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Barbara Reed, MD
University of Michigan
Neuroimmunology/Cytokine Alterations In Vulvodynia
Abstract: Hundreds of thousands of women in the United States suffer
from vulvodynia a chronic burning vulvar pain of unknown cause.
Millions of health care dollars are spent annually for this disorder
in the United States alone, not only on management, but also on
the large proportion of cases that are misdiagnosed and inadequately
treated. This pain, associated with allodynia and hyperpathia, has
a strong genetic predelection, with African-American women rarely
being affected. The broad, long-term objectives of this proposal
are to assess the differences in specific neuroimmunological characteristics
between women with vulvodynia and asymptomatic controls. The specific
aims include: evaluation of l) the individual cytokine/neurokine
production response to stimulation of peripheral blood; 2) local
changes in nerve fiber, mast cell, Substance P and serotonin density
in vulvar tissue; 3) the interactions of the systemic and local
immunologic systems assessed in l) and 2); and 4) the multivariable
assessment of these laboratory factors with historical risk factors
for vulvodynia to explore potential pathophysiologic mechanisms
accounting for the historical risk factors identified. The research
design involves a case-control evaluation of 100 women with vulvodynia,
100 controls matched for ethnicity, and 100 African-American control
women, using questionnaires, physical examinations, clinical laboratory
data, cytokine/neurokine levels in stimulated peripheral blood,
and neuroimmunohistological assessment of vulvar biopsy specimens
for nerve fiber density, mast cells, Substance P and serotonin.
Results from this study will lead to improved understanding of neuroimmunologic
alterations in women with vulvodynia which will direct future therapeutic
strategies for this disorder.
back to NIH Funding
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