RESUMO
Background: Recurrent vulvovaginal candidiasis [RVVC] is a common cause of morbidity affecting millions of women worldwide. Patients with RVVC are thought to have an underlying immunologic defect. This study has been established to evaluate cell-mediated immunity defect in response to Candida antigen in RVVC cases
Materials and Methods: Our cross-sectional study was performed in 3 groups of RVVC patients [cases], healthy individuals [control I] and known cases of chronic mucocuta-neous candidiasis [CMC] [control II]. Patients who met the inclusion criteria of RVVC were selected consecutively and were allocated in the case group. Peripheral blood mon-onuclear cells were isolated and labeled with CFSE and proliferation rate was measured in exposure to Candida antigen via flow cytometry
Results: T lymphocyte proliferation in response to Candida was significantly lower in RVVC cases [n=24] and CMC patients [n=7] compared to healthy individuals [n=20, P<0.001], but no statistically significant difference was seen between cases and control II group [P>0.05]. Family history of primary immunodeficiency diseases [PID] differed significantly among groups [P>0.0l], RVVC patients has family history of PID more than control I [29.2 vs. 0%, P=0.008] but not statistically different from CMC patients [29.2 vs. 42.9%, P>0.05]. Prevalence of atopy was greater in RVVC cases compared to healthy individuals [41.3 vs. 15%, P=0.054]. Lymphoproliferative activity and vaginal symptoms were significantly different among RVVC cases with and without allergy [P=0.01, P=0.02]
Conclusion: Our findings revealed that T cells do not actively proliferate in response to Candida antigen in some RVVC cases. So it is concluded that patients with cell-mediated immunity defect are more susceptible to recurrent fungal infections of vulva and vagina. Nonetheless, some other cases of RVVC showed normal function of T cells. Further evaluations showed that these patients suffer from atopy. It is hypothesized that higher frequency of VVC in patients with history of atopy might be due to allergic response in mucocutaneous membranes rather than a functional impairment in immune system components
RESUMO
Potassium citrate [K-Cit] is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate [CaOx] urolithiasis, the significant response to alkaline therapy with K-Cit alone does not occur. There is scarce published data on the effect of magnesium chloride [Mg-Cl2] on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K-Cit - MgCl[2] as oral supplements on urinary parameters in children with CaOx urolithiasis. This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate [K-Cit] and magnesium chloride [Mg-Cl2]. The serum and urinary electrolytes were measured before [phase 0] and after prescribing K-Cit alone [phase 1] and a combination of K-Cit and Mg-Cl[2] [phase 2]. Each phase of therapy lasted for 4 weeks. The mean age of patients was 6.46 +/- 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, P < 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, P < 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications. These results suggested that a combination of K-Cit and Mg-Cl2 chloride is more effective on decreasing urinary oxalate excretion than K-Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1