Biotherapeutic agents and vaginal health

Vaginal prevention of Candida albicans: synergistic effect of lactobacilli and mannan oligosaccharides (MOS)

Vulvovaginal candidiasis (VVC) affects approximately 30-50% of women at least once during their lifetime, causing uncomfortable symptoms and limitations in their daily quality of life. Antifungal therapy is not very effective, does not prevent recurrencies and usually causes side effects. Therefore, alternative therapies are urgently needed. The goal of this work was to investigate the potential benefits of using mannan oligosaccharides (MOS) extracts together with a Lactobacillus sp. pool, composed by the most significant species present in the vaginal environment, to prevent infections by Candida albicans. Microbial growth of isolated strains of the main vaginal lactobacilli and Candida strains was assessed in the presence of MOS, to screen their impact upon growth. A pool of the lactobacilli was then tested against C. albicans in competition and prophylaxis studies; bacterial and yeast cell numbers were quantified in specific time points, and the above-mentioned studies were assessed in simulated vaginal fluid (SVF). Finally, adhesion to vaginal epithelial cells (HeLa) was also evaluated, once again resorting to simultaneous exposure (competition) or prophylaxis assays, aiming to measure the effect of MOS presence in pathogen adherence. Results demonstrated that MOS extracts have potential to prevent vaginal candidiasis in synergy with vaginal lactobacilli, with improved results than those obtained when using lactobacilli alone. KEY POINTS: Potential benefits of MOS extracts with vaginal lactobacilli to prevent C. albicans infections. MOS impacts on growth of vaginal lactobacilli pool and C. albicans in SVF. MOS extracts in synergy with L. crispatus inhibit C. albicans adhesion in HeLa cells.

Exploring the effects of Qijiao Shengbai capsule on leukopenic mice from the perspective of intestinbased on metabolomics and 16S rRNA sequencing

Qijiao Shengbai capsule (QJSB) is formulated according to the traditional Chinese medicine formula, its function is to nourish Qi and blood, improve the body's immunity. Leukopenia has been treated with it in clinical settings. However, the mechanism of leukopenia from the perspective of intestinal tract has not been reported. This study combined metabolomics and 16S rRNA sequencing technologies to investigate the mechanism of QJSB on leukopenia from the intestine. As a result of cyclophosphamide induction in mice, the results demonstrated that QJSB may greatly increase the quantity of peripheral leukocytes (including neutrophils). Meanwhile, QJSB had a restorative effect on the colon of leukopenic mice; it also increased the level of IL-2, IL-6 and G-CSF in the intestine, further enhancing the immunity and hematopoietic function of mice. Metabolic studies showed that QJSB altered 27 metabolites, most notably amino acid metabolism. In addition, QJSB had a positive regulatory effect on the intestinal microbiota, and could alter community composition by improving the diversity and abundance of the intestinal microbial, which mainly involved 6 related bacterial groups, and primarily regulates three associated SCFAs (acetic acid, butyrate acid and valeric acid). Therefore, this study suggests that QJSB can improve hematopoietic function, enhance the immune system, relieve leucopenia and improve the gut in leucopenic mice by modulating metabolic response pathways, fecal metabolites and intestinal microbiota.

Dietary acid load, alternative healthy eating index score, and bacterial vaginosis: is there any association? A case-control study

Background:

Changing the dietary pattern may be an alternative treatment for bacterial vaginosis, the prevalent vaginal infection in women.

Methods:

One hundred and forty-three bacterial vaginosis-affected women diagnosed by Amsel criteria and 151 healthy controls aged 18 to 45 entered the current case-control research. To calculate the alternative healthy eating index and dietary acid load score, food consumption was recorded with an accurate and precise food frequency questionnaire. The dietary acid load was measured by potential renal acid load (PRAL) and net endogenous acid production (NEAP) indices. Using logistic regression models, the association between the alternative healthy eating index and dietary acid load score with bacterial vaginosis was investigated.

Results:

The last tertile of the alternative healthy eating index had a 75% decreased odds of experiencing bacterial vaginosis in the adjusted model (adjusted odds ratio (aOR) = 0.25, 95% confidence interval (CI) = 0.12–0.53, P for trend = 0.001). Besides, vegetables (aOR = 0.34, 95% CI = 0.17–0.69, P for trend = 0.003), nuts and legumes (aOR = 0.44, 95% CI = 0.23–0.87, P for trend = 0.028), and meats (aOR = 0.31, 95% CI = 0.16–0.60, P for trend = 0.001) intake was linked to a decreased bacterial vaginosis odds. However, sugar-sweetened beverages and fruit juice (aOR = 3.47, 95% CI = 1.68–7.17, P for trend < 0.001), trans fatty acids (aOR = 2.29, 95% CI = 1.18–4.43, P for trend = 0.005), and sodium (aOR = 3.44, 95% CI = 1.67–7.06, P for trend = 0.002) intake were directly associated with bacterial vaginosis odds. There was no evidence of a link between dietary acid load and bacterial vaginosis.

Conclusion:

According to the present study’s findings, there is no correlation between dietary acid load and the likelihood of developing bacterial vaginosis. However, following a plant-based dietary pattern based on the healthy eating index may lead to a lower odds of bacterial vaginosis.

Is there any association between adherence to the Mediterranean Diet and Dietary Total Antioxidant Capacity with Bacterial Vaginosis? Results from a Case-Control study

Background

Bacterial vaginosis, BV, is a common inflammatory vaginal dysbiosis. The Mediterranean diet, MD, containing foods rich in antioxidant compounds, is shown to be beneficial for inflammatory conditions. This study aimed to investigate the association between MD adherence and dietary total antioxidant capacity (DTAC) with BV.

Methods

This case–control study was conducted on 143 BV-affected and 151 healthy individuals aged between 15 and 45 years. The Amsel criteria were used to detect newly diagnosed patients with BV by a gynecologist. The 168-item food frequency questionnaire (FFQ) was used to record participants' dietary intakes in the last year. The reported data in the FFQ was used to measure adherence to the MD by calculating the Medi-Lite score and to measure the DTAC by calculating ferric-reducing antioxidant power, FRAP, based on the related databases. Logistic regression models were used to determine the association between Medi-Lite and DTAC and BV odds.

Results

The highest tertile of Medi-Lite score was associated with a reduced odds of BV in the crude model (Odds Ratio, OR: 0.49, 95% Confidence Interval, 95% CI 0.25, 0.96, P for trend: 0.023). This significant inverse association was not observed in the last model adjusted for age, body mass index (kg/m²), waist circumferences (cm), cigarette smoking, frequency of pregnancy, and physical activity (MET/h/d). In crude and adjusted odels, BV odds decreased in the highest tertile of vegetable (adjusted OR, aOR: 0.32, 95% CI 0.16, 0.63, P for trend: 0.001), fish (aOR: 0.46, 95% CI 0.25, 0.84, P for trend: 0.009), legumes (aOR: 0.26, 95% CI 0.14, 0.50, P for trend < 0.001), and meat (aOR: 0.29, 95% CI 0.15, 0.56, P for trend < 0.001) groups. There was no significant association between DTAC and BV odds.

Conclusions

The significant inverse association between the MD adherence and BV odds did not remain after modifying for confounders; besides, DTAC was not associated with BV odds. However, some of the MD components might be associated with a reduced odds of BV.

Antiviral Effects and Underlying Mechanisms of Probiotics as Promising Antivirals

Probiotics exert a variety of beneficial effects, including maintaining homeostasis and the balance of intestinal microorganisms, activating the immune system, and regulating immune responses. Due to the beneficial effects of probiotics, a wide range of probiotics have been developed as probiotic agents for animal and human health. Viral diseases cause serious economic losses to the livestock every year and remain a great challenge for animals. Moreover, strategies for the prevention and control of viral diseases are limited. Viruses enter the host through the skin and mucosal surface, in which are colonized by hundreds of millions of microorganisms. The antiviral effects of probiotics have been proved, including modulation of chemical, microbial, physical, and immune barriers through various probiotics, probiotic metabolites, and host signaling pathways. It is of great significance yet far from enough to elucidate the antiviral mechanisms of probiotics. The major interest of this review is to discuss the antiviral effects and underlying mechanisms of probiotics and to provide targets for the development of novel antivirals.

The Antibiofilm Role of Biotics Family in Vaginal Fungal Infections

“Unity in strength” is a notion that can be exploited to characterize biofilms as they bestow microbes with protection to live freely, escalate their virulence, confer high resistance to therapeutic agents, and provide active grounds for the production of biofilms after dispersal. Naturally, fungal biofilms are inherently resistant to many conventional antifungals, possibly owing to virulence factors as their ammunitions that persistently express amid planktonic transition to matured biofilm state. These ammunitions include the ability to form polymicrobial biofilms, emergence of persister cells post-antifungal treatment and acquisition of resistance genes. One of the major disorders affecting vaginal health is vulvovaginal candidiasis (VVC) and its reoccurrence is termed recurrent VVC (RVVC). It is caused by the Candida species which include Candida albicans and Candida glabrata. The aforementioned Candida species, notably C. albicans is a biofilm producing pathogen and habitually forms part of the vaginal microbiota of healthy women. Latest research has implicated the role of fungal biofilms in VVC, particularly in the setting of treatment failure and RVVC. Consequently, a plethora of studies have advocated the utilization of probiotics in addressing these infections. Specifically, the excreted or released compounds of probiotics which are also known as postbiotics are being actively researched with vast potential to be used as therapeutic options for the treatment and prevention of VVC and RVVC. These potential sources of postbiotics are harnessed due to their proven antifungal and antibiofilm. Hence, this review discusses the role of Candida biofilm formation in VVC and RVVC. In addition, we discuss the application of pro-, pre-, post-, and synbiotics either individually or in combined regimen to counteract the abovementioned problems. A clear understanding of the role of biofilms in VVC and RVVC will provide proper footing for further research in devising novel remedies for prevention and treatment of vaginal fungal infections.

Microbiota and epigenetics: promising therapeutic approaches?

The direct/indirect responsibility of the gut microbiome in disease induction in and outside the digestive tract is well studied. These results are usually from the overpopulation of certain species on the cost of others, interaction with beneficial microflora, interference with normal epigenetic control mechanisms, or suppression of the immune system. Consequently, it is theoretically possible to cure such disorders by rebalancing the microbiome inside our bodies. This can be achieved by changing the lifestyle pattern and diet or by supplementation with beneficial bacteria or their metabolites. Various approaches have been explored to manipulate the normal microbial inhabitants, including nutraceutical, supplementations with prebiotics, probiotics, postbiotics, synbiotics, and antibiotics, or through microbiome transplantation (fecal, skin, or vaginal microbiome transplantation). In the present review, the interaction between the microbiome and epigenetics and their role in disease induction is discussed. Possible future therapeutic approaches via the reestablishment of equilibrium in our internal micro-ecosystem are also highlighted.

The Role of Fatty Acid Metabolites in Vaginal Health and Disease: Application to Candidiasis

Although the vast majority of women encounters at least one vaginal infection during their life, the amount of microbiome-related research performed in this area lags behind compared to alternative niches such as the intestinal tract. As a result, effective means of diagnosis and treatment, especially of recurrent infections, are limited. The role of the metabolome in vaginal health is largely elusive. It has been shown that lactate produced by the numerous lactobacilli present promotes health by limiting the chance of infection. Short chain fatty acids (SCFA) have been mainly linked to dysbiosis, although the causality of this relationship is still under debate. In this review, we aim to bring together information on the role of the vaginal metabolome and microbiome in infections caused by Candida. Vulvovaginal candidiasis affects near to 70% of all women at least once in their life with a significant proportion of women suffering from the recurrent variant. We assess the role of fatty acid metabolites, mainly SCFA and lactate, in onset of infection and virulence of the fungal pathogen. In addition, we pinpoint where lack of research limits our understanding of the molecular processes involved and restricts the possibility of developing novel treatment strategies.

Bacterial Vaginosis: Effects on reproduction and its therapeutics

Bacterial Vaginosis (BV) is the most common vaginal infection. A large amount of evidence shows that the anatomical scope of BV's pathogenic effect is far beyond the lower reproductive tract. BV is closely related to adverse reproductive outcomes, which may be due to the infection of the vaginal flora ascending to the upper genital tract. In addition, the incidence of BV is relatively high in infertile women. The vaginal microbiome also plays an important role in women's health and diseases. For most women, the normal vaginal microbiota is dominated by Lactobacillus, which can maintain a healthy vaginal environment by producing lactic acid, H₂O₂ and bacteriocin, etc. BV is characterized by the imbalanced vaginal flora. It changes the acidic environment that is normally dominated by Lactobacillus, and causes an overgrowth of anaerobic and facultative anaerobic bacteria such as Gardnerella vaginalis and Atopobium vaginae. Studies have shown that bacterial infections in the vagina can spread to upper genital tract and cause adverse fertility outcome. Therefore, early diagnosis and therapeutics of symptomatic BV is helpful to improve the outcome of poor fertility.

Nutrition in Gynecological Diseases: Current Perspectives

Diet and nutrition are fundamental in maintaining the general health of populations, including women’s health. Health status can be affected by nutrient deficiency and vice versa. Gene–nutrient interactions are important contributors to health management and disease prevention. Nutrition can alter gene expression, as well as the susceptibility to diseases, including cancer, through several mechanisms. Gynecological diseases in general are diseases involving the female reproductive system and include benign and malignant tumors, infections, and endocrine diseases. Benign diseases such as uterine fibroids and endometriosis are common, with a negative impact on women’s quality of life, while malignant tumors are among the most common cause of death in the recent years. In this comprehensive review article, a bibliographic search was performed for retrieving information about nutrients and how their deficiencies can be associated with gynecological diseases, namely polycystic ovary syndrome, infertility, uterine fibroids, endometriosis, dysmenorrhea, and infections, as well as cervical, endometrial, and ovarian cancers. Moreover, we discussed the potential beneficial impact of promising natural compounds and dietary supplements on alleviating these significant diseases.

Lactobacillus rhamnosus BMX 54 + Lactose, A Symbiotic Long-Lasting Vaginal Approach to Improve Women's Health

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.

Anti-Biofilm Properties of Saccharomyces cerevisiae CNCM I-3856 and Lacticaseibacillus rhamnosus ATCC 53103 Probiotics against G. vaginalis

Bacterial vaginosis (BV) is characterized by the presence of a polymicrobial biofilm where Gardnerella vaginalis plays a key role. Previously, we demonstrated that Saccharomyces cerevisiae CNCM (French National Collection of Cultures of Microorganisms) I-3856 is helpful in resolving experimental simulated BV in mice. In this study, we analyzed its capacity to affect G. vaginalis biofilms and to potentiate the activity of standard antimicrobial agents. We also investigated the anti-biofilm activity of Lacticaseibacillus rhamnosus GG (ATCC 53103), a well-known strain for its intestinal healthy benefits. Biofilm biomass was assessed by crystal violet staining, and G. vaginalis viability was assessed by a colony forming unit (CFU) assay. Here, for the first time, we demonstrated that S. cerevisiae CNCM I-3856 as well as L. rhamnosus GG were able (i) to significantly inhibit G. vaginalis biofilm formation, (ii) to markedly reduce G. vaginalis viability among the biomass constituting the biofilm, (iii) to induce disaggregation of preformed biofilm, and (iv) to kill a consistent amount of bacterial cells in a G. vaginalis preformed biofilm. Furthermore, S. cerevisiae CNCM I-3856 strongly potentiates the metronidazole effect on G. vaginalis biofilm viability. These results suggest that S. cerevisiae CNCM I-3856 as well as L. rhamnosus GG could be potential novel therapeutic agents against bacterial vaginosis.

Cranberry Polyphenols and Prevention against Urinary Tract Infections: Relevant Considerations

Cranberry (Vaccinium macrocarpon) is a distinctive source of polyphenols as flavonoids and phenolic acids that has been described to display beneficial effects against urinary tract infections (UTIs), the second most common type of infections worldwide. UTIs can lead to significant morbidity, especially in healthy females due to high rates of recurrence and antibiotic resistance. Strategies and therapeutic alternatives to antibiotics for prophylaxis and treatment against UTIs are continuously being sought after. Different to cranberry, which have been widely recommended in traditional medicine for UTIs prophylaxis, probiotics have emerged as a new alternative to the use of antibiotics against these infections and are the subject of new research in this area. Besides uropathogenic Escherichia coli (UPEC), the most common bacteria causing uncomplicated UTIs, other etiological agents, such as Klebsiellapneumoniae or Gram-positive bacteria of Enterococcus and Staphylococcus genera, seem to be more widespread than previously appreciated. Considerable current effort is also devoted to the still-unraveled mechanisms that are behind the UTI-protective effects of cranberry, probiotics and their new combined formulations. All these current topics in the understanding of the protective effects of cranberry against UTIs are reviewed in this paper. Further progresses expected in the coming years in these fields are also discussed.

Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis

The vaginal microbiota has importance in preserving vaginal health and defending the host against disease. The advent of new molecular techniques and computer science has allowed researchers to discover microbial composition in depth and associate the structure of vaginal microbial communities. There is a consensus that vaginal flora is grouped into a restricted number of communities, although the structure of the community is constantly changing. Certain Community-State Types (CSTs) are more associated with poor reproductive outcomes and sexually transmitted diseases (STDs) meanwhile, CSTs dominated by Lactobacillus species—particularly Lactobacillus crispatus—are more related to vaginal health. In this work, we have reviewed how modifiable and non-modifiable factors may affect normal vaginal microbiota homeostasis—including sexual behavior, race or ethnicity, and hygiene. Special interest has been given to how the use of probiotics, diet intake, and use of hormone replacement therapies (HRTs) can potentially impact vaginal microbiota composition.

Evaluation of the Bacterial Diversity of Inner Mongolian Acidic Gruel Using Illumina MiSeq and PCR-DGGE

As a traditional fermented cereal, Inner Mongolian acidic gruel has a unique flavor and rich nutrition, but the microbial diversity of acidic gruel and the microbial differences among the products in different regions have not been reported. The bacterial diversity and the lactic acid bacteria species of 27 types of traditional handmade acidic gruel were evaluated using a combination of MiSeq high-throughput sequencing and PCR-DGGE. All 358,205 high-quality 16S rRNA reads were divided into 25,171 OTUs under the similarity of 97%. Firmicutes, Proteobacteria, and Bacteroidetes were the dominant bacterial phyla, and the core dominant genera were Lactobacillus and Acetobacter with average relative abundances of 64.06% and 24.13%, respectively. The primary genera that caused the differences in the bacterial community structure between the Bayan Nur and Ordos acidic gruel samples were Pseudomonas, Leuconostoc, and Acinetobacter as revealed by redundancy analysis (RDA). PCR-DGGE analyses revealed that the lactic acid bacteria in both the Bayan Nur and Ordos samples of acidic gruel were Lactobacillus (L.) amylolyticus, L. alimentarius, L. fermentum, L. hamsteri, L. helveticus, L. panis, L. plantarum, L. pontis, and Leuconostoc lactis. In addition, L. hamsteri was the core strain detected among all the samples. The results deepened the understanding of the microbial community composition and the diversity of acidic gruel to provide a theoretical basis for the preservation and protection of microbial resources in acidic gruel in the Inner Mongolia area.

Preterm Birth: A Narrative Review of the Current Evidence on Nutritional and Bioactive Solutions for Risk Reduction

Preterm birth (PTB) (<37 weeks of gestation) is the leading cause of newborn death and a risk factor for short and long-term adverse health outcomes. Most cases are of unknown cause. Although the mechanisms triggering PTB remain unclear, an inappropriate increase in net inflammatory load seems to be key. To date, interventions that reduce the risk of PTB are effective only in specific groups of women, probably due to the heterogeneity of its etiopathogenesis. Use of progesterone is the most effective, but only in singleton pregnancies with history of PTB. Thus, primary prevention is greatly needed and nutritional and bioactive solutions are a promising alternative. Among these, docosahexaenoic acid (DHA) is the most promising to reduce the risk for early PTB. Other potential nutrient interventions include the administration of zinc (possibly limited to populations with low nutritional status or poor zinc status) and vitamin D; additional preliminary evidence exists for vitamin A, calcium, iron, folic acid, combined iron-folate, magnesium, multiple micronutrients, and probiotics. Considering the public health relevance of PTB, promising interventions should be studied in large and well-designed clinical trials. The objective of this review is to describe, summarize, and discuss the existing evidence on nutritional and bioactive solutions for reducing the risk of PTB.

Strain-specific inhibition of the adherence of uropathogenic bacteria to bladder cells by probiotic Lactobacillus spp

Urinary tract infections (UTIs), one of most common infections worldwide, face high recurrence rates and increasing antimicrobial resistance. Probiotic bacteria, especially of the genus Lactobacillus, are considered a promising preventive and/or treatment therapy against UTIs. In order to elucidate the mechanisms involved in these beneficial effects, we studied the impact of different Lactobacillus strains (Lactobacillus salivarius UCM572, L. plantarum CLC17 and L. acidophilus 01) in the adherence of reference and clinical uropathogenic strains (Escherichia coli ATCC® 53503, E. coli 10791, Enterococcus faecalis 04-1, En. faecalis 08-1 and Staphylococcus epidermidis 08-3) to T24 epithelial bladder cells. In general, the Lactobacillus strains with previous in vivo evidence of beneficial effects against UTIs (L. salivarius UCM572 and L. acidophilus 01) significantly inhibited the adherence of the five uropathogens to T24 cells, displaying percentages of inhibition ranging between 22.2% and 43.9%, and between 16.5% and 53.7%, respectively. On the other hand, L. plantarum CLC17, a strain with no expected effects on UTIs, showed almost negligible anti-adherence effects.Therefore, these in vitro results suggest that inhibition of the adherence of uropathogens to epithelial bladder cells may be one of the mechanisms involved in the potential beneficial effects of probiotics against UTIs in vivo.

Role of prebiotics and probiotics in oral health

Purpose

This paper aims to focus on the utilisation of pre- and probiotics for oral care and the state of knowledge at this time.

Design/methodology/approach

Pre- and probiotics describe beneficial carbohydrates and microbiota, respectively, for optimal gut health. Carbohydrates provide energy selectively for the gut-friendly bacteria. The use of both carbohydrates and bacteria is, however, being expanded into other areas of the body – including the skin, vagina and oral cavity – for health-related applications.

Findings

There is increased interest in both pre- and probiotics for oral care products. The importance of oral microflora and their selective substrates is discussed against a background of contemporary oral care approaches. The issues and benefits are discussed in this review.

Originality/value

It is clear that consumption of prebiotics and probiotics may play a role as potential prophylactic or therapeutic agents for reducing the presence of organisms in the mouth associated with tooth decay. To confirm a beneficial effect of pre- and probiotics further in vivo studies involving healthy human volunteers should be considered.

Intrinsic and extrinsic carbohydrates in the vagina: A short review on vaginal glycogen

The reasons for (i) the presence and (ii) mechanisms of utilisation of glycogen by the lactic acid bacteria in the human vaginal tract are not well understood. It is probable that the vaginal epithelia produce both glycogen and α-amylase where the enzyme depolymerises the polysaccharide within the vagina itself. Only these depolymerised residues are then utilised for growth by the lactic acid bacteria. The lactic acid bacteria cannot metabolise the glycogen directly due to their incapacity to produce the α-amylase enzyme. These bacteria may, however, metabolise exogenous carbohydrates (such as prebiotics) selectively for growth effectively. These carbohydrate utilisation issues within the vagina are considered in this short review.

Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health

Stress stimuli are ubiquitous and women do not enjoy any exemptions. The physiologic "fight-or-flight" response may be deleterious to the female lower genital tract microbiome if the stress stimuli persist for longer than necessary. Persistent exposure to psychosocial stress and stimulation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes, and associated hormones are risk factors for several infections including genitourinary tract infections. Though this could be due to a dysregulated immune response, a cortisol-induced inhibition of vaginal glycogen deposition may be involved especially in the instance of vaginal infection. The estrogen-related increased vaginal glycogen and epithelial maturation are required for the maintenance of a healthy vaginal ecosystem (eubiosis). The ability of cortisol to disrupt this process as indicated in animal models is important in the pathogenesis of vaginal dysbiosis and the subsequent development of infection and inflammation. This phenomenon may be more crucial in pregnancy where a healthy Lactobacillus-dominated vaginal microbiota is sacrosanct, and there is local production of more corticotropin-releasing hormone (CRH) from the decidua, fetal membranes and placenta. To highlight the relationship between the stress hormone cortisol and the vaginal microbiomial architecture and function, the potential role of cortisol in the maintenance of vaginal health is examined.

Impact of Health-Promoting Educational Intervention on Lifestyle (Nutrition Behaviors, Physical Activity and Mental Health) Related to Vaginal Health Among Reproductive-Aged Women With Vaginitis

Background

Vaginitis is one of the most common diseases in reproductive-aged women (15 - 49 years of age). Side effects of vaginitis can affect other aspects of health, which could be prevented by promoting a healthy lifestyle related to vaginal health.

Objectives

This study aimed at determining the impact of health-promoting educational intervention on lifestyle (nutrition behaviors, physical activities, and mental health) related to vaginal health among reproductive-aged women with vaginitis.

Methods

The data set was collected as part of an experimental study conducted on 350 reproductive-aged women with vaginitis. Participants were selected through a stratified two-stage clustered sampling and simple randomization from 10 attending health centers affiliated with Kermanshah University of Medical Sciences in five regions (North, South, East, West, and Center) of Kermanshah (a city in western Iran) in 2015. Two clinics in each region were selected; patients from the first center were chosen as the intervention group and patients from the second center made up the control group. To collect data, a questionnaire including socio-demographic and lifestyle questions was used. The questionnaire was designed and validated via the psychometric process. Educational intervention was performed over twenty sessions of 25 to 35 minutes. The intervention group was followed up with face-to-face education, a pamphlet, phone contact, and by social media. The control group continued the routine treatment without contacting the intervention group. Data were collected from both groups before the intervention and six months after the intervention. Data were analyzed using the SPSS-20 package, using the independent t-test, paired t-test, chi-square test, and analysis of covariance (ANCOVA) test. The confidence interval was 95% and P < 0.05 was considered statistically significant.

Results

ANCOVA showed that after adjusting for effects of pretest scores, the difference between mean scores on the scale of lifestyle related to vaginal health in the intervention group (28.48 ± 0.38) and control group (23.65 ± 1.23) was significant (P < 0.001). Intervention has a positive significant effect on increasing the mean scores of lifestyle in the intervention group (P < 0.001). Comparing mean differences between the two groups indicated significant difference between them (P < 0.001). Results of the paired t-test in the control group did not show significant changes in lifestyle scores after 6 months (P > 0.05). The independent t-test did not show significant statistical differences between the two groups in terms of demographic characteristics (P > 0.05).

Conclusions

According to the findings, educational intervention is beneficial in promoting three aspects of women's lifestyle related to vaginal health. Therefore, a health-promoting lifestyle seems essential for having a healthy vagina and for preventing vaginitis.

Determination of factors affecting relapse of vaginitis among reproductive-aged women: An experimental study

INTRODUCTION

Vaginitis is a common problem for women, especially in reproductive-aged women. It is a worldwide health problem with many side effects but could be prevented by a health-promoting lifestyle related to vagina health. The aim of this study was to determine the factors affecting relapse of vaginitis.

METHODS

In this experimental study, 350 reproductive-aged women with vaginitis were selected from 10 health centers in Kermanshah (Iran) during 2015 and were equally included in the intervention and control groups. To collect data, a researcher-created questionnaire, which included sociodemographic and health-promoting lifestyle questions, was used. The educational intervention was performed over 20 sessions, each lasting 25-35 minutes. An intervention group was educated by face-to-face education, pamphlets, phone contacts, text messages, and social media. Another group continued the routine clinic education and treatment without contacting the intervention group. Data were analyzed through chi-square and a logistics regression model using IBM-SPSS version 20.

RESULTS

The results of the study indicated a significant relation between sociodemographic characteristics such as women and their husbands' literacy, job, family size, income, area for each member of family, tendency of pregnancy, body mass index (BMI), and caesarean experience (p<0.001) and vaginitis. In addition, significant relationships between health-promoting lifestyle dimensions and prevention of vaginitis were identified. Relapse after intervention in the intervention group was 27.7% and 72.3% in the control group. According to the logistic regression analysis, chance for relapse of vaginitis in the group that did not receive intervention was more than the same chance in the intervention group (OR=5.14).

CONCLUSION

Health-promoting lifestyle intervention influences prevention of vaginitis. Health-promoting lifestyle, literacy promotion, prevention of caesarian, and obesity are beneficial to improvement in lifestyle dimensions associated with vagina health could be implemented as a successful prevention method. Therefore, it seems that applying a health-promoting lifestyle is essential for a healthy vagina and prevention of vaginitis.

Beneficial health characteristics of native and hydrolysed konjac (Amorphophallus konjac) glucomannan

The impact of ingesting glucomannans on health is not limited to colonic-focused fermentation into short-chain fatty acids (SCFAs), which might have some local health benefits; it also helps in treating disease states and enhancing the body's immune system, both within the gut and in/on other parts of the body. The local and systemic roles of hydrolysed glucomannans, especially konjac glucomannans, in the mouth, oesophagus, stomach, small intestine, large intestine, gut-associated lymphoid tissue (GALT), skin and vagina, are highlighted. Therapeutic applications are discussed. © 2015 Society of Chemical Industry.