Literaturni pregled vaginalnih laktobacilov za zdravljenje vaginalnih infekcij in izolacija novih bakterijskih sevov

Miklavc, Anja (avtor), Zupančič, Špela (mentor), Jeverica, Samo (komentor)

Vaginalna mikrobiota (VMB) je sestavljena iz milijarde mikrobov. Najštevilčnejši predstavniki so bakterije rodu Lactobacillus. Pri zmanjšanju števila laktobacilov se pojavi disbioza, ki lahko vodi v nastanek bakterijske vaginoze (BV) ali vulvovaginalne kandidaze (VVC). Ti obolenji najpogosteje pestita ženske v rodni dobi in povzročata neprijetno, v nekaterih primerih nevarno simptomatiko. Konvencionalna terapija za BV in VVC so antibiotiki oziroma antimikotiki. Obe bolezni imata visok odstotek ponavljajočih se epizod, ki zmanjšujejo kvaliteto življenja bolnic. V izogib kronični uporabi antibiotikov in antimikotikov se za zdravljenje BV in VVC raziskujejo probiotiki za lokalno aplikacijo. V okviru magistrske naloge smo preučili raziskave na področju lokalne uporabe laktobacilov za zdravljenje ali preprečevanje vaginalnih okužb. Dodatno smo izvedli tudi laboratorijsko izolacijo in identifikacijo laktobacilov iz brisov nožnic. Izvedli smo literaturni pregled o vaginalnih laktobacilih v treh sklopih: a) izolacija in karakterizacija, b) formulacijske študije ter c) študije in vivo. Podatke smo iskali v treh različnih podatkovnih bazah ter obravnavali objave tipa klinična študija ali znanstveni članek v angleškem jeziku, objavljene do novembra 2022. V laboratoriju smo brise nožnic nacepili na krvni agar in posamične vrste mikrobov prečistili. Vrste izoliranih laktobacilov smo določili z MALDI-TOF MS. Iz vseh treh podatkovnih baz smo skupno pridobili 1265 zadetkov, od katerih je bilo le 88 objav ustreznih; 40 objav je obravnavalo izolacijo in karakterizacijo laktobacilov, 6 je bilo formulacijskih študij, 42 objav pa je zajemalo testiranja in vivo. V mikrobiološkem laboratoriju smo iz brisov nožnic 127 zdravih prostovoljk izolirali L. crispatus (31 %), L. jensenii (30 %), L. gasseri (17 %), L. iners (11 %), L. vaginalis (7 %), L. rhamnosus (1 %), L. coleohominis (1 %), L. fermentum (1 %) in L. plantarum (1 %). Zbrani literaturni podatki kažejo, da se metode izolacije laktobacilov skozi čas niso spreminjale, medtem ko smo pri identifikaciji opazili velik premik k uporabi genotipskih in spektroskopskih metod. Razvoj novih dostavnih sistemov za lokalno aplikacijo probiotikov pa poteka predvsem v smeri uporabe nanovlaken. V kliničnih študijah so za zdravljenje BV in VVC najbolj preučevali L. rhamnosus. Pri našem laboratorijskem delu smo opazili sevno specifičnost morfologij kolonij. VMB prostovoljk se je ujemala z literaturnimi podatki sestave zdravih VMB pripadnic belske populacije.

• Jezik: Slovenski jezik
• Ključne besede: probiotiki, Lactobacillus, BV, VVC, literaturni pregled, izolacija novih sevov
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: FFA - Fakulteta za farmacijo
• Leto izida: 2024
• PID: 20.500.12556/RUL-158517
• Datum objave v RUL: 14.06.2024

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: A literature review of vaginal lactobacilli for vaginal infections treatment and isolation of new bacterial strains

Izvleček

Vaginal microbiota (VMB) is composed of billions of microbes, with the most abundant representatives belonging to the Lactobacillus genus. Reduction in the number of lactobacilli can lead to dysbiosis, potentially resulting in bacterial vaginosis (BV) or vulvovaginal candidiasis (VVC). These conditions predominantly affect women of reproductive age, causing uncomfortable symptoms and, in some cases, pose greater health risks. Conventional therapies for BV and VVC involve antibiotics or antifungals. Both conditions exhibit a high rate of recurring episodes, which decreases the quality of life of the affected individuals. To avoid chronic use of antibiotics and antifungals, the use of probiotics for local administration for treatment of BV and VVC is being researched. As part of our master's thesis, our aim was to review scientific literature on the local use of lactobacilli for the treatment or prevention of vaginal infections. Additionally, we conducted laboratory isolation and identification of lactobacilli from vaginal swabs. We conducted a literature review of vaginal lactobacilli in three sections: a) isolation and characterization, b) formulation studies, and c) in vivo studies. Searches were performed in three different databases. The review only included clinical studies or scientific articles in English, published by November 2022. In the laboratory, vaginal swabs were inoculated onto blood agar and the individual species were purified. The isolated lactobacilli were identified using MALDI-TOF MS. A total of 1265 articles were obtained, of which only 88 publications were deemed relevant. 40 articles addressed the isolation and characterization of lactobacilli, 6 were formulation studies, and 42 included in vivo testing. In the laboratory, we isolated L. crispatus (31%), L. jensenii (30%), L. gasseri (17%), L. iners (11%), L. vaginalis (7%), L. rhamnosus (1%), L. coleohominis (1%), L. fermentum (1%), and L. plantarum (1%) from vaginal swabs of 127 healthy volunteers. Lactobacilli isolation methods have remained unchanged over time, while there has been a significant shift towards genotypic and spectroscopic methods in identification. The development of new delivery systems for local application of probiotics is mainly directed towards nanofibers. L. rhamnosus has been the most extensively studied probiotic for treating BV and VVC in clinical trials. We observed strain-specific colony morphologies. The VMB of volunteers matched literature data on the composition of healthy VMB in Caucasian women.

• Ključne besede: probiotics, Lactobacillus, BV, VVC, literature review, isolation of new strains