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PERSPECTIVE article

Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1505845

Localized Provoked Vulvodynia as an Immune-Mediated Inflammatory Disease: Rationale for a New Line of Research

Provisionally accepted
Jorma Paavonen Jorma Paavonen 1*Robert C Brunham Robert C Brunham 2
  • 1 University of Helsinki, Helsinki, Finland
  • 2 University of British Columbia, Vancouver, British Columbia, Canada

The final, formatted version of the article will be published soon.

    Localized provoked vulvodynia (LPV), also called vulvar vestibulitis or provoked vestibulodynia, is a major cause of dyspareunia that severely impacts sexual health. At the tissue level, lymphocytic inflammation and hyperinnervation are characteristic pathological features, explaining the main symptoms and signs. A recent experimental animal study suggests that the histopathological findings of LPV may be due to mucosal CD4 Th17 immune responses to microbial antigens. We hypothesize that LPV is an immunemediated inflammatory disease and challenge the concept of LPV as a chronic pain syndrome of unknown cause. Since most treatment modalities currently used in LPV are no better than placebo, we therefore warrant future research investigating the possible presence of CD4 Th17 cells and IL17 cytokine in affected tissues together with treatment trials that include inhibitors of the IL17 pathway.

    Keywords: Vulvodynia, localized provoked vulvodynia, Vulvar vestibulitis syndrome, Vestibulodynia, inflammatory disease

    Received: 04 Oct 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Paavonen and Brunham. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jorma Paavonen, University of Helsinki, Helsinki, Finland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.