Research ArticlePain

Repeated Vulvovaginal Fungal Infections Cause Persistent Pain in a Mouse Model of Vulvodynia

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Science Translational Medicine  21 Sep 2011:
Vol. 3, Issue 101, pp. 101ra91
DOI: 10.1126/scitranslmed.3002613

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Progress in Parsing Vulvodynia, a Particularly Painful Malady

The causes of some chronic pain syndromes have been mysterious. One of these is vulvodynia, in which the vulva becomes excruciatingly sensitive to touch. Now, Farmer and her colleagues reinforce one hypothesis as to its origins by showing that a vulvodynia-like state can be induced in mice by repeated yeast infections.

The authors showed that two rounds of vulvar yeast infection had no effect on the response of mice to touch in the vulvar area, but after a third infection, 6 of 15 mice became hypersensitive. The vulvar tissue of hypersensitive mice was not inflamed or otherwise abnormal after microscopic inspection, but the affected mice did have particularly dense sympathetic and peptidergic vulvar innervations. A single, long infection could have the same effect and, as long as 70 days after the infection cleared up, the mice were hypersensitive to touch. Live yeast were not required, because injections of the yeast cell wall glucan zymosan produced the same chronic pain syndrome, as measured by hypersensitivity to touch.

The re-creation of a vulvodynia-like state in mice by repeated infection with yeast raises key questions that need to be asked in further experiments. Does repeated exposure to infection induce hyperinnervation in some individuals? If so, what is the mechanistic basis of this effect? Is this innervation the cause of the chronic pain of vulvodynia? Some of these questions may be best asked in mice, but the ultimate goal is to understand this process in women well enough to effectively interfere with it.

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