Sansom Institute for Health Research, University of South Australia, and the Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, University of Adelaide, Adelaide, South Australia, Australia.
Obstet Gynecol. 2016 Aug;128(2):337-47. doi: 10.1097/AOG.0000000000001510.
To synthesize and critically evaluate all available evidence investigating whether localized, provoked vestibulodynia is associated with a specific inflammatory profile at both a local and a systemic level.
Comprehensive electronic searches were performed in MEDLINE, EMBASE, Scopus, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Collaboration databases, and ClinicalTrials.gov. The search strategy was developed using MeSH terms related to localized, provoked vestibulodynia, and inflammatory markers.
Two independent investigators screened titles and abstracts and performed data extraction and risk of bias assessments. Studies were included if they reported at least one baseline inflammatory marker in women with localized, provoked vestibulodynia and compared them with healthy women. Reference lists from published reviews on localized, provoked vestibulodynia were screened for additional studies.
TABULATION, INTEGRATION, AND RESULTS: There were 1,619 studies identified. Eighteen studies met the inclusion criteria, including 400 women with localized, provoked vestibulodynia and 212 healthy women in a control group. Risk of bias assessment revealed that the methodologic quality was generally low. Fifteen studies investigated local inflammation and three studies investigated systemic inflammation. On a local level, the number of mast cells expressed in vestibular tissues was greater in women with localized, provoked vestibulodynia expressed than in women in the control group. Several studies reported undefined inflammatory infiltrate in vestibular tissues to a greater level in women with localized, provoked vestibulodynia than in women in the control group. Systemically, levels of natural killer cells were lower in women with localized, provoked vestibulodynia than in women in the control group. There were no systemic differences in systemic interferon-α and interferon-υ levels between groups.
There is limited and contradictory evidence regarding the characteristics of local and systemic inflammation in women with localized, provoked vestibulodynia.
综合并批判性评估所有现有证据，以调查局部、诱发的外阴痛是否与局部和全身水平的特定炎症特征相关。
全面电子检索了 MEDLINE、EMBASE、Scopus、PubMed、Web of Science、护理学和联合健康文献累积索引、Cochrane 协作数据库和 ClinicalTrials.gov。使用与局部、诱发的外阴痛和炎症标志物相关的 MeSH 术语制定了检索策略。
两名独立的调查员筛选标题和摘要，并进行数据提取和偏倚风险评估。如果研究报告了至少一个局部、诱发的外阴痛女性的基线炎症标志物，并将其与健康女性进行比较，则纳入研究。对已发表的关于局部、诱发的外阴痛的综述的参考文献进行了筛选，以寻找其他研究。
列表、整合和结果：共确定了 1619 项研究。18 项研究符合纳入标准，包括 400 名局部、诱发的外阴痛女性和 212 名健康对照组女性。偏倚风险评估显示，方法学质量普遍较低。15 项研究调查了局部炎症，3 项研究调查了全身炎症。在局部水平上，患有局部、诱发的外阴痛的女性前庭组织中表达的肥大细胞数量多于对照组女性。几项研究报告称，患有局部、诱发的外阴痛的女性前庭组织中存在未定义的炎症浸润程度大于对照组女性。系统性方面，患有局部、诱发的外阴痛的女性自然杀伤细胞水平低于对照组女性。两组间系统性干扰素-α和干扰素-υ水平无差异。
关于局部和系统性炎症特征在患有局部、诱发的外阴痛的女性中的特征，证据有限且相互矛盾。
