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Amigh P, Ahmadi Y, Mohkam M, Shokri D. Antimicrobial Potential of Probiotic Strains From Bulgarian Cheese and Shallot Yogurt Against Staphylococcus saprophyticus. BIOMED RESEARCH INTERNATIONAL 2024; 2024:2978083. [PMID: 39445209 PMCID: PMC11496581 DOI: 10.1155/2024/2978083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 09/09/2024] [Indexed: 10/25/2024]
Abstract
The escalating incidence of hospital infections due to antibiotic resistance necessitates the identification of alternative therapeutic agents such as probiotics. This study was designed to isolate and evaluate the efficacy of probiotics against Staphylococcus saprophyticus, a prevalent etiological agent of urinary tract infections (UTIs). A total of 100 S. saprophyticus strains were isolated from clinical samples and subjected to antibiotic susceptibility testing via the disc diffusion method. Concurrently, probiotic bacteria were isolated from Bulgarian cheese and shallot yogurt, and their antibacterial activity against S. saprophyticus strains was assessed. The inhibitory potential of probiotic supernatants was evaluated using microtiter plate assays, with the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) determined at a 1/2 dilution. Cytotoxicity was evaluated using the MTT assay, and high-performance liquid chromatography (HPLC) was employed to analyze the concentrations of organic acids produced by the probiotics. The results revealed that all S. saprophyticus strains were resistant to tetracycline and doxycycline but susceptible to other antibiotics. Lactobacillus rhamnosus strains M and B demonstrated notable antibacterial and antibiofilm activity against S. saprophyticus isolates. These probiotics exhibited susceptibility to most antibiotics and lacked virulence factors, suggesting their safety for therapeutic use. The organic acids produced by the probiotics were identified as lactic acid, acetic acid, and formic acid. In conclusion, L. rhamnosus strains M and B exhibit potent antimicrobial properties against S. saprophyticus, indicating their potential as therapeutic agents for UTIs. Further research is warranted to validate these findings and explore the possibility of these probiotics in clinical applications.
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Affiliation(s)
- Pardis Amigh
- Department of Biotechnology, Faculty of Biological Sciences and Technology, Shahid Ashrafi Esfahani University, Isfahan, Iran
| | - Yasaman Ahmadi
- Department of Microbiology, Kish International Branch of Islamic Azad University, Kish, Iran
| | - Milad Mohkam
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dariush Shokri
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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2
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Yuan C, Xie K, Feng L, Gao S, Cai L. The role and challenges of regulating endometrial microbiome in uterine health and diseases. Crit Rev Microbiol 2024; 50:937-954. [PMID: 38488586 DOI: 10.1080/1040841x.2024.2320247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/10/2024] [Indexed: 10/09/2024]
Abstract
The uterine environment provides necessary conditions for the existence of endometrial microbiota, which in turn plays an important role in maintaining the homeostasis of the uterine environment. The endometrial microbiome is highly susceptible to external factors such as age, hormones, menstrual, pregnancy, etc. When the microbiota is imbalanced, it will further promote the occurrence of uterine diseases such as endometritis and endometrial cancer. Regulating the microbiome of the endometrium is of positive significance for promoting uterine health. Among them, antibiotics, probiotics, prebiotics, and microbial transplantation may be important pathways for regulating endometrial microbiota in the future. However, there is currently no unified plan for evaluating the endometrial microbiota. In addition, due to the small sample size, it is easy to be contaminated by exogenous bacterial DNA, which poses great challenges for studying the mechanism of microbial community regulating uterine health. Therefore, there are still many areas worth exploring for the future of endometrial microbiome.
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Affiliation(s)
- Chongshan Yuan
- Department of Obstetrics, China-Japan Union hospital of Jilin University, Changchun, Jilin, China
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun, Jilin Province, China
| | - Kunyu Xie
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun, Jilin Province, China
| | - Lianjun Feng
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun, Jilin Province, China
| | - Shouyang Gao
- Department of Obstetrics, China-Japan Union hospital of Jilin University, Changchun, Jilin, China
| | - Lifu Cai
- Department of Obstetrics, China-Japan Union hospital of Jilin University, Changchun, Jilin, China
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3
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Chen R, Peng C, Wang Z, Xiao Y, Tang S. Effects of vaginal microbiota on human papillomavirus infection and its related diseases. Microb Pathog 2024; 193:106761. [PMID: 38925345 DOI: 10.1016/j.micpath.2024.106761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/29/2024] [Accepted: 06/24/2024] [Indexed: 06/28/2024]
Abstract
With the knowledge of female reproductive tract microbiota gradually increasing, the connection between vaginal microbiota (VMB) and its related diseases is increasingly highlighted. Manifestation of VMB keeps changing with various dominated bacteria, which can affect the immune response of mucosal barrier and the entrance of pathogens. Human papillomavirus (HPV), as an oncogenic virus, is closely related to viral-associated cancer, such as cervical cancer. According to HPV infection status, VMB can transform into different types, and result in accelerating or restraining the progression of diseases, which have exposed the inner link between VMB and HPV. Therefore, probiotics therapy promises to be a new complementary therapy to rebuild a healthy VMB for patients, but there's still a long way to go before its ready for the clinic. This review focuses on composition, immune response, and application of VMB in HPV and its associated diseases and aims to provide the new ideas and directions for the research on VMB.
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Affiliation(s)
- Ranzhong Chen
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical College, University of South China, Hengyang 421001, Hunan, People's Republic of China.
| | - Changmin Peng
- School of Public Health, Hengyang Medical College, University of South China, Hengyang 421001, Hunan, China.
| | - Zhenlei Wang
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical College, University of South China, Hengyang 421001, Hunan, People's Republic of China.
| | - Yuanyuan Xiao
- School of Public Health, Hengyang Medical College, University of South China, Hengyang 421001, Hunan, China.
| | - Shuangyang Tang
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of pathogenic Biology, School of Basic Medicine Sciences, Hengyang Medical College, University of South China, Hengyang 421001, Hunan, People's Republic of China.
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Zhang J, Li K, Cao T, Duan Z. Characterization of a Lactobacillus gasseri strain as a probiotic for female vaginitis. Sci Rep 2024; 14:14426. [PMID: 38910172 PMCID: PMC11194266 DOI: 10.1038/s41598-024-65550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 06/20/2024] [Indexed: 06/25/2024] Open
Abstract
Vaginitis, a prevalent gynecological condition in women, is mainly caused by an imbalance in the vaginal micro-ecology. The two most common types of vaginitis are vaginal bacteriosis and vulvovaginal candidiasis, triggered by the virulent Gardnerella vaginalis and Candida albicans, respectively. In this study, a strain capable of inhibiting G. vaginalis and C. albicans was screened from vaginal secretions and identified as Lactobacillus gasseri based on 16S rRNA sequences. The strain, named L. gasseri VHProbi E09, could inhibit the growth of G. vaginalis and C. albicans under co-culture conditions by 99.07% ± 0.26% and 99.95% ± 0.01%, respectively. In addition, it could significantly inhibit the adhesion of these pathogens to vaginal epithelial cells. The strain further showed the ability to inhibit the enteropathogenic bacteria Escherichia coli and Salmonella enteritidis, to tolerate artificial gastric and intestinal fluids and to adhere to intestinal Caco-2 cells. These results suggest that L. gasseri VHProbi E09 holds promise for clinical trials and animal studies whether administered orally or directly into the vagina. Whole-genome analysis also revealed a genome consisting of 1752 genes for L. gasseri VHProbi E09, with subsequent analyses identifying seven genes related to adhesion and three genes related to bacteriocins. These adhesion- and bacteriocin-related genes provide a theoretical basis for understanding the mechanism of bacterial inhibition of the strain. The research conducted in this study suggests that L. gasseri VHProbi E09 may be considered as a potential probiotic, and further research can delve deeper into its efficacy as an agent which can restore a healthy vaginal ecosystem.
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Affiliation(s)
- Jingyan Zhang
- Qingdao Vland Biotech Group Co., Ltd, Qingdao, China
| | - Kailing Li
- Qingdao Vland Biotech Group Co., Ltd, Qingdao, China
| | - Tishuang Cao
- Qingdao Vland Biotech Group Co., Ltd, Qingdao, China
| | - Zhi Duan
- Qingdao Vland Biotech Group Co., Ltd, Qingdao, China.
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Wang Y, Zhang Z, Chen Q, Chen T. Simultaneous application of oral and intravaginal probiotics for Helicobacter pylori and its antibiotic-therapy-induced vaginal dysbacteriosis. NPJ Biofilms Microbiomes 2024; 10:49. [PMID: 38902244 PMCID: PMC11190290 DOI: 10.1038/s41522-024-00521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 06/07/2024] [Indexed: 06/22/2024] Open
Abstract
Helicobacter pylori is a prevalent bacterial pathogen globally, implicated in various gastrointestinal disorders. Current recommended antibiotic therapies for H. pylori infection have been proven to be therapeutically insufficient, with low eradication rates and high recurrence rates. Emerging evidence suggests that antibiotic therapy for H. pylori can lead to gastrointestinal and subsequent vaginal dysbiosis, posing challenges for conventional antibiotic approaches. Thus, this article proposes a novel probiotic therapy involving simultaneous oral and intra-vaginal probiotic administration alongside antibiotics for H. pylori treatment, aiming to enhance eradication rates and mitigate dysbiosis. We begin by providing an overview of gastrointestinal and vaginal microbiota and their interconnectedness through the vagina-gut axis. We then review the efficacy of current antibiotic regimens for H. pylori and discuss how antibiotic treatment impacts the vaginal microenvironment. To explore the feasibility of this approach, we evaluate the effectiveness of oral and intra-vaginal probiotics in restoring normal microbiota in the gastrointestinal and vaginal tracts, respectively. Additionally, we analyze the direct mechanisms by which oral and intra-vaginal probiotics act on their respective tracts and discuss potential cross-tract mechanisms. Considering the potential synergistic therapeutic effects of probiotics in both the gastrointestinal and vaginal tracts, dual-channel probiotic therapy holds promise as a more effective approach for H. pylori eradication and dysbiosis mitigation, presenting a novel concept in the collaborative treatment of gastrointestinal and genital disorders.
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Affiliation(s)
- Yufan Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
- Queen Mary School, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
- National Engineering Research Centre for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Zhenyu Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Qi Chen
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China.
| | - Tingtao Chen
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China.
- National Engineering Research Centre for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China.
- School of Pharmacy, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China.
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6
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Ashique S, Faruk A, Ahmad FJ, Khan T, Mishra N. It Is All about Probiotics to Control Cervical Cancer. Probiotics Antimicrob Proteins 2024; 16:979-992. [PMID: 37880560 DOI: 10.1007/s12602-023-10183-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Cervical cancer (CC) is the fourth most common malignancy in female patients. "Human papillomavirus" (HPV) contamination is a leading cause of all forms of cervical cancer, accounting for an expected 570,000 reported incidents in 2018. Two HPV strains (16 and 18) are responsible for 70% of CC and pre-cancerous cervical abnormalities. CC is one of the foremost reasons for the malignancy death rate in India among women ranging from 30 to 69 years of age in India, responsible for 17% of all cancer deaths. Currently approved cervical cancer treatments are associated with adverse reactions that might harm the lives of women affected by this disease. Consequently, probiotics can play a vital role in the treatment of CC. It is reflected from various studies regarding the role of probiotics in the diagnosis, prevention or treatment of cancer. In this review article, we have discussed the rationale of probiotics for treatment of CC, the role of probiotics as effective adjuvants in anti-cancer therapy and the combined effect of the anti-cancer drug along with probiotics to minimize the side effects due to chemotherapy.
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Affiliation(s)
- Sumel Ashique
- Department of Pharmaceutics, School of Pharmacy, Pandaveswar, West Bengal, 713346, India
| | - Abdul Faruk
- Department of Pharmaceutical Sciences, Hemwati Nandan Bahuguna Garhwal University, Srinagar, Uttarakhand, India.
| | - Farhan Jalees Ahmad
- Department of Pharmaceutics, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi, 110062, India
| | - Tasneem Khan
- Department of Pharmaceutics, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi, 110062, India
| | - Neeraj Mishra
- Amity Institute of Pharmacy, Amity University, Gwalior, 474005, Madhya Pradesh, India
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Chaudhary PP, Kaur M, Myles IA. Does "all disease begin in the gut"? The gut-organ cross talk in the microbiome. Appl Microbiol Biotechnol 2024; 108:339. [PMID: 38771520 PMCID: PMC11108886 DOI: 10.1007/s00253-024-13180-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
The human microbiome, a diverse ecosystem of microorganisms within the body, plays pivotal roles in health and disease. This review explores site-specific microbiomes, their role in maintaining health, and strategies for their upkeep, focusing on oral, lung, vaginal, skin, and gut microbiota, and their systemic connections. Understanding the intricate relationships between these microbial communities is crucial for unraveling mechanisms underlying human health. Recent research highlights bidirectional communication between the gut and distant microbiome sites, influencing immune function, metabolism, and disease susceptibility. Alterations in one microbiome can impact others, emphasizing their interconnectedness and collective influence on human physiology. The therapeutic potential of gut microbiota in modulating distant microbiomes offers promising avenues for interventions targeting various disorders. Through interdisciplinary collaboration and technological advancements, we can harness the power of the microbiome to revolutionize healthcare, emphasizing microbiome-centric approaches to promote holistic well-being while identifying areas for future research.
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Affiliation(s)
- Prem Prashant Chaudhary
- Laboratory of Clinical Immunology and Microbiology, Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Mahaldeep Kaur
- Laboratory of Clinical Immunology and Microbiology, Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Ian A Myles
- Laboratory of Clinical Immunology and Microbiology, Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, 20892, USA
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Lyu J, Gao M, Zhao S, Liu X, Zhao X, Zou Y, Zhong Y, Ge L, Zhang H, Huang L, Fan S, Xiao L, Zhang X. From whole genomes to probiotic candidates: A study of potential lactobacilli strains selection for vaginitis treatment. Heliyon 2024; 10:e30495. [PMID: 38765070 PMCID: PMC11098787 DOI: 10.1016/j.heliyon.2024.e30495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/12/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
Vaginitis, characterized by pathogenic invasion and a deficiency in beneficial lactobacilli, has recognized lactobacilli supplementation as a novel therapeutic strategy. However, due to individual differences in vaginal microbiota, identifying universally effective Lactobacillus strains is challenging. Traditional methodologies for probiotic selection, which heavily depend on extensive in vitro experiments, are both time-intensive and laborious. The aim of this study was to pinpoint possible vaginal probiotic candidates based on whole-genome screening. We sequenced the genomes of 98 previously isolated Lactobacillus strains, annotating their genes involved in probiotic metabolite biosynthesis, adherence, acid/bile tolerance, and antibiotic resistance. A scoring system was used to assess the strains based on their genomic profiles. The highest-scoring strains underwent further in vitro evaluation. Consequently, two strains, Lactobacillus crispatus LG55-27 and Lactobacillus gasseri TM13-16, displayed an outstanding ability to produce d-lactate and adhere to human vaginal epithelial cells. They also showed higher antimicrobial activity against Gardnerella vaginalis, Escherichia coli, Candida albicans, Staphylococcus aureus, and Pseudomonas aeruginosa compared to reference Lactobacillus strains. Their resilience to acid and bile environments highlights the potential for oral supplementation. Oral and vaginal administration of these two strains were tested in a bacterial vaginosis (BV) rat model at various doses. Results indicated that combined vaginal administration of these strains at 1 × 106 CFU/day significantly mitigated BV in rats. This research offers a probiotic dosage guideline for vaginitis therapy, underscoring an efficient screening process for probiotics using genome sequencing, in vitro testing, and in vivo BV model experimentation.
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Affiliation(s)
- Jinli Lyu
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- BGI-Shenzhen, Shenzhen, 518083, China
| | - Mengyu Gao
- BGI-Shenzhen, Shenzhen, 518083, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, 518083, China
| | - Shaowei Zhao
- BGI-Shenzhen, Shenzhen, 518083, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, 518083, China
| | - Xinyang Liu
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Xinlong Zhao
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuanqiang Zou
- BGI-Shenzhen, Shenzhen, 518083, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, 518083, China
| | - Yiyi Zhong
- BGI Precision Nutrition (Shenzhen) Technology Co., Ltd, Shenzhen, 518083, China
| | - Lan Ge
- BGI Precision Nutrition (Shenzhen) Technology Co., Ltd, Shenzhen, 518083, China
| | - Hiafeng Zhang
- BGI Precision Nutrition (Shenzhen) Technology Co., Ltd, Shenzhen, 518083, China
| | - Liting Huang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Shangrong Fan
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Liang Xiao
- BGI-Shenzhen, Shenzhen, 518083, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, 518083, China
| | - Xiaowei Zhang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- BGI-Shenzhen, Shenzhen, 518083, China
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Abavisani M, Sahebi S, Dadgar F, Peikfalak F, Keikha M. The role of probiotics as adjunct treatment in the prevention and management of gynecological infections: An updated meta-analysis of 35 RCT studies. Taiwan J Obstet Gynecol 2024; 63:357-368. [PMID: 38802199 DOI: 10.1016/j.tjog.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE The present study aims to conduct a comprehensive meta-analysis of randomized controlled trials (RCTs) investigating the efficacy of probiotics as an adjunct treatment for preventing and treating gynecological infections. MATERIALS AND METHODS The study adopted a systematic review of scientific databases including PubMed, Cochrane, and EMBASE, using defined MeSH terms. The inclusion and exclusion criteria were set to refine the search, with the data extraction and quality assessment being conducted by two independent investigators. RESULTS A total of 35 articles, comprising 3751 patients, were included in the meta-analysis. The application of probiotics demonstrated a notable increase in the cure rates of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) as compared to control groups. A significant BV cure rate (OR: 5.972; 95% CI: 2.62-13.59; p-value: 0.01) was noted with probiotic use, which was even more pronounced when used as an adjunctive treatment with antibiotics (OR: 2.504; 95% CI: 1.03-6.06; p-value: 0.04). Additionally, probiotic use significantly reduced the recurrence rates of BV (OR: 0.34; 95% CI: 0.167-0.71; p-value: 0.004). For VVC, a significant increase in the cure rate was observed in the probiotic group (OR: 3.425; 95% CI: 2.404-4.879; p-value: 0.01), along with a lower recurrence rate (OR: 0.325; 95% CI: 0.175-0.606; p-value: 0.01). CONCLUSION Our findings underscore the potential role of probiotics as a beneficial adjunctive treatment for gynecological infections, indicating an improved cure rate and decreased recurrence. However, additional well-designed studies are necessary to corroborate these findings.
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Affiliation(s)
- Mohammad Abavisani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Sahebi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Dadgar
- Department of Internal Medicine, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Farzaneh Peikfalak
- Department of Internal Medicine, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Masoud Keikha
- Department of Medical Microbiology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
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Vaccalluzzo A, Pino A, Grimaldi RL, Caggia C, Cianci S, Randazzo CL. Lacticaseibacillus rhamnosus TOM 22.8 (DSM 33500) is an effective strategy for managing vaginal dysbiosis, rising the lactobacilli population. J Appl Microbiol 2024; 135:lxae110. [PMID: 38755019 DOI: 10.1093/jambio/lxae110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/16/2024] [Accepted: 05/15/2024] [Indexed: 05/18/2024]
Abstract
AIM The present study is a single-centre, randomized, controlled clinical trial aimed to evaluate the effectiveness of the probiotic Lacticaseibacillus rhamnosus TOM 22.8 (DSM 33500) strain, orally administrated, to treat vaginal dysbiosis. METHODS AND RESULTS Overall, 80 women, with signs and symptoms of vaginal dysbiosis, were enrolled and allocated to the treatment group (A, n=60), who took 1 capsule of the probiotic strain for 10 consecutive days, or the non-treatment group (B, n=20), who did not receive any treatment. Clinical (vaginal signs and symptoms; pH of the vaginal fluid; Amsel criteria; Nugent score; Lactobacillary grade) and microbiological examinations were performed at baseline (T0), 10 days (T1), and 30 (T2) days after the oral administration of the probiotic TOM 22.8 strain. The latter resulted in a restoration of the physiological pH, accompanied by remission or attenuation of clinical signs and symptoms as well as the improvement of the quality of life (QoL). Microbiological data revealed a significant reduction of potentially pathogenic bacteria. CONCLUSION The administration of the L. rhamnosus TOM 22.8 probiotic strain could be proposed as an effective strategy for the treatment of vaginal dysbiosis.
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Affiliation(s)
- Amanda Vaccalluzzo
- Department of Agriculture, Food and Environment, University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
| | - Alessandra Pino
- Department of Agriculture, Food and Environment, University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
- ProBioEtna SRL, Spin off of the University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
| | - Raffaela Luisa Grimaldi
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Santa Sofia Street, 78, 95123 Catania, Italy
| | - Cinzia Caggia
- Department of Agriculture, Food and Environment, University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
- ProBioEtna SRL, Spin off of the University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
| | - Stefano Cianci
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, 98122 Messina, Italy
| | - Cinzia Lucia Randazzo
- Department of Agriculture, Food and Environment, University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
- ProBioEtna SRL, Spin off of the University of Catania, Santa Sofia Street, 100, 95123 Catania, Italy
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11
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Shen J, Sun H, Chu J, Gong X, Liu X. Cervicovaginal microbiota: a promising direction for prevention and treatment in cervical cancer. Infect Agent Cancer 2024; 19:13. [PMID: 38641803 PMCID: PMC11027553 DOI: 10.1186/s13027-024-00573-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024] Open
Abstract
Cervical cancer is a common malignancy in women, with high incidence rate and mortality. Persistent infection of high-risk human papillomavirus (HPV) is the most important risk factor for cervical cancer and precancerous lesions. Cervicovaginal microbiota (CVM) plays an essential role in the defense of HPV infections and prevention of subsequent lesions. Dominance of Lactobacillus is the key of CVM homeostasis, which can be regulated by host, exogenous and endogenous factors. Dysbiosis of CVM, including altered microbial, metabolic, and immune signatures, can contribute to persist HPV infection, leading to cervical cancer. However, there is no evidence of the causality between CVM and cervical cancer, and the underlying mechanism remains unexplored. Considering the close correlation between CVM dysbiosis and persistent HPV infection, this review will overview CVM, its role in cervical cancer development and related mechanisms, and the prospects for therapeutic applications.
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Affiliation(s)
- Jie Shen
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), 200003, Shanghai, China
| | - Hao Sun
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), 200003, Shanghai, China
| | - Jing Chu
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), 200003, Shanghai, China
| | - Xiaodi Gong
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), 200003, Shanghai, China.
| | - Xiaojun Liu
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), 200003, Shanghai, China.
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Gao H, Liu Q, Wang X, Li T, Li H, Li G, Tan L, Chen Y. Deciphering the role of female reproductive tract microbiome in reproductive health: a review. Front Cell Infect Microbiol 2024; 14:1351540. [PMID: 38562966 PMCID: PMC10982509 DOI: 10.3389/fcimb.2024.1351540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Relevant studies increasingly indicate that female reproductive health is confronted with substantial challenges. Emerging research has revealed that the microbiome interacts with the anatomy, histology, and immunity of the female reproductive tract, which are the cornerstone of maintaining female reproductive health and preventing adverse pregnancy outcomes. Currently, the precise mechanisms underlying their interaction and impact on physiological functions of the reproductive tract remain elusive, constituting a prominent area of investigation within the field of female reproductive tract microecology. From this new perspective, we explore the mechanisms of interactions between the microbiome and the anatomy, histology, and immunity of the female reproductive tract, factors that affect the composition of the microbiome in the female reproductive tract, as well as personalized medicine approaches in managing female reproductive tract health based on the microbiome. This study highlights the pivotal role of the female reproductive tract microbiome in maintaining reproductive health and influencing the occurrence of reproductive tract diseases. These findings support the exploration of innovative approaches for the prevention, monitoring and treatment of female reproductive tract diseases based on the microbiome.
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Affiliation(s)
- Hong Gao
- Nursing Department, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
| | - Qiao Liu
- School of Nursing, University of South China, Hengyang, China
| | - Xiaolan Wang
- Center for a Combination of Obstetrics and Gynecology and Reproductive Medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Ting Li
- Department of Obstetrics, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Huanhuan Li
- Department of Gynaecology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Genlin Li
- Center for a Combination of Obstetrics and Gynecology and Reproductive Medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Lingling Tan
- Nursing Department, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Yahui Chen
- School of Nursing, University of South China, Hengyang, China
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Abou Chacra L, Drouet H, Ly C, Bretelle F, Fenollar F. Evaluation of Various Diagnostic Strategies for Bacterial Vaginosis, Including a New Approach Based on MALDI-TOF Mass Spectrometry. Microorganisms 2024; 12:111. [PMID: 38257938 PMCID: PMC10821145 DOI: 10.3390/microorganisms12010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Bacterial vaginosis (BV) is a common dysbiosis of unclear etiology but with potential consequences representing a public health problem. The diagnostic strategies vary widely. The Amsel criteria and Nugent score have obvious limitations, while molecular biology techniques are expensive and not yet widespread. We set out to evaluate different diagnostic strategies from vaginal samples using (1) a combination of abnormal vaginal discharge and vaginal pH > 4.5; (2) the Amsel-like criteria (replacing the "whiff test" with "malodorous discharge"); (3) the Nugent score; (4) the molecular quantification of Fannyhessea vaginae and Gardnerella vaginalis (qPCR); (5) and MALDI-TOF mass spectrometry (we also refer to it as "VAGI-TOF"). Overall, 54/129 patients (42%) were diagnosed with BV using the combination of vaginal discharge and pH, 46/118 (39%) using the Amsel-like criteria, 31/130 (24%) using qPCR, 32/130 (25%) using "VAGI-TOF", and 23/84 (27%) using the Nugent score (not including the 26 (31%) with intermediate flora). Of the 84 women for whom the five diagnostic strategies were performed, the diagnosis of BV was considered for 38% using the combination of vaginal discharge and pH, 34.5% using the Amsel-like criteria, 27% using the Nugent score, 25% using qPCR, and 25% using "VAGI-TOF". When qPCR was considered as the reference, the sensitivity rate for BV was 76.2% for the combination of vaginal discharge and pH, 90.5% for the Amsel-like criteria, 95.2% for the Nugent score, and 90.5% for "VAGI-TOF", while the specificity rates were 74.6%, 84.1%, 95.3%, and 95.3%, respectively. When the Nugent score was considered as the reference, the sensitivity for BV was 69.6% for the combination of vaginal discharge and pH, 82.6% for the Amsel-like criteria, 87% for qPCR, and 78.7% for "VAGI-TOF", while the specificity rates were 80%, 94.3%, 100%, and 97.1%, respectively. Overall, the use of qPCR and "VAGI-TOF" provided a consistent diagnosis of BV, followed by the Nugent score. If qPCR seems tedious and for some costly, "VAGI-TOF" could be an inexpensive, practical, and less time-consuming alternative.
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Affiliation(s)
- Linda Abou Chacra
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (H.D.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France
| | - Hortense Drouet
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (H.D.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France
| | - Claudia Ly
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (H.D.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France
| | - Florence Bretelle
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
- Department of Gynaecology and Obstetrics, Gynépole, La Conception, AP-HM, 13005 Marseille, France
| | - Florence Fenollar
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (H.D.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France
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14
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Rai V, Kyser AJ, Goodin DA, Mahmoud MY, Steinbach-Rankins JM, Frieboes HB. Computational Modeling of Probiotic Recovery from 3D-Bioprinted Scaffolds for Localized Vaginal Application. ANNALS OF 3D PRINTED MEDICINE 2023; 11:100120. [PMID: 37583971 PMCID: PMC10424195 DOI: 10.1016/j.stlm.2023.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Lactobacilli, play a beneficial role in the female reproductive tract (FRT), regulating pH via lactic acid metabolism to help maintain a healthy environment. Bacterial vaginosis (BV) is characterized by a dysregulated flora in which anaerobes such as Gardnerella vaginalis (Gardnerella) create a less acidic environment. Current treatment focuses on antibiotic administration, including metronidazole, clindamycin, or tinidazole; however, lack of patient compliance as well as antibiotic resistance may contribute to 50% recurrence within a year. Recently, locally administered probiotics such as Lactobacillus crispatus (L. crispatus) have been evaluated as a prophylactic against recurrence. To mitigate the lack of patient compliance, sustained probiotic delivery has been proposed via 3D-bioprinted delivery vehicles. Successful delivery depends on a variety of vehicle fabrication parameters influencing timing and rate of probiotic recovery; detailed evaluation of these parameters would benefit from computational modeling complementary to experimental evaluation. This study implements a novel simulation platform to evaluate sustained delivery of probiotics from 3D-bioprinted scaffolds, taking into consideration bacterial lactic acid production and associated pH changes. The results show that the timing and rate of probiotic recovery can be realistically simulated based on fabrication parameters that affect scaffold degradation and probiotic survival. Longer term, the proposed approach could help personalize localized probiotic delivery to the FRT to advance women's health.
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Affiliation(s)
- Veeresh Rai
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Anthony J. Kyser
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Dylan A. Goodin
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
- School of Interdisciplinary and Graduate Studies, University of Louisville, Louisville, KY, USA
| | - Mohamed Y. Mahmoud
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
- Center for Predictive Medicine, University of Louisville, Louisville, KY, USA
- Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt
| | - Jill M. Steinbach-Rankins
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
- Center for Predictive Medicine, University of Louisville, Louisville, KY, USA
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, USA
- Department of Microbiology and Immunology, University of Louisville, Louisville, KY, USA
| | - Hermann B. Frieboes
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
- Center for Predictive Medicine, University of Louisville, Louisville, KY, USA
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, USA
- UofL-Health –Brown Cancer Center, University of Louisville, Louisville, KY, USA
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15
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Kyser AJ, Mahmoud MY, Herold SE, Lewis WG, Lewis AL, Steinbach-Rankins JM, Frieboes HB. Formulation and characterization of pressure-assisted microsyringe 3D-printed scaffolds for controlled intravaginal antibiotic release. Int J Pharm 2023; 641:123054. [PMID: 37207856 PMCID: PMC10330500 DOI: 10.1016/j.ijpharm.2023.123054] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/24/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
Bacterial vaginosis (BV) is a highly recurrent vaginal condition linked with many health complications. Topical antibiotic treatments for BV are challenged with drug solubility in vaginal fluid, lack of convenience and user adherence to daily treatment protocols, among other factors. 3D-printed scaffolds can provide sustained antibiotic delivery to the female reproductive tract (FRT). Silicone vehicles have been shown to provide structural stability, flexibility, and biocompatibility, with favorable drug release kinetics. This study formulates and characterizes novel metronidazole-containing 3D-printed silicone scaffolds for eventual application to the FRT. Scaffolds were evaluated for degradation, swelling, compression, and metronidazole release in simulated vaginal fluid (SVF). Scaffolds retained high structural integrity and sustained release. Minimal mass loss (<6%) and swelling (<2%) were observed after 14 days in SVF, relative to initial post-cure measurements. Scaffolds cured for 24 hr (50 °C) demonstrated elastic behavior under 20% compression and 4.0 N load. Scaffolds cured for 4 hr (50 °C), followed by 72 hr (4 °C), demonstrated the highest, sustained, metronidazole release (4.0 and 27.0 µg/mg) after 24 hr and 14 days, respectively. Based upon daily release profiles, it was observed that the 24 hr timepoint had the greatest metronidazole release of 4.08 μg/mg for scaffolds cured at 4 hr at 50 °C followed by 72 hr at 4 °C. For all curing conditions, release of metronidazole after 1 and 7 days showed > 4.0-log reduction in Gardnerella concentration. Negligible cytotoxicity was observed in treated keratinocytes comparable to untreated cells, This study shows that pressure-assisted microsyringe 3D-printed silicone scaffolds may provide a versatile vehicle for sustained metronidazole delivery to the FRT.
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Affiliation(s)
- Anthony J Kyser
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Mohamed Y Mahmoud
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Sydney E Herold
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Warren G Lewis
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA 92093, USA; Glycobiology Research and Training Center, University of California San Diego, La Jolla, CA 92093, USA.
| | - Amanda L Lewis
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA 92093, USA; Glycobiology Research and Training Center, University of California San Diego, La Jolla, CA 92093, USA.
| | - Jill M Steinbach-Rankins
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, KY 40202, USA.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; UofL Health - Brown Cancer Center, University of Louisville, KY 40202, USA.
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16
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Cocomazzi G, De Stefani S, Del Pup L, Palini S, Buccheri M, Primiterra M, Sciannamè N, Faioli R, Maglione A, Baldini GM, Baldini D, Pazienza V. The Impact of the Female Genital Microbiota on the Outcome of Assisted Reproduction Treatments. Microorganisms 2023; 11:1443. [PMID: 37374945 DOI: 10.3390/microorganisms11061443] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
The vaginal microbiota plays a critical role in the health of the female genital tract, and its composition contributes to gynecological disorders and infertility. Lactobacilli are the dominant species in the female genital tract: their production of lactic acid, hydrogen peroxide, and bacteriocins prevents the invasion and growth of pathogenic microorganisms. Several factors such as hormonal changes, age of reproduction, sexual practices, menstrual cycle, pregnancy, and antimicrobial drugs use can cause imbalance and dysbiosis of the vaginal microbiota. This review aims to highlight the impact of the vaginal microbiota in Assisted Reproductive Technology techniques (ART) and it examines the factors that influence the vaginal microbiota, the consequences of dysbiosis, and potential interventions to restore a healthy female genital tract.
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Affiliation(s)
- Giovanna Cocomazzi
- Division of Gastroenterology, Fondazione IRCCS-Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | | | - Lino Del Pup
- Gynecological Endocrinology and Fertility, University Sanitary Agency Friuli Central (ASUFC), Via Pozzuolo, 330, 33100 Udine, Italy
| | - Simone Palini
- Ospedale "Cervesi" di Cattolica-AUSL Romagna Via Ludwig Van Beethoven, 1, 47841 Cattolica, Italy
| | - Matteo Buccheri
- Instituto Bernabeu Via Castellana, 88, 30030 Martellago, Italy
| | | | - Natale Sciannamè
- Gynecology and Obstetrics, IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy
| | - Raffaele Faioli
- Gynecology and Obstetrics, IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy
| | - Annamaria Maglione
- Gynecology and Obstetrics, IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy
| | - Giorgio Maria Baldini
- IVF Center, Momò Fertilife, 76011 Bisceglie Via Cala dell'Arciprete, 76011 Bisceglie, Italy
| | - Domenico Baldini
- IVF Center, Momò Fertilife, 76011 Bisceglie Via Cala dell'Arciprete, 76011 Bisceglie, Italy
| | - Valerio Pazienza
- Division of Gastroenterology, Fondazione IRCCS-Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
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17
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Kyser AJ, Masigol M, Mahmoud MY, Ryan M, Lewis WG, Lewis AL, Frieboes HB, Steinbach-Rankins JM. Fabrication and characterization of bioprints with Lactobacillus crispatus for vaginal application. J Control Release 2023; 357:545-560. [PMID: 37076014 PMCID: PMC10696519 DOI: 10.1016/j.jconrel.2023.04.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
Bacterial vaginosis (BV) is characterized by low levels of lactobacilli and overgrowth of potential pathogens in the female genital tract. Current antibiotic treatments often fail to treat BV in a sustained manner, and > 50% of women experience recurrence within 6 months post-treatment. Recently, lactobacilli have shown promise for acting as probiotics by offering health benefits in BV. However, as with other active agents, probiotics often require intensive administration schedules incurring difficult user adherence. Three-dimensional (3D)-bioprinting enables fabrication of well-defined architectures with tunable release of active agents, including live mammalian cells, offering the potential for long-acting probiotic delivery. One promising bioink, gelatin alginate has been previously shown to provide structural stability, host compatibility, viable probiotic incorporation, and cellular nutrient diffusion. This study formulates and characterizes 3D-bioprinted Lactobacillus crispatus-containing gelatin alginate scaffolds for gynecologic applications. Different weight to volume (w/v) ratios of gelatin alginate were bioprinted to determine formulations with highest printing resolution, and different crosslinking reagents were evaluated for effect on scaffold integrity via mass loss and swelling measurements. Post-print viability, sustained-release, and vaginal keratinocyte cytotoxicity assays were conducted. A 10:2 (w/v) gelatin alginate formulation was selected based on line continuity and resolution, while degradation and swelling experiments demonstrated greatest structural stability with dual genipin and calcium crosslinking, showing minimal mass loss and swelling over 28 days. 3D-bioprinted L. crispatus-containing scaffolds demonstrated sustained release and proliferation of live bacteria over 28 days, without impacting viability of vaginal epithelial cells. This study provides in vitro evidence for 3D-bioprinted scaffolds as a novel strategy to sustain probiotic delivery with the ultimate goal of restoring vaginal lactobacilli following microbiological disturbances.
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Affiliation(s)
- Anthony J Kyser
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Mohammadali Masigol
- Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA.
| | - Mohamed Y Mahmoud
- Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Mark Ryan
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Warren G Lewis
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA; Glycobiology Research and Training Center, University of California San Diego, La Jolla, CA, USA.
| | - Amanda L Lewis
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA; Glycobiology Research and Training Center, University of California San Diego, La Jolla, CA, USA.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; UofL Health - Brown Cancer Center, University of Louisville, KY 40202, USA.
| | - Jill M Steinbach-Rankins
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, KY, USA.
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18
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Han M, Wang N, Han W, Ban M, Sun T, Xu J. Vaginal and tumor microbiomes in gynecological cancer (Review). Oncol Lett 2023; 25:153. [PMID: 36936020 PMCID: PMC10018329 DOI: 10.3892/ol.2023.13739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Cervical, ovarian and endometrial cancer are the three most common types of gynecologic cancer. As a hub, the vagina connects the site of gynecological cancer with the external environment. Lactobacilli participate in the formation of a healthy vaginal microenvironment as the first line of defense against pathogen invasion; a dysbiotic vaginal microenvironment loses its original protective function and is associated with the onset, metastasis, poor efficacy and poor prognosis of gynecological cancer. The early diagnosis of cancer is the key to improve the survival time of patients with cancer. The screening of Porphyromonas, Sneathia and Atopobium vaginae, and other microbial markers, can assist the diagnosis of gynecological cancer, and screen out the high-risk population as early as possible. With the in-depth study of the microbes in tumor tissues, reasearchers have analyzed the immunological associations of microorganisms in tumor tissues. Due to the structural-functional interconnection between the organ of gynecological tumorigenesis and the vagina, the present study aims to review the relationship between vaginal and tumor microorganisms and gynecological cancer in terms of occurrence, screening, treatment and prognosis.
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Affiliation(s)
- Mengzhen Han
- Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, Liaoning 110000, P.R. China
| | - Na Wang
- Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, Liaoning 110000, P.R. China
| | - Wenjie Han
- Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, Liaoning 110000, P.R. China
| | - Meng Ban
- Liaoning Microhealth Biotechnology Co., Ltd., Shenyang, Liaoning 110000, P.R. China
| | - Tao Sun
- Department of Breast Medicine, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital, Shenyang, Liaoning 110000, P.R. China
| | - Junnan Xu
- Department of Breast Medicine, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital, Shenyang, Liaoning 110000, P.R. China
- Correspondence to: Professor Junnan Xu, Department of Breast Medicine, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital, 44 Xiaoheyan Road, Dadong, Shenyang, Liaoning 110000, P.R. China, E-mail:
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19
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Bassi A, Sharma G, Deol PK, Madempudi RS, Kaur IP. Preclinical Potential of Probiotic-Loaded Novel Gelatin-Oil Vaginal Suppositories: Efficacy, Stability, and Safety Studies. Gels 2023; 9:gels9030244. [PMID: 36975693 PMCID: PMC10048646 DOI: 10.3390/gels9030244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
The current study describes a suppository base composed of aqueous gelatin solution emulsifying oil globules with probiotic cells dispersed within. The favorable mechanical properties of gelatin to provide a solid gelled structure, and the tendency of its proteins to unravel into long strings that interlace when cooled, lead to a three-dimensional structure that can trap a lot of liquid, which was exploited herein to result in a promising suppository form. The latter maintained incorporated probiotic spores of Bacillus coagulans Unique IS-2 in a viable but non-germinating form, preventing spoilage during storage and imparting protection against the growth of any other contaminating organism (self-preserved formulation). The gelatin-oil-probiotic suppository showed uniformity in weight and probiotic content (23 ± 2.481 × 108 cfu) with favorable swelling (double) followed by erosion and complete dissolution within 6 h of administration, leading to the release of probiotic (within 45 min) from the matrix into simulated vaginal fluid. Microscopic images indicated presence of probiotics and oil globules enmeshed in the gelatin network. High viability (24.3 ± 0.46 × 108), germination upon application and a self-preserving nature were attributed to the optimum water activity (0.593 aw) of the developed composition. The retention of suppositories, germination of probiotics and their in vivo efficacy and safety in vulvovaginal candidiasis murine model are also reported.
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Affiliation(s)
- Anchal Bassi
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India
| | - Garima Sharma
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India
| | - Parneet Kaur Deol
- G.H.G. Khalsa College of Pharmacy, Gurusar Sadhar, Ludhiana 141104, India
| | | | - Indu Pal Kaur
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India
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20
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Evaluation of the efficacy of Lactobacillus-containing feminine hygiene products on vaginal microbiome and genitourinary symptoms in pre- and postmenopausal women: A pilot randomized controlled trial. PLoS One 2022; 17:e0270242. [PMID: 36584204 PMCID: PMC9803311 DOI: 10.1371/journal.pone.0270242] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/23/2022] [Indexed: 01/01/2023] Open
Abstract
As estrogen level decreases with aging, the vaginal mucosa gets thinner, and collagen amount decreases. In addition, the population of Lactobacillus in the vagina declines, increasing the risk of atrophic vaginitis, bacterial vaginosis, and genitourinary symptoms in the postmenopausal women. In this study, we evaluated the effects of Lactobacillus-containing feminine hygiene products on vaginal microbiome and genitourinary symptoms in pre- and postmenopausal women. This was a pilot randomized controlled trial in 35 premenopausal and 35 postmenopausal healthy women. For 4 weeks, treatment 1 group (14 premenopausal and 16 postmenopausal women) used the Lactobacillus-containing feminine soap and cream, and treatment 2 group (15 premenopausal and 14 postmenopausal women) used Lactobacillus-containing feminine gel in addition to soap and cream. The remaining 6 premenopausal and 5 postmenopausal women served as controls without using any products. We then compared the changes in the vaginal microbiota, genitourinary symptoms, and other related biomarkers after completion of treatment. Vaginal pH and pathogenic flora were reduced in both treatment groups compared to control group, which was more significant in the treatment 2 group of postmenopausal women. Genitourinary symptoms significantly improved in 60% of premenopausal women in treatment 1 group and 81.3% of postmenopausal women in treatment 2 group, compared to control group (0%, p = 0.043 and p<0.01 respectively). Overactive bladder symptom scores were significantly improved after using the products in eleven out of twelve postmenopausal women suspected of having overactive bladder. The use of Lactobacillus-containing feminine products was associated with improved vaginal ecosystem and urogenital health compared to control group, especially in those women using feminine gel.
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21
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Mei Z, Li D. The role of probiotics in vaginal health. Front Cell Infect Microbiol 2022; 12:963868. [PMID: 35967876 PMCID: PMC9366906 DOI: 10.3389/fcimb.2022.963868] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/05/2022] [Indexed: 11/25/2022] Open
Abstract
Probiotics have been widely used in the treatment of intestinal diseases, but the effect of probiotics on female reproductive tract health is still controversial. Lactobacillus is the most abundant microorganism in the vagina, which is related to the vaginal mucosal barrier. Lactobacillus adheres to the vaginal epithelium and can competitively antagonize the colonization of pathogens. The factors produced by Lactobacillus, such as bacteriocin and hydrogen peroxide (H2O2), can inhibit the growth of pathogenic microorganisms and maintain the low pH environment of the vagina. Probiotics play an important role in maintaining the stability of vaginal microenvironment, improving immune defense and blocking the progression of cervical cancer. We review the research progress of probiotics represented by Lactobacillus in gynecological diseases such as human papilloma virus (HPV) infection, bacterial vaginosis (BV) and Genitourinary Syndrome of Menopause (GSM), so as to provide basis for further exerting the role of probiotics in women’s health.
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Affiliation(s)
- Zhaojun Mei
- Luzhou Maternal and Child Health Hospital, Luzhou Second People’s Hospital, Luzhou, China
| | - Dandan Li
- University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Dandan Li,
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22
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Fang B, Li Q, Wan Z, OuYang Z, Zhang Q. Exploring the Association Between Cervical Microbiota and HR-HPV Infection Based on 16S rRNA Gene and Metagenomic Sequencing. Front Cell Infect Microbiol 2022; 12:922554. [PMID: 35800388 PMCID: PMC9253761 DOI: 10.3389/fcimb.2022.922554] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
The relationship between the cervico-vaginal microbiome and high-risk human papillomavirus (HR-HPV) is well observed. However, there is a lack of adequate research regarding the cervical microbiota in HR-HPV infection. Most published research results have used 16S rRNA gene sequencing technology; this technology only focuses on marker sequences, resulting in incomplete gene information acquisition. Metagenomic sequencing technology can effectively compensate for the deficiency of 16S rRNA gene sequencing, thus improving the analysis of microbiota function. Cervical swab samples from 20 females with HR-HPV infection and 20 uninfected (Control) women were analyzed through 16S rRNA gene and metagenomic sequencing. Our results indicated that the composition and function of the cervical microbiota of HR-HPV infection differed notably from that of control women. Compared with control women, Firmicutes was decreased during HR-HPV infection, whereas Actinobacteria was increased. At the genus level, Lactobacillus was enriched in control women, while levels of Gardnerella and Bifidobacterium were lower. At the species level, Lactobacillus crispatus, L. jensenii, and L. helveticus were enriched in control women; these were the top three species with biomarker significance between the two groups. Eight pathways and four KEGG orthologies of the cervical microbiota of statistical differences were identified between the HR-HPV infection and control women. Collectively, our study described the cervical microbiota and its potential function during HR-HPV infection. Biomarkers of cervical microbiota and the changed bacterial metabolic pathways and metabolites can help clarify the pathogenic mechanism of HR-HPV infection, making them promising targets for clinical treatment and intervention for HR-HPV infection and cervical carcinoma.
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Affiliation(s)
- Bingyan Fang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qun Li
- Graduate Collaborative Training Base of Guangdong Second Provincial General Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Zixian Wan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhenbo OuYang
- Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qiushi Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
- *Correspondence: Qiushi Zhang,
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23
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Wu S, Hugerth LW, Schuppe-Koistinen I, Du J. The right bug in the right place: opportunities for bacterial vaginosis treatment. NPJ Biofilms Microbiomes 2022; 8:34. [PMID: 35501321 PMCID: PMC9061781 DOI: 10.1038/s41522-022-00295-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/31/2022] [Indexed: 11/23/2022] Open
Abstract
Bacterial vaginosis (BV) is a condition in which the vaginal microbiome presents an overgrowth of obligate and facultative anaerobes, which disturbs the vaginal microbiome balance. BV is a common and recurring vaginal infection among women of reproductive age and is associated with adverse health outcomes and a decreased quality of life. The current recommended first-line treatment for BV is antibiotics, despite the high recurrence rate. Live biopharmaceutical products/probiotics and vaginal microbiome transplantation (VMT) have also been tested in clinical trials for BV. In this review, we discuss the advantages and challenges of current BV treatments and interventions. Furthermore, we provide our understanding of why current clinical trials with probiotics have had mixed results, which is mainly due to not administering the correct bacteria to the correct body site. Here, we propose a great opportunity for large clinical trials with probiotic strains isolated from the vaginal tract (e.g., Lactobacillus crispatus) and administered directly into the vagina after pretreatment.
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Affiliation(s)
- Shengru Wu
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Luisa Warchavchik Hugerth
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Science for Life Laboratory, Stockholm, Sweden
| | - Ina Schuppe-Koistinen
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Science for Life Laboratory, Stockholm, Sweden
| | - Juan Du
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
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24
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Jeong JJ, Park HJ, Cha MG, Park E, Won SM, Ganesan R, Gupta H, Gebru YA, Sharma SP, Lee SB, Kwon GH, Jeong MK, Min BH, Hyun JY, Eom JA, Yoon SJ, Choi MR, Kim DJ, Suk KT. The Lactobacillus as a Probiotic: Focusing on Liver Diseases. Microorganisms 2022; 10:microorganisms10020288. [PMID: 35208742 PMCID: PMC8879051 DOI: 10.3390/microorganisms10020288] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 12/12/2022] Open
Abstract
Over the past decade, scientific evidence for the properties, functions, and beneficial effects of probiotics for humans has continued to accumulate. Interest in the use of probiotics for humans has increased tremendously. Among various microorganisms, probiotics using bacteria have been widely studied and commercialized, and, among them, Lactobacillus is representative. This genus contains about 300 species of bacteria (recently differentiated into 23 genera) and countless strains have been reported. They improved a wide range of diseases including liver disease, gastrointestinal diseases, respiratory diseases, and autoimmune diseases. Here, we intend to discuss in depth the genus Lactobacillus as a representative probiotic for chronic liver diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ki Tae Suk
- Correspondence: ; Tel.: +82-10-5365-5700; Fax: +82-033-248-3481
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25
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Toson B, Simon C, Moreno I. The Endometrial Microbiome and Its Impact on Human Conception. Int J Mol Sci 2022; 23:ijms23010485. [PMID: 35008911 PMCID: PMC8745284 DOI: 10.3390/ijms23010485] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 12/18/2022] Open
Abstract
Changes in the female genital tract microbiome are consistently correlated to gynecological and obstetrical pathologies, and tract dysbiosis can impact reproductive outcomes during fertility treatment. Nonetheless, a consensus regarding the physiological microbiome core inside the uterine cavity has not been reached due to a myriad of study limitations, such as sample size and experimental design variations, and the influence of endometrial bacterial communities on human reproduction remains debated. Understanding the healthy endometrial microbiota and how changes in its composition affect fertility would potentially allow personalized treatment through microbiome management during assisted reproductive therapies, ultimately leading to improvement of clinical outcomes. Here, we review current knowledge regarding the uterine microbiota and how it relates to human conception.
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Affiliation(s)
- Bruno Toson
- INCLIVA Biomedical Research Institute, Av. Menendez y Pelayo 4, 46010 Valencia, Spain;
| | - Carlos Simon
- Igenomix Foundation/INCLIVA Biomedical Research Institute, Narcis Monturiol Estarriol 11B, 46980 Paterna, Spain
- Department of Obstetrics and Gynecology, University of Valencia, Av. Blásco Ibáñez 15, 46010 Valencia, Spain
- Beth Israel Deaconess Medical Center, Harvard University, 330 Brookline Ave, Boston, MA 02215, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
- Correspondence: (C.S.); (I.M.)
| | - Inmaculada Moreno
- Igenomix Foundation/INCLIVA Biomedical Research Institute, Narcis Monturiol Estarriol 11B, 46980 Paterna, Spain
- Correspondence: (C.S.); (I.M.)
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Abstract
Viral infections represent a major health problem worldwide. Due to the wide variety of etiological agents and their increasing resistance to anti-virals and antibiotics treatments, new strategies for effective therapies need to be developed. Scientific evidence suggests that probiotics may have prophylactic and therapeutic effects in viral diseases. Indeed, these microorganisms interact harmoniously with the intestinal microbiota and protect the integrity of the intestinal barrier as well as modulate the host immune system. Currently, clinical trials with probiotics have been documented in respiratory tract infections, infections caused by human immunodeficiency viruses, herpes, human papillomavirus and hepatic encephalopathy. However, the benefits documented so far are difficult to extrapolate, due to the strain-dependent effect. In addition, the dose of the microorganism used as well as host characteristics are other parameters that should be consider when advocating the use of probiotics to treat viral infections. This review addresses the scientific evidence of the efficacy of probiotics in clinical strains perspective in viral infectious diseases in the last 10 years.
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27
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Han Y, Ren QL. Does probiotics work for bacterial vaginosis and vulvovaginal candidiasis. Curr Opin Pharmacol 2021; 61:83-90. [PMID: 34649216 DOI: 10.1016/j.coph.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 02/09/2023]
Abstract
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.
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Affiliation(s)
- Yue Han
- The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, Jiangsu, China
| | - Qing-Ling Ren
- The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, Jiangsu, China.
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28
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Zhang Y, Lyu J, Ge L, Huang L, Peng Z, Liang Y, Zhang X, Fan S. Probiotic Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 as an Adjunctive Treatment for Bacterial Vaginosis Do Not Increase the Cure Rate in a Chinese Cohort: A Prospective, Parallel-Group, Randomized, Controlled Study. Front Cell Infect Microbiol 2021; 11:669901. [PMID: 34295831 PMCID: PMC8291149 DOI: 10.3389/fcimb.2021.669901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/01/2021] [Indexed: 12/30/2022] Open
Abstract
The purpose of this study was to evaluate the effectiveness of metronidazole and oral probiotics adjunct to metronidazole in the treatment of bacterial vaginosis (BV). One hundred and twenty-six Chinese women with BV were enrolled in this parallel, controlled trial, and were randomly assigned into two study arms: the metronidazole group, which was prescribed metronidazole vaginal suppositories for 7 days, and the adjunctive probiotic group, which received Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 orally for 30 days as an adjunct to metronidazole. Clinical symptoms and Nugent scores at the initial visit, 30 days and 90 days were compared. There was no significant difference of the 30-day total cure rate between the adjunctive probiotic group (57.69%) and the metronidazole group (59.57%), with an odds ratio (OR) of 0.97 (95% confidence interval (CI), 0.70 to 1.35, p-value = 0.04), or of the 90-day total cure rate (36.54% vs. 48.94%, OR, 0.75; 95% CI, 0.47 to 1.19; p-value = 0.213). Also, no significant difference of the vaginal and faecal microbial diversity and structure between the two groups at 0, 30 or 90 days were shown based on 16S rRNA sequences. The probiotic species were rarely detected in either the vaginal microbiota or the faecal microbiota after administration which may revealed the cause of noneffective of oral probiotics. No serious adverse effects were reported in the trial. The study indicated that oral probiotic adjunctive treatment did not increase the cure rate of Chinese BV patients compared to metronidazole.
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Affiliation(s)
- Yongke Zhang
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynaecological Disease, Shenzhen, China
| | - Jinli Lyu
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Lan Ge
- BGI-Shenzhen, Shenzhen, China
| | - Liting Huang
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynaecological Disease, Shenzhen, China
| | - Zhuobing Peng
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Yiheng Liang
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynaecological Disease, Shenzhen, China
| | - Xiaowei Zhang
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynaecological Disease, Shenzhen, China
| | - Shangrong Fan
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynaecological Disease, Shenzhen, China
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29
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Joseph RJ, Ser HL, Kuai YH, Tan LTH, Arasoo VJT, Letchumanan V, Wang L, Pusparajah P, Goh BH, Ab Mutalib NS, Chan KG, Lee LH. Finding a Balance in the Vaginal Microbiome: How Do We Treat and Prevent the Occurrence of Bacterial Vaginosis? Antibiotics (Basel) 2021; 10:719. [PMID: 34203908 PMCID: PMC8232816 DOI: 10.3390/antibiotics10060719] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/27/2021] [Accepted: 06/10/2021] [Indexed: 12/30/2022] Open
Abstract
Bacterial vaginosis (BV) has been reported in one-third of women worldwide at different life stages, due to the complex balance in the ecology of the vaginal microbiota. It is a common cause of abnormal vaginal discharge and is associated with other health issues. Since the first description of anaerobic microbes associated with BV like Gardnerella vaginalis in the 1950s, researchers have stepped up the game by incorporating advanced molecular tools to monitor and evaluate the extent of dysbiosis within the vaginal microbiome, particularly on how specific microbial population changes compared to a healthy state. Moreover, treatment failure and BV recurrence rate remain high despite the standard antibiotic treatment. Consequently, researchers have been probing into alternative or adjunct treatments, including probiotics or even vaginal microbiota transplants, to ensure successful treatment outcomes and reduce the colonization by pathogenic microbes of the female reproductive tract. The current review summarizes the latest findings in probiotics use for BV and explores the potential of vaginal microbiota transplants in restoring vaginal health.
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Affiliation(s)
- Rebecca Jane Joseph
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Hooi-Leng Ser
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Yi-He Kuai
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Loh Teng-Hern Tan
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru 80100, Malaysia;
| | | | - Vengadesh Letchumanan
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Lijing Wang
- Vascular Biology Research Institute, Guangdong Pharmaceutical University, Guangzhou 510006, China;
| | - Priyia Pusparajah
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Bey-Hing Goh
- Biofunctional Molecule Exploratory Research Group (BMEX), School of Pharmacy, Monash University Malaysia, Bandar Sunway 47500, Malaysia;
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Nurul-Syakima Ab Mutalib
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
- UKM Medical Molecular Biology Institute (UMBI), UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Kok-Gan Chan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
- International Genome Centre, Jiangsu University, Zhenjiang 212013, China
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
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30
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Moumne O, Hampe ME, Montoya-Williams D, Carson TL, Neu J, Francois M, Rhoton-Vlasak A, Lemas DJ. Implications of the vaginal microbiome and potential restorative strategies on maternal health: a narrative review. J Perinat Med 2021; 49:402-411. [PMID: 33554571 DOI: 10.1515/jpm-2020-0367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/10/2020] [Indexed: 11/15/2022]
Abstract
The vaginal microbiome undergoes dramatic shifts before and throughout pregnancy. Although the genetic and environmental factors that regulate the vaginal microbiome have yet to be fully elucidated, high-throughput sequencing has provided an unprecedented opportunity to interrogate the vaginal microbiome as a potential source of next-generation therapeutics. Accumulating data demonstrates that vaginal health during pregnancy includes commensal bacteria such as Lactobacillus that serve to reduce pH and prevent pathogenic invasion. Vaginal microbes have been studied as contributors to several conditions occurring before and during pregnancy, and an emerging topic in women's health is finding ways to alter and restore the vaginal microbiome. Among these restorations, perhaps the most significant effect could be preterm labor (PTL) prevention. Since bacterial vaginosis (BV) is known to increase risk of PTL, and vaginal and oral probiotics are effective as supplemental treatments for BV prevention, a potential therapeutic benefit exists for pregnant women at risk of PTL. A new method of restoration, vaginal microbiome transplants (VMTs) involves transfer of one women's cervicovaginal secretions to another. New studies investigating recurrent BV will determine if VMTs can safely establish a healthy Lactobacillus-dominant vaginal microbiome. In most cases, caution must be taken in attributing a disease state and vaginal dysbiosis with a causal relationship, since the underlying reason for dysbiosis is usually unknown. This review focuses on the impact of vaginal microflora on maternal outcomes before and during pregnancy, including PTL, gestational diabetes, preeclampsia, and infertility. It then reviews the clinical evidence focused on vaginal restoration strategies, including VMTs.
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Affiliation(s)
- Olivia Moumne
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mary E Hampe
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Tiffany L Carson
- Division of Preventive Medicine, Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Josef Neu
- Division of Neonatology, Department of Pediatrics, University of Florida, Gainesville, FL, USA
| | - Magda Francois
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Alice Rhoton-Vlasak
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Dominick J Lemas
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
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31
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Chandrashekhar P, Minooei F, Arreguin W, Masigol M, Steinbach-Rankins JM. Perspectives on Existing and Novel Alternative Intravaginal Probiotic Delivery Methods in the Context of Bacterial Vaginosis Infection. AAPS J 2021; 23:66. [PMID: 33973067 PMCID: PMC8356663 DOI: 10.1208/s12248-021-00602-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/27/2021] [Indexed: 12/17/2022] Open
Abstract
Bacterial vaginosis (BV) is one of the most common vaginal infections that affects hundreds of millions of women of reproductive age, worldwide. Traditional treatment strategies, such as oral and topical antibiotics, have shown efficacy against BV, but frequent recurrence of infection and the development of antibiotic-resistant bacteria remain as significant challenges. Alternatively, recent progress in understanding immune, microbiological, and metabolic interactions in the vaginal microbiota has prompted the consideration of administering probiotic organisms to restore and maintain vaginal health within the context of BV prevention and treatment. Given this, the objective of this review is to discuss existing and potential alternative approaches to deliver, and to potentially sustain the delivery of probiotics, to prevent and/or treat BV infections. First, a brief overview is provided regarding the probiotic species and combinatorial probiotic strategies that have shown promise in the treatment of BV and in restoring female reproductive health. Additionally, the advantages and challenges associated with current oral and intravaginal probiotic delivery platforms are discussed. Lastly, we present emerging and promising alternative dosage forms, such as electrospun fibers and 3D bioprinted scaffolds, that may be adapted as new strategies to intravaginally deliver probiotic organisms. Graphical abstract.
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Affiliation(s)
| | - Farnaz Minooei
- Department of Chemical Engineering, University of Louisville Speed School of Engineering, Louisville, Kentucky, USA
- Center for Predictive Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Wenndy Arreguin
- Department of Bioengineering, University of Louisville Speed School of Engineering, 505 S. Hancock St., Room 623, Louisville, Kentucky, 40202, USA
| | - Mohammadali Masigol
- Center for Predictive Medicine, University of Louisville, Louisville, Kentucky, USA
- Department of Bioengineering, University of Louisville Speed School of Engineering, 505 S. Hancock St., Room 623, Louisville, Kentucky, 40202, USA
| | - Jill M Steinbach-Rankins
- Center for Predictive Medicine, University of Louisville, Louisville, Kentucky, USA.
- Department of Bioengineering, University of Louisville Speed School of Engineering, 505 S. Hancock St., Room 623, Louisville, Kentucky, 40202, USA.
- Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
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32
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Chen X, Lu Y, Chen T, Li R. The Female Vaginal Microbiome in Health and Bacterial Vaginosis. Front Cell Infect Microbiol 2021; 11:631972. [PMID: 33898328 PMCID: PMC8058480 DOI: 10.3389/fcimb.2021.631972] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/19/2021] [Indexed: 12/11/2022] Open
Abstract
The vaginal microbiome is an intricate and dynamic microecosystem that constantly undergoes fluctuations during the female menstrual cycle and the woman's entire life. A healthy vaginal microbiome is dominated by Lactobacillus which produce various antimicrobial compounds. Bacterial vaginosis (BV) is characterized by the loss or sharp decline in the total number of Lactobacillus and a corresponding marked increase in the concentration of anaerobic microbes. BV is a highly prevalent disorder of the vaginal microbiota among women of reproductive age globally. BV is confirmed to be associated with adverse gynecologic and obstetric outcomes, such as sexually transmitted infections, pelvic inflammatory disease, and preterm birth. Gardnerella vaginalis is the most common microorganism identified from BV. It is the predominant microbe in polymicrobial biofilms that could shelter G. vaginalis and other BV-associated microbes from adverse host environments. Many efforts have been made to increase our understanding of the vaginal microbiome in health and BV. Thus, improved novel and accurate diagnosis and therapeutic strategies for BV have been developed. This review covers the features of vaginal microbiome, BV, BV-associated diseases, and various strategies of diagnosis and treatment of BV, with an emphasis on recent research progresses.
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Affiliation(s)
| | | | | | - Rongguo Li
- Department of Clinical Laboratory, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
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Kaur AP, Bhardwaj S, Dhanjal DS, Nepovimova E, Cruz-Martins N, Kuča K, Chopra C, Singh R, Kumar H, Șen F, Kumar V, Verma R, Kumar D. Plant Prebiotics and Their Role in the Amelioration of Diseases. Biomolecules 2021; 11:440. [PMID: 33809763 PMCID: PMC8002343 DOI: 10.3390/biom11030440] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/12/2022] Open
Abstract
Prebiotics are either natural or synthetic non-digestible (non-)carbohydrate substances that boost the proliferation of gut microbes. Undigested fructooligosaccharides in the large intestine are utilised by the beneficial microorganisms for the synthesis of short-chain fatty acids for their own growth. Although various food products are now recognized as having prebiotic properties, several others, such as almonds, artichoke, barley, chia seeds, chicory, dandelion greens, flaxseeds, garlic, and oats, are being explored and used as functional foods. Considering the benefits of these prebiotics in mineral absorption, metabolite production, gut microbiota modulation, and in various diseases such as diabetes, allergy, metabolic disorders, and necrotising enterocolitis, increasing attention has been focused on their applications in both food and pharmaceutical industries, although some of these food products are actually used as food supplements. This review aims to highlight the potential and need of these prebiotics in the diet and also discusses data related to the distinct types, sources, modes of action, and health benefits.
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Affiliation(s)
- Amrit Pal Kaur
- School of Bioengineering and Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (A.P.K.); (H.K.)
| | - Sonali Bhardwaj
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India; (S.B.); (D.S.D.); (C.C.); (R.S.)
| | - Daljeet Singh Dhanjal
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India; (S.B.); (D.S.D.); (C.C.); (R.S.)
| | - Eugenie Nepovimova
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, 50003 Hradec Kralove, Czech Republic;
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
| | - Kamil Kuča
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, 50003 Hradec Kralove, Czech Republic;
| | - Chirag Chopra
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India; (S.B.); (D.S.D.); (C.C.); (R.S.)
| | - Reena Singh
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India; (S.B.); (D.S.D.); (C.C.); (R.S.)
| | - Harsh Kumar
- School of Bioengineering and Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (A.P.K.); (H.K.)
| | - Fatih Șen
- Sen Research Group, Biochemistry Department, Faculty of Arts and Science, EvliyaÇelebi Campus, Dumlupınar University, Kütahya 43100, Turkey;
| | - Vinod Kumar
- School of Water, Energy and Environment, Cranfield University, Cranfield MK430AL, UK;
| | - Rachna Verma
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India;
| | - Dinesh Kumar
- School of Bioengineering and Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (A.P.K.); (H.K.)
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Baldacci F, Baldacci M, Bertini M. Lactobacillus rhamnosus BMX 54 + Lactose, A Symbiotic Long-Lasting Vaginal Approach to Improve Women's Health. Int J Womens Health 2020; 12:1099-1104. [PMID: 33244276 PMCID: PMC7684798 DOI: 10.2147/ijwh.s259311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/12/2020] [Indexed: 12/03/2022] Open
Abstract
The proposal to restore vaginal microbiota using biotherapeutic agents ended with controversial results. Vaginal microbiota modifications from eubiosis to dysbiosis (desquamative inflammatory vaginitis, “aerobic vaginitis”) and pathobiosis have recently been demonstrated to have a pivotal role in women’s clinical health. Bacterial vaginosis (BV) and its related women’s pathology seem to be “the most common vaginal infections” in women; the Center for Disease Control (CDC) recommended treatment for this pathology: metronidazole, clyndamicin or other well known treatment such as dequalinium chloride, unfortunately, has been demonstrated to fail in control of this infection and especially in its recurrence rates. A long-lasting vaginal approach with a symbiotic drug (Lactobacillus rhamnosus BMX 54 + lactose) (NORMOGIN™) has demonstrated on a large sample of women enrolled in clinical trials (more than 3000 patients) not only to be able to significantly reduce the BV recurrences, after the CDC standard of care administration, but also to control the vaginal pathobiosis pathway, restoring the physiological eubiosis from dysbiosis. These results are really very encouraging and clearly demonstrate that a symbiotic long-lasting vaginal application of a selected Lactobacillus population plus a prebiotic could be helpful if added to the recommended standard of care.
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Affiliation(s)
| | - Mara Baldacci
- R&D Department, Laboratori Baldacci SpA, Pisa 56124, Italy
| | - Marco Bertini
- R&D Department, Laboratori Baldacci SpA, Pisa 56124, Italy
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Chee WJY, Chew SY, Than LTL. Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health. Microb Cell Fact 2020; 19:203. [PMID: 33160356 PMCID: PMC7648308 DOI: 10.1186/s12934-020-01464-4] [Citation(s) in RCA: 223] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
Human vagina is colonised by a diverse array of microorganisms that make up the normal microbiota and mycobiota. Lactobacillus is the most frequently isolated microorganism from the healthy human vagina, this includes Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii. These vaginal lactobacilli have been touted to prevent invasion of pathogens by keeping their population in check. However, the disruption of vaginal ecosystem contributes to the overgrowth of pathogens which causes complicated vaginal infections such as bacterial vaginosis (BV), sexually transmitted infections (STIs), and vulvovaginal candidiasis (VVC). Predisposing factors such as menses, pregnancy, sexual practice, uncontrolled usage of antibiotics, and vaginal douching can alter the microbial community. Therefore, the composition of vaginal microbiota serves an important role in determining vagina health. Owing to their Generally Recognised as Safe (GRAS) status, lactobacilli have been widely utilised as one of the alternatives besides conventional antimicrobial treatment against vaginal pathogens for the prevention of chronic vaginitis and the restoration of vaginal ecosystem. In addition, the effectiveness of Lactobacillus as prophylaxis has also been well-founded in long-term administration. This review aimed to highlight the beneficial effects of lactobacilli derivatives (i.e. surface-active molecules) with anti-biofilm, antioxidant, pathogen-inhibition, and immunomodulation activities in developing remedies for vaginal infections. We also discuss the current challenges in the implementation of the use of lactobacilli derivatives in promotion of human health. In the current review, we intend to provide insights for the development of lactobacilli derivatives as a complementary or alternative medicine to conventional probiotic therapy in vaginal health.
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Affiliation(s)
- Wallace Jeng Yang Chee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Shu Yih Chew
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
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Younis N, Mahasneh A. Probiotics and the envisaged role in treating human infertility. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00039-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Considerable attention is being directed nowadays towards using probiotics as an alternative therapy in treating several human diseases including gastrointestinal tract diseases especially colorectal cancers, cardiovascular diseases, hyperlipidemia, and blood pressure cases. However, infertility as affected by the microbiome and the probable role of probiotics in alleviating infertility problems did not receive the deserved attention, especially in IVF patients with male or female factors.
Main body
In this review, we tried to draw the attention of researchers in the medical settings to the importance of the forthcoming role of probiotics use in elucidating the role of the microbiome in infertile patients. The hope is to attain the best performance of both male and female reproductive systems and to shed some light on infertility problems.
Conclusion
More in vivo experiments are still needed to address many aspects of probiotics like proper administration, exact functional strains, required dose, application method, duration of treatment, and combination with antibiotics before considering probiotics as an alternative treatment.
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Jeng HS, Yan TR, Chen JY. Treating vaginitis with probiotics in non-pregnant females: A systematic review and meta-analysis. Exp Ther Med 2020; 20:3749-3765. [PMID: 32855726 PMCID: PMC7444381 DOI: 10.3892/etm.2020.9090] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/24/2020] [Indexed: 01/01/2023] Open
Abstract
Vaginitis, also known as vulvovaginitis, is an inflammation of the vagina and vulva and a common disease in females. It is thought to be caused by vaginal dysbiosis and improved by probiotics. Bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) are the major types of vaginal infections. The present systematic review and meta-analysis aimed to clarify the efficacy of probiotics in the treatment of common vaginal infections in non-pregnant females. Literature on randomized controlled trials and two-armed prospective studies on any intervention with probiotics published until December 24th, 2018 was searched in the PubMed, Cochrane and EMBASE databases. The outcomes of interest were recurrence rate, cure rate, remission rate and normal vaginal flora restoration. Finally, a total of 30 studies on bacterial vaginosis (BV) and/or VVC were included and stratified into 3 study types based on treatment design as follows: Type I, antibiotic/probiotics vs. antibiotics/antifungals (22 studies); Type II, probiotics vs. placebo (5 studies); Type III, probiotics vs. antibiotics (3 studies). The type I studies comprised 1,788 non-pregnant females and had the highest inter-study comparability in post-treatment follow-up design and meta-analysis outcome data. Probiotics interventions were significantly associated with a lower recurrence rate of vaginitis [pooled odds ratio (OR)=0.27, 95% CI: 0.18-0.41, P<0.001] and higher cure/remission rate (pooled OR=2.28, 95% CI: 1.20-4.32, P=0.011). However, a significant increase in normal vaginal flora after probiotic treatment was observed only in BV (pooled OR=4.55, 95% CI: 1.44-14.35, P=0.01). In addition, supportive but heterogeneous results were obtained from the 6-month follow-up data of Type-I studies, different infection types and supplementary analysis of Type-II studies. In conclusion, probiotics have a significant short-term effect in the treatment of common vaginal infections in non-pregnant females. In order to evaluate the long-term effects of probiotics in common vaginal infections, it is worthwhile to perform higher-quality clinical trials in the future.
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Affiliation(s)
- Huey-Sheng Jeng
- Department of Chemical Engineering and Biotechnology, Institute of Chemical Engineering and Biotechnology, Tatung University, Taipei 10452, Taiwan, R.O.C.,Department of Urology, Zhong-Xing Branch, Taipei City Hospital, Taipei 10341, Taiwan
| | - Tsong-Rong Yan
- Department of Chemical Engineering and Biotechnology, Institute of Chemical Engineering and Biotechnology, Tatung University, Taipei 10452, Taiwan, R.O.C
| | - Jing-Yi Chen
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan, R.O.C
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Tomás M, Palmeira-de-Oliveira A, Simões S, Martinez-de-Oliveira J, Palmeira-de-Oliveira R. Bacterial vaginosis: Standard treatments and alternative strategies. Int J Pharm 2020; 587:119659. [PMID: 32687973 DOI: 10.1016/j.ijpharm.2020.119659] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/24/2020] [Accepted: 07/13/2020] [Indexed: 12/23/2022]
Abstract
Bacterial vaginosis (BV) affects many women and has a high influence on their self-esteem, being associated with huge discomfort and changes in the routines, especially the sexual life. International guidelines recommend the administration of metronidazole, clindamycin or tinidazole orally or intravaginally as the standard treatment. However, the treatment with these antibiotics is associated with high levels of failure and recurrence rates. These may be associated with antibiotic resistance, the inability to eradicate the polymicrobial biofilms, and failure to reestablish acidic pH and the lactobacillus-dominated commensal flora. Therefore, it is emergent to study alternative strategies to replace or to be combined with standard therapies in order to prevent and treat BV more efficiently. Alternative strategies may include antimicrobial substances (other antimicrobials, antiseptics and natural compounds) or substances that aim to reestablish the physiologic vaginal environment (probiotics, prebiotics and acidifying agents) while improving the local immunity response. Besides, the development of formulation strategies and new dosage forms and drug delivery systems can improve treatment efficacy and overcome some limitations associated with conventional products.
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Affiliation(s)
- Mariana Tomás
- CICS-UBI, Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Avenida, Infante D. Henrique, 6200-506 Covilhã, Portugal
| | - Ana Palmeira-de-Oliveira
- CICS-UBI, Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Avenida, Infante D. Henrique, 6200-506 Covilhã, Portugal; Labfit-HPRD Health Products Research and Development, Lda Edifício UBIMedical, Estrada Municipal 506, 6200-281 Covilhã, Portugal
| | - Sérgio Simões
- CNC-Center for Neurosciences and Cell Biology, University of Coimbra, 3004-531 Coimbra, Portugal
| | - José Martinez-de-Oliveira
- CICS-UBI, Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Avenida, Infante D. Henrique, 6200-506 Covilhã, Portugal
| | - Rita Palmeira-de-Oliveira
- CICS-UBI, Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Avenida, Infante D. Henrique, 6200-506 Covilhã, Portugal; CNC-Center for Neurosciences and Cell Biology, University of Coimbra, 3004-531 Coimbra, Portugal.
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Szajewska H, Hojsak I. Health benefits of Lactobacillus rhamnosus GG and Bifidobacterium animalis subspecies lactis BB-12 in children. Postgrad Med 2020; 132:441-451. [DOI: 10.1080/00325481.2020.1731214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Hania Szajewska
- Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Iva Hojsak
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, Zagreb, Croatia
- Department of Pediatrics, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Pediatrics, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
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Mechanistic insights into the action of probiotics against bacterial vaginosis and its mediated preterm birth: An overview. Microb Pathog 2020; 141:104029. [PMID: 32014462 DOI: 10.1016/j.micpath.2020.104029] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023]
Abstract
The human body is a reservoir of numerous micro-creatures; whose role is substantial and indispensable in the overall development of human beings. The advances in omic approaches have offered powerful means to decipher the core microbiome and metabolome diversities in a specific organ system. The establishment of lactobacilli in the female reproductive tract is thought to be a paramount prerequisite that maintains homeostatic conditions for a sustainable and healthy pregnancy. Nevertheless, a plethora of such Lactobacillus strains of vaginal source revealed probiotic phenotypes. The plummeting in the occurrence of lactobacilli in the vaginal ecosystem is associated with several adverse pregnancy outcomes (APOs). One such pathological condition is "Bacterial Vaginosis" (BV), a pathogen dominated gynecological threat. In this scenario, the ascending traffic of notorious Gram-negative/variable BV pathogens to the uterus is one of the proposed pathways that give rise to inflammation-related APOs like preterm birth. Since antibiotic resistance is aggravating among urogenital pathogens, the probiotics intervention remains one of the alternative biotherapeutic strategies to overcome BV and its associated APOs. Perhaps, the increased inclination towards the safer and natural biotherapeutic strategies rather than pharmaceutical drugs for maintaining gestational and reproductive health resulted in the use of probiotics in pregnancy diets. In this context, the current review is an attempt to highlight the microbiome and metabolites signatures of BV and non-BV vaginal ecosystem, inflammation or infection-related preterm birth, host-microbial interactions, role and effectiveness of probiotics to fight against aforesaid diseased conditions.
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Curty G, de Carvalho PS, Soares MA. The Role of the Cervicovaginal Microbiome on the Genesis and as a Biomarker of Premalignant Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer. Int J Mol Sci 2019; 21:ijms21010222. [PMID: 31905652 PMCID: PMC6981542 DOI: 10.3390/ijms21010222] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 12/24/2022] Open
Abstract
The microbiome is able to modulate immune responses, alter the physiology of the human organism, and increase the risk of viral infections and development of diseases such as cancer. In this review, we address changes in the cervical microbiota as potential biomarkers to identify the risk of cervical intraepithelial neoplasia (CIN) development and invasive cervical cancer in the context of human papillomavirus (HPV) infection. Current approaches for clinical diagnostics and the manipulation of microbiota with the use of probiotics and through microbiota transplantation are also discussed.
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Elsharkawy I, Noureldin E, Mohamed E, Mohamed A, Abdeldayem H, Mansour SAM. Continuous versus interrupted use of vaginal probiotics plus vaginal clindamycin cream for bacterial vaginosis: a randomized controlled study. J Matern Fetal Neonatal Med 2019; 34:58-65. [PMID: 30879366 DOI: 10.1080/14767058.2019.1588246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To compare between continuous and interrupted use of vaginal probiotic after vaginal clindamycin cream for treatment and prevention of recurrence of bacterial vaginosis.Methods: A double-blinded randomized controlled clinical trial, 273 women were randomly allocated to use clindamycin 2% vaginal cream 5 g at bedtime for 7 days followed after 1 week by continuous probiotics vaginal capsule once daily for 6 weeks (n = 129) or clindamycin 2% vaginal cream 5 g at bedtime for 7 days followed by one probiotic vaginal capsule twice a week for 6 weeks (n = 144). The initial evaluation was at 1 week after cessation of probiotics treatment to estimate the cure rates, the follow-up visits were at 1, 3, 6, and 9 months from the initial visit. The primary outcome of this study was cure rate; the secondary outcomes were the frequency of recurrence, the presence of vaginal discharge, pH > 4.5, positive whiff test and detection of clue cells.Results: At the initial visit there was no significant difference in cure rate between continuous probiotics group and interrupted probiotics group (87.4 versus 82.5%; p = .81). There was no significant difference between the two groups in the recurrence rate at one, three, six and 9 months follow up visits (p = .16, p = .42, p = .59, p = .66). There was no significant difference between both groups regarding vaginal discharge reduction, pH dropping, the presence of positive whiff test and detection of clue cells at one, three, six and 9 months follow up visits. Except at 9-month visits, the differences in vaginal discharge reduction and positive whiff test were statically significant.Conclusions: After initial treatment of bacterial vaginosis with vaginal clindamycin cream, the continuous use of vaginal probiotics is equally effective to short repetitive courses in terms of cure rates and prevention of relapse.
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Affiliation(s)
| | | | - Ekramy Mohamed
- Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Ali Mohamed
- Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
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Bacterial vaginosis: An insight into the prevalence, alternative treatments regimen and it's associated resistance patterns. Microb Pathog 2018; 127:21-30. [PMID: 30502515 DOI: 10.1016/j.micpath.2018.11.046] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 02/06/2023]
Abstract
Bacterial Vaginosis (BV) is a complex polymicrobial infection of vagina that shifts the paradigms of vaginal flora from lactobacilli to opportunistic pathogens. BV is catagorized by greyish white discharge, pH greater than 4.5. It results in the preterm labor, abortion, pelvic inflammatory disorders, post cesarean infections. BV is associated with Sexually Transmitted Diseases (STDs) or immune deficiency disorders like Human Immunodeficiency Virus, Human Papilloma Virus, Herpes Simplex Virus 1 and 2, and Neisseria gonorrhoeae. The prevalence rate is about 21.2 million (29.2%) worldwide. BV is more frequent in black females as compared to white females, independent of geographical distribution. Globally, BV is treated with the current recommended antibiotic therapy including Metronidazole and Clindamycin. The recurrence rates are 76% and occur within 06 months of treatment due to antibiotic resistance against pathogenic bacteria and their biofilms. The antibiotic resistance is a global health issue which directs the attentions towards other treatments. One of these is the treatment of sex partners, thus helping to stop the recurrence rates in females. However, this method does not show any positive results. Probiotic therapy is an incorporation of Lactobacilli orally or intravaginally for the recolonization of healthy microbes. This therapy has exhibited promising results but some studies revealed that Probiotic therapy does not control the recurrence rate. The other methods are in trials period and none of them are used clinically or commercially available for the treatment. The thermoplastic polyurethane (TPU) intravaginal rings contain lactic acid and metronidazole showed promising results in trials of BV treatment. The vaginal acidifiers are used as an alternative method to maintain the vaginal pH but the process of douching is a major limitation. The activated charcoal is used to treat BV patients in clinical trials showed decrease in the pH with only 3.1% loss of lactobacilli. Phage therapy is a reemerging field to overcome the bacterial resistance. They are host specific and easier to handle. They can be used naturally, synthetically; phage cocktails and phage-antibiotics combination can be used. Phages show auspicious results for the treatment of bacterial infections as compared to antibiotics as they also treat biofilms. This is one of the promising therapy in future to treat infections with no side effects. Phage therapy can be used in pharmaceuticals according to Food and Drug Administration (FDA) guidelines. Taken together, it is suggested that large funding is required by pharmaceutical sector or government for further investigation of bacteriophages to be used against BV pathogenesis.
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Khalesi S, Bellissimo N, Vandelanotte C, Williams S, Stanley D, Irwin C. A review of probiotic supplementation in healthy adults: helpful or hype? Eur J Clin Nutr 2018; 73:24-37. [PMID: 29581563 DOI: 10.1038/s41430-018-0135-9] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/16/2018] [Accepted: 02/09/2018] [Indexed: 12/21/2022]
Abstract
Probiotic supplements have a positive impact on several health outcomes. However, the majority of published studies have focused on populations with specific health pathologies. Therefore, this study reviewed the current literature on the health effects of probiotic consumption in "healthy adults." The findings from this review may help guide consumers, researchers, and manufacturers regarding probiotic supplementation. Relevant literature published between 1990 and August 2017 was reviewed. Studies were included if they were experimental trials, included healthy adults, used live bacteria, and had accessible full-text articles published in English. Included studies were classified according to common foci that emerged. Forty-five studies were included in this review. Five foci emerged: gut microbiota changes (n = 15); immune system response (n = 16); lipid profile and cardiovascular disease risk (n = 14); gastrointestinal discomfort (n = 11); and female reproductive health (n = 4). Results suggest that probiotic supplementation in healthy adults can lead to transient improvement in gut microbiota concentration of supplement-specific bacteria. Evidence also supports the role of probiotics in improving immune system responses, stool consistency, bowel movement, and vaginal lactobacilli concentration. There is insufficient evidence to support the role of probiotics to improve blood lipid profile. Probiotic consumption can improve in the immune, gastrointestinal, and female reproductive health systems in healthy adults. However, this review failed to support the ability of probiotics to cause persistent changes in gut microbiota, or improve lipid profile in healthy adults. The feasibility of probiotics consumption to provide benefits in healthy adults requires further investigation.
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Affiliation(s)
- Saman Khalesi
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.
| | - Nick Bellissimo
- School of Nutrition, Ryerson University, Toronto, ON, Canada
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Susan Williams
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Dragana Stanley
- School of Health Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Christopher Irwin
- Menzies Health Institute, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
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Palma E, Recine N, Domenici L, Giorgini M, Pierangeli A, Panici PB. Long-term Lactobacillus rhamnosus BMX 54 application to restore a balanced vaginal ecosystem: a promising solution against HPV-infection. BMC Infect Dis 2018; 18:13. [PMID: 29304768 PMCID: PMC5756375 DOI: 10.1186/s12879-017-2938-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/25/2017] [Indexed: 12/14/2022] Open
Abstract
Background Over recent years, a growing interest has developed in microbiota and in the concept of maintaining a special balance between Lactobacillus and other bacteria species in order to promote women’s well-being. The aim of our study was to confirm that vaginal Lactobacilli long-lasting implementation in women with HPV-infections and concomitant bacterial vaginosis or vaginitis might be able to help in solving the viral infection, by re-establishing the original eubiosis. Methods A total of 117 women affected by bacterial vaginosis or vaginitis with concomitant HPV-infections were enrolled at Department of Gynecological Obstetrics and Urological Sciences, La Sapienza University, Rome, Italy between February 2015 and March 2016. Women were randomized in two groups, standard treatment (metronidazole 500 mg twice a day for 7 days or fluconazole 150 mg orally once a day for 2 consecutive days) plus short-term (3 months) vaginal Lactobacillus implementation (group 1, short probiotics treatment protocol group, n = 60) versus the same standard treatment plus long-lasting (6 months) vaginal Lactobacillus rhamnosus BMX 54 administration (group 2, treatment group, n = 57). Results After a median follow up of 14 months (range 9–30 months) the chance to solve HPV-related cytological anomalies was twice higher in probiotic long-term users (group 2) versus short probiotics implementation group (group 1) (79.4% vs 37.5%, p = 0.041). Moreover, a total HPV-clearance was shown in 11.6% of short schedule probiotics implementation patients compared to a percentage of 31.2% in vaginal Lactobacilli long term users (p = 0.044), assessed as negative HPV-DNA test documented at the end of the study period. Conclusions The consistent percentage of clearance of PAP-smear abnormalities and HPV-clearance obtained in long-term treatment group has been interestingly high and encouraging. Obviously, larger and randomized studies are warranted to confirm these encouraging results, but we believe that eubiosis re-establishment is the key to tackle effectively even HPV-infection. Trial registration Retrospectively registered on PRS NCT03372395 (12/12/2017).
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Affiliation(s)
- Ettore Palma
- Department of Gynecological, Obstetric and Urologic Sciences, University "Sapienza" of Rome, Rome, Italy
| | - Nadia Recine
- Department of Gynecological, Obstetric and Urologic Sciences, University "Sapienza" of Rome, Rome, Italy
| | - Lavinia Domenici
- Department of Gynecological, Obstetric and Urologic Sciences, University "Sapienza" of Rome, Rome, Italy.
| | - Margherita Giorgini
- Department of Gynecological, Obstetric and Urologic Sciences, University "Sapienza" of Rome, Rome, Italy
| | | | - Pierluigi Benedetti Panici
- Department of Gynecological, Obstetric and Urologic Sciences, University "Sapienza" of Rome, Rome, Italy
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Filardo S, Di Pietro M, Porpora MG, Recine N, Farcomeni A, Latino MA, Sessa R. Diversity of Cervical Microbiota in Asymptomatic Chlamydia trachomatis Genital Infection: A Pilot Study. Front Cell Infect Microbiol 2017; 7:321. [PMID: 28770172 PMCID: PMC5509768 DOI: 10.3389/fcimb.2017.00321] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/28/2017] [Indexed: 12/21/2022] Open
Abstract
Chlamydia trachomatis genital infection continues to be an important public health problem worldwide due to its increasing incidence. C. trachomatis infection can lead to severe sequelae, such as pelvic inflammatory disease, obstructive infertility, and preterm birth. Recently, it has been suggested that the cervico-vaginal microbiota may be an important defense factor toward C. trachomatis infection as well as the development of chronic sequelae. Therefore, the investigation of microbial profiles associated to chlamydial infection is of the utmost importance. Here we present a pilot study aiming to characterize, through the metagenomic analysis of sequenced 16s rRNA gene amplicons, the cervical microbiota from reproductive age women positive to C. trachomatis infection. The main finding of our study showed a marked increase in bacterial diversity in asymptomatic C. trachomatis positive women as compared to healthy controls in terms of Shannon's diversity and Shannon's evenness (P = 0.031 and P = 0.026, respectively). More importantly, the cervical microbiota from C. trachomatis positive women and from healthy controls significantly separated into two clusters in the weighted UniFrac analysis (P = 0.0027), suggesting that differences between the two groups depended entirely on the relative abundance of bacterial taxa rather than on the types of bacterial taxa present. Furthermore, C. trachomatis positive women showed an overall decrease in Lactobacillus spp. and an increase in anaerobes. These findings are part of an ongoing larger epidemiological study that will evaluate the potential role of distinct bacterial communities of the cervical microbiota in C. trachomatis infection.
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Affiliation(s)
- Simone Filardo
- Section of Microbiology, Department of Public Health and Infectious Diseases, University of Rome "Sapienza"Rome, Italy
| | - Marisa Di Pietro
- Section of Microbiology, Department of Public Health and Infectious Diseases, University of Rome "Sapienza"Rome, Italy
| | - Maria G Porpora
- Department of Gynecology, Obstetrics and Urology, University of Rome "Sapienza"Rome, Italy
| | - Nadia Recine
- Department of Gynecology, Obstetrics and Urology, University of Rome "Sapienza"Rome, Italy
| | - Alessio Farcomeni
- Section of Statistics, Department of Public Health and Infectious Diseases, University of Rome "Sapienza"Rome, Italy
| | - Maria A Latino
- Unit of Bacteriology, STIs Diagnostic Centre, Sant'Anna HospitalTurin, Italy
| | - Rosa Sessa
- Section of Microbiology, Department of Public Health and Infectious Diseases, University of Rome "Sapienza"Rome, Italy
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Clemmons BA, Reese ST, Dantas FG, Franco GA, Smith TPL, Adeyosoye OI, Pohler KG, Myer PR. Vaginal and Uterine Bacterial Communities in Postpartum Lactating Cows. Front Microbiol 2017. [PMID: 28642755 PMCID: PMC5463355 DOI: 10.3389/fmicb.2017.01047] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Reproductive inefficiency in cattle has major impacts on overall productivity of cattle operations, increasing cost of production, and impacting the sustainability of the cattle enterprise. Decreased reproductive success and associated disease states have been correlated with the presence of specific microbes and microbial community profiles, yet details of the relationship between microbial communities and host physiology are not well known. The present study profiles and compares the microbial communities in the bovine uterus and vagina using 16S rRNA sequencing of the V1-V3 hypervariable region at the time of artificial insemination. Significant differences (p < 0.05) between the vaginal and uterine communities were observed at the level of α-diversity metrics, including Chao1, Shannon's Diversity Index, and observed OTU. Greater clustering of vaginal OTU was apparent in principal coordinate analysis compared to uterine OTU, despite greater diversity in the vaginal community in both weighted and unweighted UniFrac distance matrices (p < 0.05). There was a significantly greater relative abundance of unassigned taxa in the uterus (p = 0.008), otherwise there were few differences between the overall community profiles. Both vaginal and uterine communities were dominated by Firmicutes, although the relative abundance of rRNA sequences corresponding to species in this phylum was significantly (p = 0.007) lower in the uterine community. Additional differences were observed at the genus level, specifically in abundances within Clostridium (p = 0.009), Anaerofustis (p = 0.018), Atopobium (p = 0.035), Oscillospira (p = 0.035), 5-7N15 (p = 0.035), Mycoplasma (p = 0.035), Odoribacter (p = 0.042), and within the families Clostridiaceae (p = 0.006), Alcaligenaceae (p = 0.021), and Ruminococcaceae (p = 0.021). Overall, the comparison revealed differences and commonalities among bovine reproductive organs, which may be influenced by host physiology. The increased abundance of unassigned taxa found in the uterus may play a significant biological role in the reproductive status of the animal. The study represents an initial dataset for comparing bacterial communities prior to establishment of pregnancy.
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Affiliation(s)
- Brooke A Clemmons
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Sydney T Reese
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Felipe G Dantas
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Gessica A Franco
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Timothy P L Smith
- U.S. Meat Animal Research Center, Agricultural Research Service, United States Department of Agriculture, Clay Center, NEUnited States
| | | | - Ky G Pohler
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Phillip R Myer
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
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48
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Daggett GJ, Zhao C, Connor-Stroud F, Oviedo-Moreno P, Moon H, Cho MW, Moench T, Anderson DJ, Villinger F. Comparison of the vaginal environment in rhesus and cynomolgus macaques pre- and post-lactobacillus colonization. J Med Primatol 2017; 46:232-238. [PMID: 28488364 DOI: 10.1111/jmp.12264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Rhesus and cynomologus macaques are valuable animal models for the study of human immunodeficiency virus (HIV) prevention strategies. However, for such studies focused on the vaginal route of infection, differences in vaginal environment may have deterministic impact on the outcome of such prevention, providing the rationale for this study. METHODS We tested the vaginal environment of rhesus and cynomolgus macaques longitudinally to characterize the normal microflora based on Nugent scores and pH. This evaluation was extended after colonization of the vaginal space with Lactobacilli in an effort to recreate NHP models representing the healthy human vaginal environment. RESULTS AND CONCLUSION Nugent scores and pH differed significantly between species, although data from both species were suggestive of stable bacterial vaginosis. Colonization with Lactobacilli was successful in both species leading to lower Nugent score and pH, although rhesus macaques appeared better able to sustain Lactobacillus spp over time.
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Affiliation(s)
- Gregory J Daggett
- Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | | | - Fawn Connor-Stroud
- Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Patricia Oviedo-Moreno
- Division of Pathology, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Hojin Moon
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University Ames, Ames, IA, USA
| | - Michael W Cho
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University Ames, Ames, IA, USA
| | | | - Deborah J Anderson
- Departments of Obstetrics/Gynecology and Microbiology, Boston University, Boston, MA, USA
| | - Francois Villinger
- New Iberia Research Center, University of Louisiana at Lafayette, New Iberia, LA, USA
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The role of lactic acid production by probiotic Lactobacillus species in vaginal health. Res Microbiol 2017; 168:782-792. [PMID: 28435139 DOI: 10.1016/j.resmic.2017.04.001] [Citation(s) in RCA: 287] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/03/2017] [Accepted: 04/03/2017] [Indexed: 12/12/2022]
Abstract
Vaginal eubiosis is characterised by beneficial lactobacillus-dominated microbiota. In contrast, vaginal dysbiosis (e.g. bacterial vaginosis, BV), characterised by an overgrowth of multiple anaerobes, is associated with an increased risk of adverse urogenital and reproductive health outcomes. A major distinguishing feature between the vaginal environment in states of eubiosis and dysbiosis is a high concentration of lactic acid, produced by lactobacilli, that acidifies the vagina in eubiosis versus a sharp drop in lactic acid and an increase in pH in dysbiosis. Here we review the antimicrobial, antiviral and immunomodulatory properties of lactic acid and the use of lactic acid and lactobacilli probiotics in preventing or treating BV.
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Campisciano G, Florian F, D'Eustacchio A, Stanković D, Ricci G, De Seta F, Comar M. Subclinical alteration of the cervical-vaginal microbiome in women with idiopathic infertility. J Cell Physiol 2017; 232:1681-1688. [DOI: 10.1002/jcp.25806] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/05/2017] [Accepted: 01/17/2017] [Indexed: 01/17/2023]
Affiliation(s)
| | - Fiorella Florian
- Department of Life Sciences; University of Trieste; Trieste Italy
| | - Angela D'Eustacchio
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”; Trieste Italy
| | - David Stanković
- Department of Life Sciences; University of Trieste; Trieste Italy
| | - Giuseppe Ricci
- Department of Medical Sciences; University of Trieste; Trieste Italy
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”; Trieste Italy
| | - Francesco De Seta
- Department of Medical Sciences; University of Trieste; Trieste Italy
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”; Trieste Italy
| | - Manola Comar
- Department of Medical Sciences; University of Trieste; Trieste Italy
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”; Trieste Italy
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