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Frontiers in Cellular and Infection... 2023The vaginal microbiome is a distinct component of the human microbiome that is colonized by a wide variety of microorganisms. Lactobacilli are the most frequently... (Review)
Review
The vaginal microbiome is a distinct component of the human microbiome that is colonized by a wide variety of microorganisms. Lactobacilli are the most frequently identified microorganisms in the healthy human vagina. These Gram-positive bacilli can acidify the vaginal microenvironment, inhibit the proliferation of other pathogenic microorganisms, and promote the maintenance of a eubiotic vaginal microbiome. However, a vaginal flora with a reduced proportion or abundance of lactobacilli is associated with various vaginal infections that have been linked to serious health consequences such as infertility, preterm birth, pelvic inflammatory disease, premature rupture of membranes, and miscarriage. Due to their "Generally Recognized as Safe" classification and critical role in vaginal health, probiotic lactobacilli have been widely used as an alternative or adjunct to traditional antibiotic therapy for the treatment of vaginal infections and restoration of the vaginal microbiome. This review focuses on the significant role of probiotic lactobacilli in the vaginal microenvironment and discusses the use of probiotic lactobacilli in the treatment of female vaginal infections and .
Topics: Infant, Newborn; Female; Humans; Lactobacillus; Premature Birth; Vagina; Vulvovaginitis; Probiotics
PubMed: 37077531
DOI: 10.3389/fcimb.2023.1153894 -
Acta Dermatovenerologica Alpina,... 2015Vulvovaginal candidiasis (VVC) affects around three-quarters of all women during their reproductive age, although the exact incidence of VVC is difficult to determine... (Review)
Review
Vulvovaginal candidiasis (VVC) affects around three-quarters of all women during their reproductive age, although the exact incidence of VVC is difficult to determine because many patients are self-treated. The infections are divided into complicated and uncomplicated. Uncomplicated VVC is most effectively treated with local azoles. Oral treatment with a single dose of fluconazole is also effective for treating uncomplicated VVC. Treatment of complicated VVC is prolonged and most commonly consists of multiple doses of oral fluconazole or at least 1 week of local azoles. The role of probiotics in treating VVC is still disputed. This article presents a review of the literature on the various treatment options for VVC. Treatment for the most common pathogens that cause complicated VVC is also discussed.
Topics: Administration, Oral; Antifungal Agents; Candidiasis, Vulvovaginal; Female; Fluconazole; Humans; Probiotics
PubMed: 25770305
DOI: 10.15570/actaapa.2015.2 -
Frontiers in Cellular and Infection... 2022Recurrent vulvovaginal candidosis (RVVC) is a chronic, difficult to treat vaginal infection, caused by species, which affects women of all ages and ethnic and social... (Review)
Review
Recurrent vulvovaginal candidosis (RVVC) is a chronic, difficult to treat vaginal infection, caused by species, which affects women of all ages and ethnic and social background. A long-term prophylactic maintenance regimen with antifungals is often necessary. In most clinical practice guidelines, oral fluconazole is recommended as the first-line treatment. Although clinical resistance to antifungal agents remains rare, overexposure to azoles may increase the development of fluconazole-resistant . strains. In addition, are frequently dose-dependent susceptible or resistant to fluconazole and other azoles, and their prevalence is rising. Available therapeutic options to treat such fluconazole-resistant and low susceptibility non- strains are limited. Ten experts from different European countries discussed problematic issues of current RVVC diagnosis and treatment in two audiotaped online sessions and two electronic follow-up rounds. A total of 340 statements were transcribed, summarized, and compared with published evidence. The profile of patients with RVVC, their care pathways, current therapeutic needs, and potential value of novel drugs were addressed. Correct diagnosis, right treatment choice, and patient education to obtain adherence to therapy regimens are crucial for successful RVVC treatment. As therapeutic options are limited, innovative strategies are required. Well- tolerated and effective new drugs with an optimized mechanism of action are desirable and are discussed. Research into the impact of RVVC and treatments on health-related quality of life and sex life is also needed.
Topics: Antifungal Agents; Azoles; Candida; Candida albicans; Candidiasis, Vulvovaginal; Female; Fluconazole; Humans; Microbial Sensitivity Tests; Quality of Life
PubMed: 36159646
DOI: 10.3389/fcimb.2022.934353 -
Women's Health (London, England) Dec 2017Women use various feminine hygiene products, often as part of their daily cleansing routine; however, there is a paucity of published medical literature related to the... (Review)
Review
Women use various feminine hygiene products, often as part of their daily cleansing routine; however, there is a paucity of published medical literature related to the external vulva and how personal hygiene practices can affect it. This review article provides background information on the physiological changes that occur during women's lives and reviews the relevance of transient and resident microbiota as they relate to common vaginal and vulvar disorders. It also discusses the need for female intimate hygiene, common practices of feminine hygiene from a global perspective, and the potential benefits of using suitable external, topical feminine vulvar washes to minimize the risk of vulvovaginal disorders and to improve overall intimate health in women around the world. Supported by international guidelines, daily gentle cleansing of the vulva is an important aspect of feminine hygiene and overall intimate health. Women should be encouraged to choose a carefully formulated and clinically tested external wash that provides targeted antimicrobial and other health benefits without negatively impacting on the natural vulvovaginal microbiota.
Topics: Female; Feminine Hygiene Products; Health Education; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Self Care; Vaginal Douching; Vulvovaginitis; Women's Health
PubMed: 28934912
DOI: 10.1177/1745505717731011 -
Science Advances May 2023Molecular therapeutics are limited for vaginitis because they damage normal cells and tissues of vagina, aggravating the imbalance of vaginal microbiota and increasing...
Molecular therapeutics are limited for vaginitis because they damage normal cells and tissues of vagina, aggravating the imbalance of vaginal microbiota and increasing the recurrence. To tackle this limitation, through the combination of peroxidase-like rGO@FeS nanozymes [reduced graphene oxide (rGO)] with -produced lactic acid and HO, a responsive hyaluronic acid (HA) hydrogel rGO@FeS/@HA (FeLab) is developed. FeLab has simultaneous anti- and vaginal microbiota-modulating activities. In particular, the hydroxyl radical produced from rGO@FeS nanozymes and kills isolated from clinical specimens without affecting . In mice with vaginitis, FeLab has obvious anti- activity but hardly damages vaginal mucosa cells, which is beneficial to vaginal mucosa repair. Moreover, a higher proportion of (especially ) and a decrease in reshape a healthy vaginal microbiota to reduce the recurrence. These results provide a combined therapeutic of nanozymes and probiotics with translational promise for vaginitis therapy.
Topics: Female; Humans; Animals; Mice; Hydrogen Peroxide; Hydrogels; Candidiasis, Vulvovaginal; Vagina; Candida albicans; Lactobacillus; Probiotics
PubMed: 37196095
DOI: 10.1126/sciadv.adg0949 -
Journal of Clinical Medicine Aug 2023Vulvovaginal candidiasis (VVC) is a common condition associated with discomfort in affected women. Due to the presence of different forms of the disease, diverse... (Review)
Review
Vulvovaginal candidiasis (VVC) is a common condition associated with discomfort in affected women. Due to the presence of different forms of the disease, diverse treatment regimens are developed; the newest ones include oteseconazole and ibrexafungerp. Here, we focus on the most up-to-date recommendations regarding VVC treatment, as well as novel treatment options. Topical and oral azoles are the drugs of choice in uncomplicated mycosis. The efficacy of probiotics and substances such as TOL-463 and chlorhexidine is indicated as satisfactory; however, there are no relevant guidelines. Although the majority of researchers agree that the treatment of non-albicans VVC should be long-lasting, the recommendations are inconsistent. Another clinical problem is the treatment of VVC with azole intolerance or resistance, for which literature proposes the use of several drugs including oteseconazole, ibrexafungerp, and voriconazole. The treatment schedules for recurrent VVC include mainly fluconazole; however, alternative options such as immunotherapeutic vaccine (NDV-3A) or designed antimicrobial peptides (dAMPs) were also described. We also focused on VVC affecting pregnant women, which is a substantial challenge in clinical practice, also due to the heterogeneous relevant guidelines. Thus far, few precise recommendations are available in the literature. Future studies should focus on atypical VVC forms to elucidate the inconsistent findings.
PubMed: 37629418
DOI: 10.3390/jcm12165376 -
Science Translational Medicine Dec 2023causes an estimated half-billion cases of vulvovaginal candidiasis (VVC) every year. VVC is most commonly caused by , which, in this setting, triggers nonprotective...
causes an estimated half-billion cases of vulvovaginal candidiasis (VVC) every year. VVC is most commonly caused by , which, in this setting, triggers nonprotective neutrophil infiltration, aggressive local inflammation, and symptomatic disease. Despite its prevalence, little is known about the molecular mechanisms underpinning the immunopathology of this fungal infection. In this study, we describe the molecular determinant of VVC immunopathology and a potentially straightforward way to prevent disease. In response to zinc limitation, releases a trace mineral binding molecule called Pra1 (pH-regulated antigen). Here, we show that the gene is strongly up-regulated during vaginal infections and that its expression positively correlated with proinflammatory cytokine concentrations in women. Genetic deletion of prevented vaginal inflammation in mice, and application of a zinc solution down-regulated expression of the gene and also blocked immunopathology. We also show that treatment of women suffering from recurrent VVC with a zinc gel prevented reinfections. We have therefore identified a key mediator of symptomatic VVC, giving us an opportunity to develop a range of preventative measures for combatting this disease.
Topics: Female; Humans; Animals; Mice; Candidiasis, Vulvovaginal; Zinc; Vagina; Candida albicans; Inflammation
PubMed: 38055800
DOI: 10.1126/scitranslmed.adi3363 -
Nature Communications Sep 2017Infectious diseases have a profound impact on our health and many studies suggest that host genetics play a major role in the pathogenesis of most of them. We perform 23...
Infectious diseases have a profound impact on our health and many studies suggest that host genetics play a major role in the pathogenesis of most of them. We perform 23 genome-wide association studies for common infections and infection-associated procedures, including chickenpox, shingles, cold sores, mononucleosis, mumps, hepatitis B, plantar warts, positive tuberculosis test results, strep throat, scarlet fever, pneumonia, bacterial meningitis, yeast infections, urinary tract infections, tonsillectomy, childhood ear infections, myringotomy, measles, hepatitis A, rheumatic fever, common colds, rubella and chronic sinus infection, in over 200,000 individuals of European ancestry. We detect 59 genome-wide significant (P < 5 × 10) associations in genes with key roles in immunity and embryonic development. We apply fine-mapping analysis to dissect associations in the human leukocyte antigen region, which suggests important roles of specific amino acid polymorphisms in the antigen-binding clefts. Our findings provide an important step toward dissecting the host genetic architecture of response to common infections.Susceptibility to infectious diseases is, among others, influenced by the genetic landscape of the host. Here, Tian and colleagues perform genome-wide association studies for 23 common infections and find 59 risk loci for 17 of these, both within the HLA region and non-HLA loci.
Topics: Candidiasis, Vulvovaginal; Case-Control Studies; Chickenpox; Chronic Disease; Common Cold; Female; Genetic Predisposition to Disease; Genome-Wide Association Study; HLA Antigens; Hepatitis A; Hepatitis B; Herpes Labialis; Herpes Zoster; Humans; Infections; Infectious Mononucleosis; Male; Measles; Meningitis, Bacterial; Middle Ear Ventilation; Mumps; Otitis Media; Pharyngitis; Pneumonia; Rheumatic Fever; Rubella; Scarlet Fever; Sinusitis; Streptococcal Infections; Tonsillectomy; Tonsillitis; Tuberculin Test; Tuberculosis; Urinary Tract Infections; Warts; White People
PubMed: 28928442
DOI: 10.1038/s41467-017-00257-5 -
Australian Prescriber Dec 2020Vulvovaginitis is a commonly encountered problem in general practice. It usually presents with irritation and vaginal discharge A thorough examination is essential in... (Review)
Review
Vulvovaginitis is a commonly encountered problem in general practice. It usually presents with irritation and vaginal discharge A thorough examination is essential in order not to miss the less common causes. Investigations may be needed to confirm the diagnosis Candidiasis and bacterial vaginosis are the most common causes. Antifungals and antibiotics are therefore used in management Not all causes are infective. Several skin disorders can affect the vulva Ongoing or recurrent symptoms require careful evaluation and further investigation
PubMed: 33363301
DOI: 10.18773/austprescr.2020.055