Candida autovaccination in the treatment of vulvovaginal Candida infections

Abstract

Vulvovaginal candidiasis (VVC) is a prevalent opportunistic infection, caused by Candida spp., predominately C. albicans. An estimated 75% of all women will experience an episode of VVC in their lifetime. The most frequent factors associated with VVC are related to life style e.g. synthetic fabric underwear, vaginal douching and biking. Recurrent episodes of VVC (RVVC) infections are reported in 40 to 50% of cases, while 5 to 8% experience chronic Candida infections [1]. The standard treatment for VVC is the use of antimycotics. However, the relapse rate is high. A possible alternative treatment of VVC is the use of specific autovaccines. Autovaccines or autogenous vaccines are prepared from microorganisms harbored by the patient. Autovaccine treatment has a long tradition and was first quoted by Sir Almroth E. Wright, a pioneer of vaccination [2]. Autovaccines are nowadays in common use within naturopathy and the veterinary medical community, for treating chronic infectious diseases. In contrast to preventive vaccines, autovaccines are exclusively usedinthe treatmentof an ongoinginfection and can therefore be considered as therapeutic vaccines. Vaginal samples were collected from ten patients diagnosed with VVC. Specific Candida autovaccines were prepared by SymbioVaccin (Herborn, Germany). Following the treatment period of 8 weeks nine out of the ten women showed an improvement of symptoms and clinical findings (Table 1). Two of the ten women were tested positive for Candida spp. However, only one reported the symptoms to persist. Although autovaccine therapy has a long medical history, autovaccination sank into oblivion due to the achievements in antimicrobial therapies. The active principle of autovaccination can only be speculated upon, as animal models are lacking and publications are scarce. Rusch et al. reported that autovaccines were able to modulate the release of three potent immunoregulatory cytokines (IFN-γ, granulocyte-macrophage-colony stimulating factor, IL-1β) significantly, whereas specific humoral immunity remained largely unaffected [3]. Thus, it may be concluded that autovaccines mainly act on the cytokine level rather than inducing specific protection. A study with promising effects of autovaccination was published by Zaluga [4]. Therein, the authors reported on the successful treatment of acne with a specific autovaccine directed against Propionibacterium acnes. Candida autovaccines may be a potent alternative in the treatment of vulvovaginal Candida infections. However, due to the small number of subjects and the lack of a control group, this treatment warrants further investigation.