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Zeng X, An R, Li H, Zhang Y. Improved treatment of vulvovaginal candidiasis with Clotrimazole plus probiotic Lacidophilin Vaginal Capsules: A prospective, real-world study. Medicine (Baltimore) 2023; 102:e32664. [PMID: 36607885 PMCID: PMC9829293 DOI: 10.1097/md.0000000000032664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Clotrimazole has long been used to treat vulvovaginal candidiasis (VVC), yet the antibiotic resistance, adverse effects and recurrences still bring about a great challenge for the clinicians. To explore the effect of probiotic Lacidophilin Vaginal Capsules plus Clotrimazole Vaginal Tablets (500mg) in the treatment of uncomplicated VVC, a self-controlled real-world study was conducted. METHODS Twenty-seven women with a normal vaginal flora and 15 women with uncomplicated VVC were recruited. The patients were treated with the single dose of Clotrimazole Vaginal Tablets (500mg) supplemented with 2 Lacidophilin Vaginal Capsules for the following 7 days. The patients were prospectively examined 4 times and the time points were at m0 (the first visit), m1 (8-10 days after the first visit), m2 (30 days after the second visit) and m3 (30 days after the third visit). However, women in the healthy normal control group were examined just once at the first visit. The obtained vaginal secretions were examined by high-throughput sequencing. RESULTS The mean age in healthy control group and case group was 28.63 ± 5.40y and 27.67 ± 3.33y, respectively. Finally, 46.67% (7/15) of patients were cured at the second visit, 61.54% (8/13) were cured at the third visit and eventually 72.73% (8/11) were cured. A total of 81 samples were sequenced, generating 1668 operation taxonomy units among all the samples. The bacterial composition of women in the healthy control group was exceedingly abundant and dominated by Lactobacillus, especially by Lactobacillus. crispatus, and followed by Lactobacillus. iners, Lactobacillus. jensenii and Gardneralla. On the contrary, the bacterial composition of women with VVC was relatively few and dominated by Lactobacillus. iners. During the process of treatment, the bacterial abundance of VVC patients was increased gradually. At the final visit, the abundance of vaginal flora was augmented further with the dominant bacteria being Lactobacillus. crispatus, followed by Lactobacillus. iners. CONCLUSION Clotrimazole Vaginal Tablets plus probiotic Lacidophilin Vaginal Capsules could improve the effect in treating uncomplicated VVC. This improved effect was achieved perhaps through improving the composition of vaginal flora and restoring vaginal microecology.
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Affiliation(s)
- Xianling Zeng
- From the Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- * Correspondence: Xianling Zeng, Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, No.1 East Jianshe Road, Zhengzhou, Henan 450052, China (e-mail: )
| | - Ruifang An
- From the Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Han Li
- From the Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yafei Zhang
- From the Department of Hepatobiliary and Pancreatic surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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das Neves Selis N, de Oliveira HBM, Leão HF, Dos Anjos YB, Sampaio BA, Correia TML, Almeida CF, Pena LSC, Reis MM, Brito TLS, Brito LF, Campos GB, Timenetsky J, Cruz MP, Rezende RP, Romano CC, da Costa AM, Yatsuda R, Uetanabaro APT, Marques LM. Lactiplantibacillus plantarum strains isolated from spontaneously fermented cocoa exhibit potential probiotic properties against Gardnerella vaginalis and Neisseria gonorrhoeae. BMC Microbiol 2021; 21:198. [PMID: 34187371 PMCID: PMC8243870 DOI: 10.1186/s12866-021-02264-5] [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: 02/25/2021] [Accepted: 06/15/2021] [Indexed: 01/24/2023] Open
Abstract
Background Probiotics are important tools in therapies against vaginal infections and can assist traditional antibiotic therapies in restoring healthy microbiota. Recent research has shown that microorganisms belonging to the genus Lactobacillus have probiotic potential. Thus, this study evaluated the potential in vitro probiotic properties of three strains of Lactiplantibacillus plantarum, isolated during the fermentation of high-quality cocoa, against Gardnerella vaginalis and Neisseria gonorrhoeae. Strains were evaluated for their physiological, safety, and antimicrobial characteristics. Results The hydrophobicity of L. plantarum strains varied from 26.67 to 91.67%, and their autoaggregation varied from 18.10 to 30.64%. The co-aggregation of L. plantarum strains with G. vaginalis ranged from 14.73 to 16.31%, and from 29.14 to 45.76% with N. gonorrhoeae. All L. plantarum strains could moderately or strongly produce biofilms. L. plantarum strains did not show haemolytic activity and were generally sensitive to the tested antimicrobials. All lactobacillus strains were tolerant to heat and pH resistance tests. All three strains of L. plantarum showed antimicrobial activity against the tested pathogens. The coincubation of L. plantarum strains with pathogens showed that the culture pH remained below 4.5 after 24 h. All cell-free culture supernatants (CFCS) demonstrated activity against the two pathogens tested, and all L. plantarum strains produced hydrogen peroxide. CFCS characterisation in conjunction with gas chromatography revealed that organic acids, especially lactic acid, were responsible for the antimicrobial activity against the pathogens evaluated. Conclusion The three strains of L. plantarum presented significant probiotic characteristics against the two pathogens of clinical importance. In vitro screening identified strong probiotic candidates for in vivo studies for the treatment of vaginal infections.
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Affiliation(s)
- Nathan das Neves Selis
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil
| | - Hellen Braga Martins de Oliveira
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil
| | - Hiago Ferreira Leão
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Yan Bento Dos Anjos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Beatriz Almeida Sampaio
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Thiago Macêdo Lopes Correia
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Carolline Florentino Almeida
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Larissa Silva Carvalho Pena
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Mariane Mares Reis
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Thamara Louisy Santos Brito
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Laís Ferraz Brito
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Guilherme Barreto Campos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Jorge Timenetsky
- Instituto de Ciências Biomédicas, Universidade de São Paulo, Avenida Professor Lineu Prestes, 2415, CEP 05508-900, São Paulo, SP, Brazil
| | - Mariluze Peixoto Cruz
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Rachel Passos Rezende
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil
| | - Carla Cristina Romano
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil
| | - Andréa Miura da Costa
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil.,Departamento de Ciências Biológicas, Laboratório de Microbiologia da Agroindústria, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil
| | - Regiane Yatsuda
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil
| | - Ana Paula Trovatti Uetanabaro
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil.,Departamento de Ciências Biológicas, Laboratório de Microbiologia da Agroindústria, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil
| | - Lucas Miranda Marques
- Programa de Pós-Graduação em Biologia e Biotecnologia de Microrganismos, Pavilhão Max de Menezes, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Salobrinho, Rodovia Jorge Amado, Km 16, CEP 45662-900, Ilhéus, BA, Brazil. .,Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira, Rua Hormindo Barros, 58, CEP 45029-094, Vitória da Conquista, BA, Brazil.
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He Y, Niu X, Wang B, Na R, Xiao B, Yang H. Evaluation of the Inhibitory Effects of Lactobacillus gasseri and Lactobacillus crispatus on the Adhesion of Seven Common Lower Genital Tract Infection-Causing Pathogens to Vaginal Epithelial Cells. Front Med (Lausanne) 2020; 7:284. [PMID: 32637420 PMCID: PMC7317292 DOI: 10.3389/fmed.2020.00284] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/21/2020] [Indexed: 12/17/2022] Open
Abstract
Background/Purpose: Lactobacillus colonization is important to maintain urogenital flora stability and prevent pathogenic infection. Different Lactobacillus species have distinct properties and effects on the urogenital flora. To select probiotics that colonize the vagina and provide protection against pathogenic infection, we evaluated the adhesion of five Lactobacillus strains and their inhibitory effects on the adhesion of pathogens to vaginal epithelial cells (VECs). Methods and Materials: (1) Lactobacillus adhesion experiments: VK2/E6E7 and primary VECs were used to evaluate the adhesion of two Lactobacillus gasseri and three Lactobacillus crispatus strains. The adhesion of these five Lactobacillus strains was compared. (2) Adhesion inhibition experiments: The inhibitory effects of the five Lactobacillus strains on the adhesion of pathogens (Gardnerella, Mobiluncus, Candida albicans, Streptococcus agalactiae, Staphylococcus aureus, Escherichia coli, and Enterococcus faecalis) were evaluated by adhesion exclusion, displacement, and competition experiments. Results: (1) Lactobacillus adhesion was stronger in the primary VECs than in the VK2/E6E7 VECs (P < 0.05). The adhesion of the three L. crispatus strains was stronger than that of the two L. gasseri strains (P < 0.05). L. crispatus 4# showed the strongest adhesion. (2) The exclusion, displacement, and competition experiments showed that all five Lactobacillus strains significantly inhibited the adhesion of the seven pathogenic strains to the VECs (P < 0.05). The displacement effect was stronger than the exclusion and competition effects of each Lactobacillus strain. (3) The results of the exclusion, displacement, and competition experiments indicated that L. gasseri 1# showed the strongest adhesion inhibition of C. albicans and S. agalactiae. L. crispatus 3# showed the strongest adhesion inhibition of S. aureus, whereas L. crispatus 4# showed the strongest adhesion inhibition of Gardnerella, Mobiluncus, E. coli, and E. faecalis. Conclusion: The source of the VECs might not affect the selection of the most adhesive Lactobacillus strain. L. crispatus showed stronger VEC adhesion than L. gasseri. The degree of antagonism of the Lactobacillus strains toward the different pathogens varied. This result provides incentives for personalized clinical treatment.
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Affiliation(s)
- Yuanhui He
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xiaoxi Niu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ben Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Risu Na
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Bingbing Xiao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Huixia Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
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Li T, Liu Z, Zhang X, Chen X, Wang S. Local Probiotic Lactobacillus crispatus and Lactobacillus delbrueckii Exhibit Strong Antifungal Effects Against Vulvovaginal Candidiasis in a Rat Model. Front Microbiol 2019; 10:1033. [PMID: 31139166 PMCID: PMC6519388 DOI: 10.3389/fmicb.2019.01033] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/24/2019] [Indexed: 01/08/2023] Open
Abstract
A comprehensive knowledge of the vaginal ecosystem is critical for the development of successful approaches to the treatment of infections. The role of Lactobacilli in preventing vulvovaginal candidiasis (VVC) is controversial. In this study, we investigated the therapeutic effects and mechanism of Lactobacillus crispatus or delbrueckii on vaginitis caused by Candida albicans in a Sprague–Dawley rat model. A microbiological evaluation was performed by Gram staining and fungal colonies were enumerated. The antifungal efficacy of the two Lactobacillus strains was assessed by hematoxylin and eosin (HE) staining, transmission electron microscopy (TEM), immunohistochemical detection of interferon-γ (IFN-γ), interleukin (IL)-4, IL-17, and epithelial-derived IgG (RP125). Our in vitro results showed that the inhibitory activity against Candida colony-forming unit (CFU) counts was demonstrated by the two Lactobacillus strains (P < 0.001). Our results indicated that Lactobacillus administration played an indispensable role in maintaining the immune homeostasis, and decreasing the Th1/Th2 ratio (IFN-γ/IL-4) by regulating the epithelial secretion of cytokines that inhibit epithelial proinflammatory cytokine release, while increasing epithelial-derived IgG expression (P < 0.05), suggesting antibody-mediated protection. Our results implicate L. crispatus and L. delbrueckii as a potential adjunct biotherapeutic agent in women with VVC, especially for those with drug resistance, adverse effects or contraindications when using antifungal agents. Further large, long-term, well-planned clinical studies should be performed in clinical practice to determine their clinical potential of L. crispatus and L. delbrueckii as an adjunct treatment for VVC.
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Affiliation(s)
- Ting Li
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Liu
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xu Zhang
- Ultrastructural Pathology Center, Peking University First Hospital, Beijing, China
| | - Xi Chen
- Laboratory of Electron Microscopy, Department of Gynecology, Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Suxia Wang
- Laboratory of Electron Microscopy, Department of Gynecology, Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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