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Comparative measurement of D- and L-lactic acid isomers in vaginal secretions: association with high-grade cervical squamous intraepithelial lesions

  • General Gynecology
  • Published:
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Abstract

Purpose

Identification of low-cost protocols to identify women at elevated susceptibility to develop cervical intra-epithelial abnormalities would aid in more individualized monitoring. We evaluated whether quantitation of the D- and L-lactic acid isomers in vaginal secretions could differentiate women with normal cervical epithelia from those with a low (LSIL) or high (HSIL) grade squamous intraepithelial lesion or with cervical cancer.

Methods

Vaginal samples, collected from 78 women undetgoing cervical colposcopy and biopsy, were tested for pH, bacterial composition by Gram stain (Nugent score) and concentrations of D- and L-lactic acid by a colorimetric assay.

Results

Subsequent diagnosis was 23 women with normal cervical epithelium, 10 with LSIL, 43 with HSIL and 2 with cervical cancer. Vaginal pH and Nugent score were comparable in all subject groups. The concentration of L-lactic acid, but not D-lactic acid, as well as the L/D-lactic acid ratio, were significantly elevated (p < 0.01) in women with HSIL and cervical cancer.

Conclusion

Comparative measurement of vaginal D- and L-lactic acid isomers may provide a low-cost alternative to identification of women with an elevated susceptibility to cervical abnormalities.

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Funding

The research was funded by the graduate course in Pathology at the Federal University of Ceará and by the laboratory Prof. Eleuterio for performing lactate research and microscopic study of microbiota.

Author information

Authors and Affiliations

  1. Master’s Program in Pathology, Federal University of Ceará, Fortaleza, Brazil

    Christina Cordeiro Benevides de Magalhães & José Eleutério Jr.

  2. Department of Gynecology and Obstetrics, São Paulo University Medical School, São Paulo, Brazil

    Iara Moreno Linhares

  3. Postgraduate Program in Development and Technological Innovation in Medicines, Federal University of Ceará, Fortaleza, Brazil

    Laís Farias Masullo

  4. UNICHRISTUS University Center, Fortaleza, Brazil

    Laís Farias Masullo & Renata Mírian Nunes Eleutério

  5. Professor Eleutério Laboratory, Fortaleza, Brazil

    Renata Mírian Nunes Eleutério & José Eleutério Jr.

  6. Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, USA

    Steven S. Witkin

  7. Bloco Didatico da Faculdade de Medicina/UFC, Rua: Prof. Costa Mendes, 1608, 2nd floor, Fortaleza, 60.430-140, Brazil

    José Eleutério Jr.

Authors
  1. Christina Cordeiro Benevides de Magalhães
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  2. Iara Moreno Linhares
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  3. Laís Farias Masullo
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  4. Renata Mírian Nunes Eleutério
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  5. Steven S. Witkin
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  6. José Eleutério Jr.
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Contributions

SSW, JE Jr and CCBM conceived and design the study. CCBM, LFM, RMNE and JE Jr collected the data and performed the analysis. All authors wrote and approved the paper.

Corresponding author

Correspondence to José Eleutério Jr..

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Conflict of interest

The authors declared that they have no conflict of interest.

Ethical approval

The study was approved by the research ethics committee of the Federal University of Ceará (number 29,89,158).

Consent to participate

All subjects provided written informed consent.

Consent for publication

The study following the guidelines and regulatory standards for research involving human beings, contained in Resolution No. 466/2012 of the National Health Council of the Ministry of Health.

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de Magalhães, C.C.B., Linhares, I.M., Masullo, L.F. et al. Comparative measurement of D- and L-lactic acid isomers in vaginal secretions: association with high-grade cervical squamous intraepithelial lesions. Arch Gynecol Obstet 305, 373–377 (2022). https://doi.org/10.1007/s00404-021-06258-6

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  • DOI: https://doi.org/10.1007/s00404-021-06258-6

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