Research Article <i>Lactobacillus</i> <i>crispatus</i> protects against bacterial vaginosis

Abstract

In medicine, the 20th century was marked by one of the most important revolutions in infectious-disease management, the discovery and increasing use of antibiotics. However, their indiscriminate use has led to the emergence of multidrug-resistant (MDR) bacteria. Drug resistance and other factors, such as the production of bacterial biofilms, have resulted in high recurrence rates of bacterial diseases. Bacterial vaginosis (BV) syndrome is the most prevalent vaginal condition in women of reproductive age, ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 18 (4): gmr18475 M.O. Almeida et al. 2 leading to considerable discomfort. BV can be a consequence of gynecological and obstetric complications, as well as sexually transmitted diseases. Given the decrease in efficiency of antibiotic therapy and high rates of recurrence, probiotics have become promising alternatives for both prevention and treatment of BV, or as an adjuvant to conventional therapy. Currently, Lactobacillus species are the most extensively studied for use as probiotics. Probiotics act through stimulation of the host immune system, competitive exclusion and antimicrobial activity; the latter involves production of substances such as lactic acid, hydrogen peroxide and bacteriocins. Lactobacillus crispatus is considered to be a biomarker of a healthy vaginal tract and is indicated for a probiotic approach to maintaining and restoring of a healthy vaginal ecosystem. Some L. crispatus probiotic strains are already commercially available with encouraging results; however, control of BV syndrome still presents many challenges.

The Effectiveness of Lactobacillus crispatus Probiotics as Prophylactic Therapy for Bacterial Vaginosis Recurrence: A Systematic Review and Meta-analysis

“…Lactobacillus crispatus CTV-05 strain is considered as one of probiotics promising candidates. [13] Lactin-V is the biotechnology product name from L. crispatus CTV-05 in human's vagina which is currently being developed by Osel, Inc (Santa Clara, CA). Lactin-V works to restore Lactobacillus population in vagina on women with BV after conventional use of antibiotics with metronidazole 0,75% gel.…”

“…One of the single strain that has gone through studies was L. crispatus GAI 98332 as recurrence prevention against urinary tract infection (UTI), L. crispatus CTV-05 (LACTIN-V) and L. crispatus IP 174178 (Physioflor) as prevention against BV recurrence. [13] The combination of L. crispatus LMG S-29995, L. brevis, and L. acidophilus probiotics also has proven to be able prevent BV recurrence. [14] Miscellaneous studies with L. crispatus probiotics after antibiotics administration showed recurrence reduction in BV and prolonged time to recurrence.…”

“…[14] Miscellaneous studies with L. crispatus probiotics after antibiotics administration showed recurrence reduction in BV and prolonged time to recurrence. [5,13]…”

Characterization of the first vaginal Lactobacillus crispatus genomes isolated in Brazil

“…This species is considered a biomarker of a healthy microbiota, and some strains are used as a probiotic to treat BV. Its effect as a probiotic is not entirely clear, but it is believed to involve competitive exclusion strategies ( Almeida et al, 2019 ). It was shown to outcompete Gardinerella vaginallis for tissue adhesion in vitro ( Ojala et al, 2014 ) and, as other lactobacilli, inhibit the growth of pathogens in vivo by the production of lactic acid, but not hydrogen peroxide ( Tachedjian, O’Hanlon & Ravel, 2018 ).…”

“…The decrease in L. crispatus is associated with BV, but the causes are not well understood. The differences in persistence and protection among strains is probably influenced by genetic differences that, if described, could be applied in the screening of more efficient probiotic strains ( Almeida et al, 2019 ).…”