Journal of Microbial Pathogenesis

Neutrophil Extracellular Traps and High Presence of NETotic Cells in Vaginal Discharges of Women with Vaginitis: An Exploratory Study

Abstract

Angélica Schulz*

Infectious vaginitis is a microbiological syndrome of great importance in public health that affects millions of women worldwide. However, no studies have explored the phenomenon of the production of the neutrophil extracellular traps (NETs) that are released into the female reproductive tract in these pathologies. This study aimed to determine the presence of NETosis in vaginal discharges of women with bacterial vaginosis, candidiasis, and trichomoniasis by characterizing NETs. Extracellular DNA with neutrophil elastase and citrullinated histones was identified to confirm the NET components (n = 10). The concentration, phenotypes of NETs, and number of NETotic cells were determined. The results showed an increase in NETotic cells in women with Candida albicans (CA) and Trichomonas vaginalis (TV) and an increase in NETs in TV-induced vaginitis. Samples of Women with CA- and TV-infections displayed several NET phenotypes (diffNETs, sprNETs, and aggNETs); diffNETs were present in high numbers in samples with CA infections and were elevated in three types of NET infections with TV infections. In contrast to samples with bacterial vaginosis, those with intermediate microbiota displayed higher concentrations of NETs and more NETotic cells. Therefore, changes in the microbiota and the presence of fungal and parasite infections are key factors in the activation and induction of NETosis, and their cytotoxic actions may increase tissue damage