Abstract
Women’s intimate health depends on several factors, such as age, diet, coexisting metabolic disorders, hormonal equilibrium, sexual activity, drug intake, contraception, surgery, and personal hygiene. These factors may affect the homeostasis of the internal environment of the genital tract: the vulva, vagina and cervix. This equilibrium is dependent on strict and complex mutual interactions between epithelial cells, immunocompetent cells and microorganisms residing in this environment. The microbiota of the genital tract in healthy women is dominated by several species of symbiotic bacteria of the Lactobacillus genus. The bacteria inhibit the growth of pathogenic microorganisms and inflammatory processes by virtue of direct and multidirectional antimicrobial action and, indirectly, by the modulation of immune system activity. For the homeostasis of the genital tract ecosystem, antimicrobial and anti-inflammatory peptides, as well as proteins secreted by mucus cells into the cervicovaginal fluid, have a fundamental significance. Of these, a multifunctional protein known as lactoferrin (LF) is one of the most important since it bridges innate and acquired immunity. Among its numerous properties, particular attention should be paid to prebiotic activity, i.e., exerting a beneficial action on symbiotic microbiota of the gastrointestinal and genital tract. Such activity of LF is associated with the inhibition of bacterial and fungal infections in the genital tract and their consequences, such as endometritis, pelvic inflammation, urinary tract infections, miscarriage, premature delivery, and infection of the fetus and newborns. The aim of this article is to review the results of laboratory as well as clinical trials, confirming the prebiotic action of LF on the microbiota of the lower genital tract.
Highlights
Published: 17 December 2021The genital tract encompasses the uterine cervix, vagina, and vulva (Figure 1A)
Probiotics, predominantly various Lactobacillus strains, are effective in the prophylaxis and therapy of dysbiosis and inflammation of the genital tract. Their efficacy may be improved by the concurrent application of prebiotics. These preparations act in a beneficial manner on the growth and activity of endogenous microbiota, as well as exogenous probiotic bacteria [18,65]
The prebiotic property is exhibited by lactoferrin—
Summary
The genital tract encompasses the uterine cervix, vagina, and vulva (Figure 1A). Its main role is to accept spermatozoa during insemination, as well as to expel the fetus and placenta during delivery and the exfoliated endometrium at the time of menstruation. We know that the restoration of the homeostasis of this complex ecosystem is crucial in the therapy of infections and inflammation of the genital tract This goal can be achieved through the application of probiotic bacteria that assist the growth of beneficial vaginal microorganisms. Numerous symbiotic bacteria reside (mainly several genera from Lactobacillus spp.) that metabolize glycogen into lactic acid, which renders the genital tract environment acidic (~pH 3.5–4.5). Via numerous investigations, 20 various physiological roles of LF have been confirmed [5,6,7,8,9,10,11] One of these is a prebiotic action on beneficial bacteria in the gastrointestinal and genital tract [2,12]. LF, through normalization of the genital tract ecosystem, allows infection and inflammation to be overcome and protects against complications in pregnancy, such as abortion or premature delivery
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