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Current Opinion in Pharmacology Dec 2021The different Lactobacillus strains of probiotics have been applied to the treatment and prevention of bacterial vaginosis and vulvovaginal candidiasis. The... (Review)
Review
The different Lactobacillus strains of probiotics have been applied to the treatment and prevention of bacterial vaginosis and vulvovaginal candidiasis. The experimental data demonstrated that it works well via reducing the number of harmful bacteria, maintaining the acidic microenvironment, inhibiting the immune response, and so on, to restore the vaginal microecology. However, the clinical data indicated that it is not sufficient to support the use of probiotics in the intervention of vulvovaginal candidiasis rather than bacterial vaginosis. Hunting for novel probiotic strains and uncovering the precise mechanism of probiotics, especially with the new concept gut-vagina axis, to maintain the homeostasis of vaginal microbiota should be a great challenge in the future.
Topics: Candidiasis, Vulvovaginal; Female; Humans; Lactobacillus; Probiotics; Vaginosis, Bacterial
PubMed: 34649216
DOI: 10.1016/j.coph.2021.09.004 -
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 -
Clinical Obstetrics and Gynecology Sep 2020Vulvovaginitis is a common gynecologic complaint in prepubertal girls. It typically presents with complaints of vulvovaginal itching, burning, irritation, discharge, or... (Review)
Review
Vulvovaginitis is a common gynecologic complaint in prepubertal girls. It typically presents with complaints of vulvovaginal itching, burning, irritation, discharge, or skin changes. Prepubertal females have anatomic, physiological, and behavioral factors that most often contribute to the development of symptoms. Careful attention to history and associated complaints will direct evaluation, diagnosis, and treatment. Most cases are nonspecific in origin and treatment includes counseling to patients and parents on hygiene and voiding techniques. Antibiotic treatment for specific pathogens may be indicated. Other less common causes include foreign bodies and lichen sclerosus.
Topics: Anti-Bacterial Agents; Child; Female; Feminine Hygiene Products; Gynecological Examination; Humans; Hygiene; Patient Education as Topic; Risk Factors; Sexual Development; Urination; Vulvovaginitis
PubMed: 32282354
DOI: 10.1097/GRF.0000000000000536 -
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 -
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 -
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 -
Journal of Pediatric and Adolescent... Oct 2023Prepubertal bleeding is a common presentation in the pediatric office and can be distressing for patients and families. A comprehensive approach to diagnosis and... (Review)
Review
BACKGROUND
Prepubertal bleeding is a common presentation in the pediatric office and can be distressing for patients and families. A comprehensive approach to diagnosis and management allows clinicians to identify patients at risk for worrisome pathology and arrange timely care.
OBJECTIVE
We aimed to review the key features of clinical history, physical exam, and diagnostic workup of a child presenting with prepubertal bleeding. We reviewed potential pathologies requiring urgent investigations and management, such as precocious puberty and malignancy, as well as more common etiologies, including foreign bodies and vulvovaginitis.
CONCLUSION
Clinicians should approach each patient with the goal of excluding diagnoses that require urgent interventions. A thoughtful clinical history and physical exam can inform appropriate investigations to optimize patient care.
Topics: Female; Child; Humans; Uterine Hemorrhage; Vulvovaginitis; Foreign Bodies; Physical Examination; Puberty, Precocious
PubMed: 37301426
DOI: 10.1016/j.jpag.2023.06.002 -
American Journal of Obstetrics and... Oct 2019
Topics: Biofilms; Candidiasis, Vulvovaginal; Female; Humans
PubMed: 31283905
DOI: 10.1016/j.ajog.2019.07.008 -
American Journal of Obstetrics and... Aug 2019
Topics: Biofilms; Candidiasis, Vulvovaginal; Female; Humans
PubMed: 31029661
DOI: 10.1016/j.ajog.2019.04.018 -
JAMA Jun 2022
Topics: Female; Humans; Premenopause; Vaginitis; Vulvovaginitis
PubMed: 35699704
DOI: 10.1001/jama.2022.9256