvovaginal candidiasis [RVVC], whereas a Th2 response exacerbates the disease. To investigate the possible effect of iron deficiency on the host's susceptibility to RVVC as a result of the Th1/Th2 cytokine polarization. We conducted a case-control study of 92 women in 4 groups based on strict inclusion and exclusion criteria: RVVC+ IDA+ group consisted of 23 women with RVVC and IDA; RVVC+ IDA- group consisted of 23 women with RVVC without IDA; RVVC- IDA+ group consisted of 23 women without RVVC and with IDA and RVVC- IDA- group consisted of 23 healthy women. The iron parameters and key cytokines [IFN-gamma, IL-10, IL-12, IL-4] were measured in blood samples. Comparison of IL-4 production between RVVC+ IDA+ [12.2 +/- 1.3 pg/ml] and RVVC+ IDA- [2.4 +/- 4.0 pg/ml] groups [p=0.044], between RVVC- IDA+ [14.6 +/- 1.7 pg/ml] and RVVC- IDA- [1.28 +/- 3.6 pg/ml] groups [p=0.006], between RVVC- IDA+ [14.6 +/- 1.7 pg/ml] and RVVC+ IDA-] 2.4 +/- 4.0 pg/ml] groups [p=0.009] and also between RVVC+ IDA+ and RVVC- IDA- [1.28 +/- 3.6 pg/ml] groups [p=0.03] showed significant differences. We found a significant positive correlation between IL-4 and total iron binding capacity [TIBC, p=0.046] and between serum IL-10 and Hb levels [p=0.041] in the RVVC+ IDA- group. There was also a significant negative correlation between serum IL-4 and levels of serum iron [SI, p=0.041] in the RVVC- IDA- group. It seems that IDA determines the balance between and the intensity of Th1 and Th2 arms of the immune response and leads to a deviation toward Th2 response which could contribute to recurrence of candidiasis