Boahen Angela, Than Leslie Thian Lung, Loke Yi-Linn, Chew Shu Yih
Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
Front Microbiol. 2022 May 26;13:787119. doi: 10.3389/fmicb.2022.787119. eCollection 2022.
"Unity in strength" is a notion that can be exploited to characterize biofilms as they bestow microbes with protection to live freely, escalate their virulence, confer high resistance to therapeutic agents, and provide active grounds for the production of biofilms after dispersal. Naturally, fungal biofilms are inherently resistant to many conventional antifungals, possibly owing to virulence factors as their ammunitions that persistently express amid planktonic transition to matured biofilm state. These ammunitions include the ability to form polymicrobial biofilms, emergence of persister cells post-antifungal treatment and acquisition of resistance genes. One of the major disorders affecting vaginal health is vulvovaginal candidiasis (VVC) and its reoccurrence is termed recurrent VVC (RVVC). It is caused by the species which include and . The aforementioned species, notably is a biofilm producing pathogen and habitually forms part of the vaginal microbiota of healthy women. Latest research has implicated the role of fungal biofilms in VVC, particularly in the setting of treatment failure and RVVC. Consequently, a plethora of studies have advocated the utilization of probiotics in addressing these infections. Specifically, the excreted or released compounds of probiotics which are also known as postbiotics are being actively researched with vast potential to be used as therapeutic options for the treatment and prevention of VVC and RVVC. These potential sources of postbiotics are harnessed due to their proven antifungal and antibiofilm. Hence, this review discusses the role of biofilm formation in VVC and RVVC. In addition, we discuss the application of pro-, pre-, post-, and synbiotics either individually or in combined regimen to counteract the abovementioned problems. A clear understanding of the role of biofilms in VVC and RVVC will provide proper footing for further research in devising novel remedies for prevention and treatment of vaginal fungal infections.
“团结就是力量”这一概念可用于描述生物膜，因为生物膜能为微生物提供自由生存的保护，增强其毒力，使其对治疗药物具有高度抗性，并为生物膜分散后重新形成提供活跃场所。自然地，真菌生物膜对许多传统抗真菌药物具有固有抗性，这可能归因于其毒力因子，这些毒力因子在浮游菌向成熟生物膜状态转变过程中持续表达。这些毒力因子包括形成多微生物生物膜的能力、抗真菌治疗后持续存在细胞的出现以及抗性基因的获得。影响阴道健康的主要疾病之一是外阴阴道念珠菌病（VVC），其复发称为复发性外阴阴道念珠菌病（RVVC）。它由包括白色念珠菌和光滑念珠菌在内的物种引起。上述白色念珠菌物种，尤其是白色念珠菌，是一种产生生物膜的病原体，通常是健康女性阴道微生物群的一部分。最新研究表明真菌生物膜在VVC中发挥作用，特别是在治疗失败和RVVC的情况下。因此，大量研究主张使用益生菌来解决这些感染。具体而言，益生菌分泌或释放的化合物（也称为后生元）正在积极研究中，具有作为治疗和预防VVC及RVVC的治疗选择的巨大潜力。这些后生元的潜在来源因其已证实的抗真菌和抗生物膜特性而被利用。因此，本综述讨论了生物膜形成在VVC和RVVC中的作用。此外我们还讨论了单独或联合使用益生元、益生元、后生元和合生元来解决上述问题。清楚了解生物膜在VVC和RVVC中的作用将为进一步研究设计预防和治疗阴道真菌感染的新疗法提供适当基础。
