Risk of vulvodynia due to immune-related health events throughout the life course

整个生命过程中因免疫相关健康事件而导致外阴痛的风险

• 批准号: 9978260
• 负责人: BERNARD L HARLOW
• 金额: $ 22.97万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-06 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9978260
• 关键词: Acute; Adolescence; Affect; Age; Age of Onset; American; Antibiotics; Autoimmune Process; Bacteria; Birth; Categories; Cesarean section; Chronic; Country; Data; Data Sources; Development; Diagnosis; Diagnostic; Disease; Epidemiology; Etiology; Event; Female; Frequencies; Gynecologic; Health; Hospitalization; Immune; Immune System Diseases; Immune system; Immunity; Immunological Diagnosis; Incidence; Infant; Inflammatory; Inflammatory Response; Inpatients; International Classification of Disease Codes; Intervention; Lead; Life Cycle Stages; Longevity; Maternal Exposure; Medical History; Morbidity - disease rate; Mothers; Natural History; Neonatal; Nested Case-Control Study; Outpatients; Pain; Pathogenicity; Patients; Pharmacy facility; Premature Rupture Fetal Membranes; Prevalence; Psychiatric therapeutic procedure; Recording of previous events; Registries; Reporting; Research; Research Support; Risk; Streptococcal Infections; Streptococcus Group B; Stress; Systems Development; Tampons; Taxes; Time; Trauma; Vision; Vulva; Vulvodynia; Woman; allergic response; base; case control; cohort; data registry; experience; external genitalia; immune function; immune health; infancy; intraamniotic infection; neonatal exposure; prenatal; prevent; reproductive; screening; vulvar pain

Vulvodynia is chronic idiopathic (or unexplained) pain of the external genitalia (vulva) that is estimated to affect 8% of American women by the age of 40. The highest incidence occurs in women during their early reproductive ages, and the onset of vulvodynia may occur during adolescence with patients reporting pain at first tampon use. While causes of vulvodynia are largely unknown, it is believed to be the result of an altered immune-inflammatory response mechanism. Our previous research supports this hypothesis by showing that women who develop vulvodynia are approximately 2 times more likely to have suffered from allergies or allergic responses prior to vulvodynia onset. Given that many women diagnosed with vulvodynia have evidence of pain with first tampon use during adolescence, women at greatest risk of vulvodynia may have had their immune systems compromised either prenatally or at birth, early in their life course, or both. Documenting health-related events across the life course would allow for the assessment of conditions or treatments that influence immune function, or are markers of compromised immune health. We propose to conduct a nested case-control study within an existing cohort of all Swedish females born between 1981 and 1996 already assembled using Swedish National Registry data for another ongoing initiative. For this nested study, all women with a specific vulvodynia diagnosis (ICD code N76.3) between 2012 and 2016 (n=~3500 women) will comprise cases, and each case will be matched to a control from the same birth year with no history of vulvar pain as of the case’s date of diagnosis. Our aims are to assess the effect of a) Maternal and neonatal events including maternal prenatal antibiotic use for chorioamnionitis, Group B streptococcal infection or premature rupture of membranes, cesarean section deliveries, and neonatal hospitalizations; b) Immune-specific conditions manifesting as deficient, autoimmune, and overactive from infancy up until onset of vulvodynia or a comparable time period among controls, and c) Psychiatric conditions from adolescence up until onset of vulvodynia and a comparable time period among controls, on the risk of vulvodynia in women between the ages of 15 and 35. Precursors to vulvar pain present at adolescence indicate a need to take a life course approach toward understanding the pathogenic mechanisms that underlie vulvodynia. Carrying out research across the lifespan can identify immune related events during critical risk periods, and its impact could lead to more careful screening based on medical histories and potential interventions to prevent or mitigate this debilitating condition.

外阴痛是外生殖器（外阴）的慢性特发性（或无法解释的）疼痛 到40岁时影响8％的美国妇女。在妇女期间，女性的发病率最高 早期生殖年龄以及外阴痛的发作可能会与患者发生青春期 首次使用卫生棉条的疼痛。 免疫炎症反应机制改变的结果。 通过表明女性发展外阴痛的妇女的可能性大约的可能性约为2倍 在发作前外阴痛之前患有过敏或过敏反应。 被诊断为外阴痛的有证据表明青春期首次使用棉塞疼痛，妇女处于 外阴痛的最大风险可能会在产前或ATT上受到免疫系统的损害 出生，在他们的人生课程中或两者都记录与健康相关的事件 允许评估影响免疫功能的疾病或治疗方法，或者是 妥协免疫健康。我们建议在现有的病例对照 1981年至1996年之间所有瑞典女性的队列使用瑞典国民组装 注册另一个OZZ倡议的数据。 2012年至2016年之间的诊断（ICD代码N76.3）（n = 〜3500名女性）将包括病例，每个案例 案例将与同一出生年度的控制匹配，没有外阴痛的病史 诊断日期。我们的目标是a） 母体产前抗生素用于绒毛膜炎，B组链球菌感染或过早 膜的破裂，剖宫产分割和新生儿螺旋化； b）特定于免疫 条件表现为缺乏，自身免疫和从婴儿期开始过度活跃 对照组之间的外阴痛或相当的时间段，c）青春期的精神病疾病 直到外阴痛发作和对照组之间的可比时间段， 15至35岁之间的妇女。青春期出现的外阴疼痛的前体表明Aneed 使生活成为一种生活课程的方法，以理解基于的致病机制 外阴痛。 风险期及其影响可能会导致基于医疗和 防止或减轻此debilitatatitiong的潜在干预措施。