In this review, the composition and regulation of vaginal microbiome that displays an apparent
microbial diversity and interacts with other microbiota in the body are presented. The role of nitric
oxide (NO) in the regulation of vaginal microflora in which lactobacillus species typically dominate
has been delineated from the perspective of maintaining gynecologic ecosystem and prevention of
onset of bacteriostatic vaginosis (BV) and/or sexually transmitted diseases (STD) including HIV-1
transmission. The interactions between NO and vaginal microbiome and its influence on the levels of
Lactobacillus, hormones and other components are described. The recent progress, such as NO drugs,
probiotic Lactobacilli and Lactobacillus microbots, that can be explored to alleviate abnormality of
vagina microbiome, is also discussed. An identification of Oral-GI-Vagina axis, as well as the
relationship between NO and Lactobacillus regulation in the healthy or pathological status of vagina
microbiome, surely offers the advanced drug delivery option against BV or STD including AIDS.
Mucosal tissues are often a desirable site of drug action to treat disease and engage the immune system. However, systemically administered drugs suffer from limited bioavailability in mucosal tissues where technologies to enable direct, local delivery to these sites would prove useful. In this Spotlight on Applications article, we discuss hydrogels as an attractive means for local delivery of therapeutics to address a range of conditions affecting the eye, nose, oral cavity, gastrointestinal, urinary bladder, and vaginal tracts. Considering the barriers to effective mucosal delivery, we provide an overview of the key parameters in the use of hydrogels for these applications. Finally, we highlight recent work demonstrating their use for inflammatory and infectious diseases affecting these tissues.
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