This happened when COC users were transitioning from normal to abnormal Nugent score 4–6, which was associated with a broadly immunosuppressive response (decreased IL-1β, IL-1RA, IL-8, MIP-3α, IL-6, VEGF and BD-2), and also when they acquired candidiasis, which was associated with a broadly proinflammatory response (increased IL-8, MIP-3α, SLPI, VEGF and ICAM-1). The gene discussed is ICAM1; the disease is candidiasis.