Vaginski mikrobiom

Vaginska flora je zastarjeli termin za pojmove vaginska mikrobiota ili vaginski mikrobiom su mikroorganizmi koji koloniziraju vaginu. Otkrio ih je njemački ginekolog Albert Döderlein 1892.^[1] i dio su ukupnog ljudskog mikrobioma. Količina i vrsta prisutnih bakterija imaju značajne implikacije na cjelokupno zdravlje pojedinca.^[2] Primarne kolonizirajuće bakterije zdrave osobe su iz roda Lactobacillus,^[3] kao što je L. crispatus, a smatra se da mliječna kiselina koju proizvode štiti od infekcija patogenim vrstama.^[4]

Laktobacili

Poređenje normalne vaginske i bakterijske vaginozne mikrobiote

Primarne kolonizujuće bakterije zdrave osobe su iz roda Lactobacillus (90-95%), a najčešća su L. crispatus, L. iners, L. jensenii i L. gasseri.^[5] Od prvog Döderleinovog opisa laktobacila, laktobacili se općenito smatraju čuvarima vaginskog ekosistema. Pokazalo se da laktobacili inhibiraju in vitro rast patogenih mikroorganizama, npr. Bacteroides fragilis, Escherichia coli, Gardnerella vaginalis, Mobiluncus spp., Neisseria gonorrhoeae, Peptostreptococcus anaerobius, Prevotella bivia i Staphylococcus aureus. Općenito je prihvaćeno da se to postiže uglavnom djelovanjem mliječne kiseline.^[6]^[7]^[8]^[9] Štaviše, laktobacili obično pomažu u sprječavanju dugotrajne kolonizacije vagine tako što se prianjaju na epitelne ćelije vagine. Ovo obično smanjuje infekciju patogena u vaginski epitel.^[10]

Pored proizvodnje mliječne kiseline i konkurencije za prianjanje, drugi antagonistički mehanizmi uključuju proizvodnju vodik-peroksida (antimikrobni lijek širokog spektra) i bakteriocina (antimikrobni lijekovi specifični za cilj).^[11]^[12]

pH i mliječna kiselina

Glikogen je složeni oblik šećera prisutan u vaginskom epitelu koji se metabolizira u mliječnu kiselinu

Općenito je prihvaćeno da je nizak pH glavni mehanizam koji kontrolira sastav vaginske mikroflore. Iako mliječna kiselina koju proizvode laktobacili doprinosi kiselosti vagine, još uvijek nije dokazano da je primarni izvor niskog vaginskog pH, ali ostaje činjenica da većina laktobacila najbolje uspijeva pri pH < 3,5.^[13]^[14]^[15] Smatra se da je normalan vaginski pH ispod 4,5 sa rasponom od 3,8 do 4,4.^[5]

Također pogledajte

Reference

^ David M (april 2006). "Albert und Gustav Döderlein – ein kritischer Blick auf zwei besondere Lebensläufe deutscher Ordinarien" [Albert and Gustav Döderlein -- a critical view to the biographies of two German professors]. Zentralblatt für Gynakologie (jezik: German). 128 (2): 56–9. doi:10.1055/s-2006-921412. PMID 16673245.CS1 održavanje: nepoznati jezik (link)
^ D'Ippolito S, Di Nicuolo F, Pontecorvi A, Gratta M, Scambia G, Di Simone N (decembar 2018). "Endometrial microbes and microbiome: Recent insights on the inflammatory and immune "players" of the human endometrium". American Journal of Reproductive Immunology. 80 (6): e13065. doi:10.1111/aji.13065. PMID 30375712. S2CID 53114757.
^ Vásquez A, Jakobsson T, Ahrné S, Forsum U, Molin G (august 2002). "Vaginal lactobacillus flora of healthy Swedish women". Journal of Clinical Microbiology. 40 (8): 2746–9. doi:10.1128/JCM.40.8.2746-2749.2002. PMC 120688. PMID 12149323.
^ Witkin SS, Linhares IM, Giraldo P (juni 2007). "Bacterial flora of the female genital tract: function and immune regulation". Best Practice & Research. Clinical Obstetrics & Gynaecology. 21 (3): 347–54. doi:10.1016/j.bpobgyn.2006.12.004. PMID 17215167.
^ ^a ^b Tidbury, Fiona Damaris; Langhart, Anita; Weidlinger, Susanna; Stute, Petra (6. 10. 2020). "Non-antibiotic treatment of bacterial vaginosis—a systematic review". Archives of Gynecology and Obstetrics. Springer Science and Business Media LLC. 303 (1): 37–45. doi:10.1007/s00404-020-05821-x. ISSN 0932-0067. PMID 33025086. S2CID 222149236.
^ Graver MA, Wade JJ (februar 2011). "The role of acidification in the inhibition of Neisseria gonorrhoeae by vaginal lactobacilli during anaerobic growth". Annals of Clinical Microbiology and Antimicrobials. 10: 8. doi:10.1186/1476-0711-10-8. PMC 3045876. PMID 21329492.
^ Matu MN, Orinda GO, Njagi EN, Cohen CR, Bukusi EA (juni 2010). "In vitro inhibitory activity of human vaginal lactobacilli against pathogenic bacteria associated with bacterial vaginosis in Kenyan women". Anaerobe. 16 (3): 210–5. doi:10.1016/j.anaerobe.2009.11.002. PMID 19925874.^{[mrtav link]}
^ Skarin A, Sylwan J (decembar 1986). "Vaginal lactobacilli inhibiting growth of Gardnerella vaginalis, Mobiluncus and other bacterial species cultured from vaginal content of women with bacterial vaginosis". Acta Pathologica et Microbiologica Scandinavica, Section B. 94 (6): 399–403. doi:10.1111/j.1699-0463.1986.tb03074.x. PMID 3494379.
^ Strus, M., M. Malinowska, and P. B. Heczko. 2002. In vitro antagonistic effect of Lactobacillus on organisms associated with bacterial vaginosis. J. Reprod. Med. 47:41–46.
^ Boris S, Barbés C (april 2000). "Role played by lactobacilli in controlling the population of vaginal pathogens". Microbes and Infection. 2 (5): 543–6. doi:10.1016/s1286-4579(00)00313-0. PMID 10865199.
^ Martín R, Suárez JE (januar 2010). "Biosynthesis and degradation of H2O2 by vaginal lactobacilli". Applied and Environmental Microbiology. 76 (2): 400–5. Bibcode:2010ApEnM..76..400M. doi:10.1128/AEM.01631-09. PMC 2805228. PMID 19948869.
^ O'Hanlon DE, Moench TR, Cone RA (juli 2011). "In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide". BMC Infectious Diseases. 11: 200. doi:10.1186/1471-2334-11-200. PMC 3161885. PMID 21771337.
^ Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, et al. (august 2001). "Defense factors of vaginal lactobacilli". American Journal of Obstetrics and Gynecology. 185 (2): 375–9. doi:10.1067/mob.2001.115867. PMID 11518895.
^ Linhares IM, Summers PR, Larsen B, Giraldo PC, Witkin SS (februar 2011). "Contemporary perspectives on vaginal pH and lactobacilli". American Journal of Obstetrics and Gynecology. 204 (2): 120.e1–5. doi:10.1016/j.ajog.2010.07.010. PMID 20832044.
^ Redondo-Lopez V, Cook RL, Sobel JD (1990). "Emerging role of lactobacilli in the control and maintenance of the vaginal bacterial microflora". Reviews of Infectious Diseases. 12 (5): 856–72. doi:10.1093/clinids/12.5.856. PMID 2237129.

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Döderlein's bacteria

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[David2006-1] David M (april 2006). "Albert und Gustav Döderlein – ein kritischer Blick auf zwei besondere Lebensläufe deutscher Ordinarien" [Albert and Gustav Döderlein -- a critical view to the biographies of two German professors]. Zentralblatt für Gynakologie (jezik: German). 128 (2): 56–9. doi:10.1055/s-2006-921412. PMID 16673245.CS1 održavanje: nepoznati jezik (link)

[Vaginal_Microbiome-2] D'Ippolito S, Di Nicuolo F, Pontecorvi A, Gratta M, Scambia G, Di Simone N (decembar 2018). "Endometrial microbes and microbiome: Recent insights on the inflammatory and immune "players" of the human endometrium". American Journal of Reproductive Immunology. 80 (6): e13065. doi:10.1111/aji.13065. PMID 30375712. S2CID 53114757.

[doi10.1128/JCM.40.8.2746-2749.2002-3] Vásquez A, Jakobsson T, Ahrné S, Forsum U, Molin G (august 2002). "Vaginal lactobacillus flora of healthy Swedish women". Journal of Clinical Microbiology. 40 (8): 2746–9. doi:10.1128/JCM.40.8.2746-2749.2002. PMC 120688. PMID 12149323.

[witkin2012-4] Witkin SS, Linhares IM, Giraldo P (juni 2007). "Bacterial flora of the female genital tract: function and immune regulation". Best Practice & Research. Clinical Obstetrics & Gynaecology. 21 (3): 347–54. doi:10.1016/j.bpobgyn.2006.12.004. PMID 17215167.

[Tidbury_Langhart_Weidlinger_Stute_2021_pp._37–45-5] Tidbury, Fiona Damaris; Langhart, Anita; Weidlinger, Susanna; Stute, Petra (6. 10. 2020). "Non-antibiotic treatment of bacterial vaginosis—a systematic review". Archives of Gynecology and Obstetrics. Springer Science and Business Media LLC. 303 (1): 37–45. doi:10.1007/s00404-020-05821-x. ISSN 0932-0067. PMID 33025086. S2CID 222149236.

[6] Graver MA, Wade JJ (februar 2011). "The role of acidification in the inhibition of Neisseria gonorrhoeae by vaginal lactobacilli during anaerobic growth". Annals of Clinical Microbiology and Antimicrobials. 10: 8. doi:10.1186/1476-0711-10-8. PMC 3045876. PMID 21329492.

[7] Matu MN, Orinda GO, Njagi EN, Cohen CR, Bukusi EA (juni 2010). "In vitro inhibitory activity of human vaginal lactobacilli against pathogenic bacteria associated with bacterial vaginosis in Kenyan women". Anaerobe. 16 (3): 210–5. doi:10.1016/j.anaerobe.2009.11.002. PMID 19925874.^{[mrtav link]}

[Skarin-8] Skarin A, Sylwan J (decembar 1986). "Vaginal lactobacilli inhibiting growth of Gardnerella vaginalis, Mobiluncus and other bacterial species cultured from vaginal content of women with bacterial vaginosis". Acta Pathologica et Microbiologica Scandinavica, Section B. 94 (6): 399–403. doi:10.1111/j.1699-0463.1986.tb03074.x. PMID 3494379.

[9] Strus, M., M. Malinowska, and P. B. Heczko. 2002. In vitro antagonistic effect of Lactobacillus on organisms associated with bacterial vaginosis. J. Reprod. Med. 47:41–46.

[Boris-10] Boris S, Barbés C (april 2000). "Role played by lactobacilli in controlling the population of vaginal pathogens". Microbes and Infection. 2 (5): 543–6. doi:10.1016/s1286-4579(00)00313-0. PMID 10865199.

[Martin1-11] Martín R, Suárez JE (januar 2010). "Biosynthesis and degradation of H2O2 by vaginal lactobacilli". Applied and Environmental Microbiology. 76 (2): 400–5. Bibcode:2010ApEnM..76..400M. doi:10.1128/AEM.01631-09. PMC 2805228. PMID 19948869.

[O'Hanlon1-12] O'Hanlon DE, Moench TR, Cone RA (juli 2011). "In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide". BMC Infectious Diseases. 11: 200. doi:10.1186/1471-2334-11-200. PMC 3161885. PMID 21771337.

[Aroutcheva-13] Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, et al. (august 2001). "Defense factors of vaginal lactobacilli". American Journal of Obstetrics and Gynecology. 185 (2): 375–9. doi:10.1067/mob.2001.115867. PMID 11518895.

[14] Linhares IM, Summers PR, Larsen B, Giraldo PC, Witkin SS (februar 2011). "Contemporary perspectives on vaginal pH and lactobacilli". American Journal of Obstetrics and Gynecology. 204 (2): 120.e1–5. doi:10.1016/j.ajog.2010.07.010. PMID 20832044.

[15] Redondo-Lopez V, Cook RL, Sobel JD (1990). "Emerging role of lactobacilli in the control and maintenance of the vaginal bacterial microflora". Reviews of Infectious Diseases. 12 (5): 856–72. doi:10.1093/clinids/12.5.856. PMID 2237129.

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