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Peer-reviewedCC BY 4.0BMC Women's Health

Cervicovaginal zinc and copper profiles across vaginitis phenotypes and hydrogel assignment: an exploratory pilot study

  • Alexandra Kunkli1,2
  • Dávid Rátonyi1,2
  • Barbara Kozma1,2
  • Bálint Farkas3
  • László Majoros3
  • Robert Póka1
  • Attila G. Sipos1,2
  • Peter Takacs4
  • Zoárd T. Krasznai1
  • Bence Kozma1,2
4 affiliations
  1. 1Faculty of Medicine, Department of Obstetrics and Gynecology, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032 Hungary
  2. 2Doctoral School of Nutrition and Food Sciences, University of Debrecen, Egyetem tér 1, Debrecen, 4032 Hungary
  3. 3Faculty of Medicine, Department of Medical Microbiology, University of Debrecen, Debrecen, Hungary
  4. 4Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 526, Norfolk, Virginia 23507-2007 USA
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Abstract

Zinc (Zn) and copper (Cu) support epithelial integrity, nutritional immunity, and host–microbiome interactions, yet cervicovaginal trace-metal dynamics across vaginitis phenotypes remain poorly defined. We prospectively quantified cervicovaginal lavage (CVL) Zn and Cu by ICP-OES in an exploratory secondary analysis nested within a single-center randomized trial involving 56 symptomatic women and asymptomatic controls (mean age, 36.0 ± 11.8 years; mean BMI, 23.1 ± 4.9 kg/m²). We examined whether CVL trace-element concentrations varied according to culture-defined phenotype and randomized hydrogel exposure. CVL Zn concentrations were higher in the Candida albicans-positive (120.2 ± 95.6 µg/L) and symptomatic culture-positive bacterial phenotypes (83.8 ± 55.2 µg/L) than in controls (58.6 ± 27.2 µg/L), whereas Cu showed less consistent variation. Among participants assigned to hydrogel, phenotype-specific differences from controls were not statistically significant. In the fluconazole-only group, higher Zn concentrations were observed in the C. albicans-positive phenotype (154.3 ± 113.5 vs. 54.2 ± 23.8 µg/L), accompanied by higher Cu concentrations (12.13 ± 4.76 vs. 5.76 ± 2.86 µg/L). These exploratory findings indicate that cervicovaginal trace-element profiles may vary across symptomatic culture-defined phenotypes and treatment groups. Our findings should be interpreted as hypothesis-generating. Biological and clinical relevance remains uncertain and warrants confirmation in adequately powered, longitudinal studies using dilution-normalized CVL measurements. Trial registration: The study protocol was approved by the Hungarian National Institutional Review Medical Research Council (approval No. 3282-7/2023/EUIG). The parent trial is registered at ClinicalTrials.gov (NCT05895162; 2023-05-15). Each participant signed a written informed consent form. All procedures performed in studies involving human participants were under the ethical standards of the Hungarian National Institutional Review Medical Research Council and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12905-026-04768-6.

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Cite

BibTeXRIS
BibTeX
@article{kunkli2026cervicovaginal,
  title = {{Cervicovaginal zinc and copper profiles across vaginitis phenotypes and hydrogel assignment: an exploratory pilot study}},
  author = {Alexandra Kunkli and Dávid Rátonyi and Barbara Kozma and Bálint Farkas and László Majoros and Robert Póka and Attila G. Sipos and Peter Takacs and Zoárd T. Krasznai and Bence Kozma},
  journal = {BMC Women's Health},
  year = {2026},
  month = aug,
  doi = {10.1186/s12905-026-04768-6},
  url = {https://doi.org/10.1186/s12905-026-04768-6},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Cervicovaginal zinc and copper profiles across vaginitis phenotypes and hydrogel assignment: an exploratory pilot study
AU  - Alexandra Kunkli
AU  - Dávid Rátonyi
AU  - Barbara Kozma
AU  - Bálint Farkas
AU  - László Majoros
AU  - Robert Póka
AU  - Attila G. Sipos
AU  - Peter Takacs
AU  - Zoárd T. Krasznai
AU  - Bence Kozma
PY  - 2026
DA  - 2026/08/01
JO  - BMC Women's Health
DO  - 10.1186/s12905-026-04768-6
UR  - https://doi.org/10.1186/s12905-026-04768-6
AB  - Zinc (Zn) and copper (Cu) support epithelial integrity, nutritional immunity, and host–microbiome interactions, yet cervicovaginal trace-metal dynamics across vaginitis phenotypes remain poorly defined. We prospectively quantified cervicovaginal lavage (CVL) Zn and Cu by ICP-OES in an exploratory secondary analysis nested within a single-center randomized trial involving 56 symptomatic women and asymptomatic controls (mean age, 36.0 ± 11.8 years; mean BMI, 23.1 ± 4.9 kg/m²). We examined whether CVL trace-element concentrations varied according to culture-defined phenotype and randomized hydrogel exposure. CVL Zn concentrations were higher in the Candida albicans-positive (120.2 ± 95.6 µg/L) and symptomatic culture-positive bacterial phenotypes (83.8 ± 55.2 µg/L) than in controls (58.6 ± 27.2 µg/L), whereas Cu showed less consistent variation. Among participants assigned to hydrogel, phenotype-specific differences from controls were not statistically significant. In the fluconazole-only group, higher Zn concentrations were observed in the C. albicans-positive phenotype (154.3 ± 113.5 vs. 54.2 ± 23.8 µg/L), accompanied by higher Cu concentrations (12.13 ± 4.76 vs. 5.76 ± 2.86 µg/L). These exploratory findings indicate that cervicovaginal trace-element profiles may vary across symptomatic culture-defined phenotypes and treatment groups. Our findings should be interpreted as hypothesis-generating. Biological and clinical relevance remains uncertain and warrants confirmation in adequately powered, longitudinal studies using dilution-normalized CVL measurements. Trial registration: The study protocol was approved by the Hungarian National Institutional Review Medical Research Council (approval No. 3282-7/2023/EUIG). The parent trial is registered at ClinicalTrials.gov (NCT05895162; 2023-05-15). Each participant signed a written informed consent form. All procedures performed in studies involving human participants were under the ethical standards of the Hungarian National Institutional Review Medical Research Council and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12905-026-04768-6.
SN  - 1472-6874
ER  -