Abstract
Lactobacillus species are the predominant vaginal microbiota found in healthy women of reproductive age and help to prevent pathogen infection by producing lactic acid, H2O2 and anti-microbial compounds. Identification of novel vaginal Lactobacillus isolates that exhibit efficient colonisation and secrete anti-Candida factors is a promising strategy to prevent vulvovaginal candidiasis. The azole antifungal agents used to treat vulvovaginal candidiasis elicit adverse effects such as allergic responses and exhibit drug interactions. Candida strains with resistance to antifungal treatments are often reported. In this study, we isolated Lactobacillus species from healthy Korean women and investigated their antifungal effects against C. albicans in vitro and in vivo. Lactobacillus conditioned supernatant (LCS) of L. crispatus and L. fermentum inhibited C. albicans growth in vitro. A Lactobacillus-derived compound, which was not affected by proteolytic enzyme digestion and heat inactivation, inhibited growth and hyphal induction of C. albicans after adjustment to neutral pH. Combination treatment with neutral LCSs of L. crispatus and L. fermentum effectively inhibited propagation of C. albicans in a murine in vivo model of vulvovaginal candidiasis.
Highlights
Lactobacillus species are the predominant vaginal microbiota found in healthy women of reproductive age and inhibit pathogen growth by producing lactic acid, H2O2 and anti-microbial compounds[1,2,3]
L. iners and L. crispatus were the most abundant species in daughters, while the bacterial community was heterogenous in mothers
We investigated the effect of the Lactobacillus conditioned supernatant (LCS) from L. fermentum SNUV175 and L. crispatus SNUV220 on hyphal induction (Fig. 5A)
Summary
Lactobacillus species are the predominant vaginal microbiota found in healthy women of reproductive age and inhibit pathogen growth by producing lactic acid, H2O2 and anti-microbial compounds[1,2,3]. The abundance of Gardnerella or Ureaplasma species, which is related to the risk of preterm birth, is elevated in bacterial communities in which Lactobacillus species are lowly abundant[7]. These findings imply that Lactobacillus species in the vagina are important for preventing infection, clearing pathogenic microbes and modulating inflammation. The risk factors for vulvovaginal candidiasis include hormonal changes, an immunocompromised state, pregnancy and antibiotic exposure[8] Antifungal medications, such as clotrimazole and fluconazole, are used to treat C. albicans infections[9]. Identification of vaginal Lactobacillus species that produce an anti-Candida factor is a potential innovative strategy to prevent vulvovaginal candidiasis[8]. We isolated and characterised vaginal lactobacilli from healthy Korean women and investigated their anti-Candida activity and preventative effect on vulvovaginal candidiasis in vitro and in vivo
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