近期对阴道微环境多方面变化的理解进展:对阴道健康和治疗的影响。

Recent advances in understanding of multifaceted changes in the vaginal microenvironment: implications in vaginal health and therapeutics.

机构信息

Division of Life Science, Institute of Advanced Study in Science and Technology, Guwahati, India.

Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, India.

出版信息

Crit Rev Microbiol. 2023 Mar;49(2):256-282. doi: 10.1080/1040841X.2022.2049696. Epub 2022 Mar 21.

Abstract

The vagina endures multifaceted changes from neonatal to menopausal phases due to hormonal flux, metabolite deposition, and microbial colonization. These features have important implications in women's health. Several pre-factors show dynamic characteristics according to the phases that shift the vaginal microbiota from anaerobes to aerobes which is a hallmark of healthy vaginal environment. These factors include oestrogen levels, glycogen deposition, and vaginal microstructure. In the adult phase, is highly dominant and regulates pH, adherence, aggregation, immune modulation, synthesis of bacteriocins, and biosurfactants (BSs) which are antagonistic to pathogens. Maternal factors are protective by favouring the colonization of lactobacilli in the vagina in the neonatal phase, which diminishes with age. The dominance of lactobacilli and dysbiosis in the adult phase depends on intrinsic and extrinsic factors in women, which vary between ethnicities. Recent developments in probiotics used against vaginal microbiome dysbiosis have shown great promise in restoring the normal microbiota including preventing the loss of beneficial bacteria. However, further in-depth studies are warranted to ensure long-term protection by probiotics. This review highlights various aspects of the vaginal microenvironment in different phases of growth and diverse ethnicities. Furthermore, it discusses future trends for formulating more effective population-specific probiotics and implications of paraprobiotics and postbiotics as effective therapeutics.

摘要

由于激素波动、代谢物沉积和微生物定植,阴道在从新生儿期到绝经期经历多方面的变化。这些特征对女性健康具有重要意义。有几个前因子根据改变阴道微生物群从厌氧菌到需氧菌的阶段表现出动态特征,这是健康阴道环境的标志。这些因素包括雌激素水平、糖原沉积和阴道微观结构。在成年期,乳杆菌高度占优势,并调节 pH 值、粘附、聚集、免疫调节、细菌素和生物表面活性剂 (BSs) 的合成,这些物质对病原体具有拮抗作用。母体因素通过有利于乳酸杆菌在新生儿期在阴道中的定植而具有保护作用,随着年龄的增长而减少。成年期乳杆菌的优势和失调取决于女性的内在和外在因素,这些因素在不同种族之间有所不同。最近在益生菌用于阴道微生物失调的研究显示,恢复正常微生物群,包括防止有益细菌的丧失,具有很大的前景。然而,需要进一步深入的研究来确保益生菌的长期保护作用。本综述强调了不同生长阶段和不同种族阴道微环境的各个方面。此外,还讨论了针对特定人群制定更有效的益生菌的未来趋势,以及副生素和后生菌素作为有效治疗方法的意义。

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