Yano Junko, Langdon Kimberly, Swor Michael, Noverr Mairi C, Fidel Paul L
Department of Oral and Craniofacial Biology, School of Dentistry, LSU Health, New Orleans, Louisiana, USA.
Coologics, Inc., Cleveland, Ohio, USA.
J Infect Dis. 2025 Apr 15;231(4):e813-e821. doi: 10.1093/infdis/jiaf028.
Vulvovaginal candidiasis (VVC), caused primarily by Candida albicans, is treated with anti-fungal drugs, often with variable efficacy and relapses. New therapeutic strategies, including drug-free alternatives, are needed. Upon overgrowth or environmental triggers, C. albicans commensal yeast transitions into hyphae resulting in an aberrant immunopathologic neutrophil response that contributes to the characteristic signs and symptoms of vaginitis. The purpose of this study was to evaluate the efficacy of an intravaginal cooling device (Vlisse) in women with VVC to provide symptom relief via putative reversal of C. albicans hyphae to yeast, with additional proof of principle in an animal model.
Five women with VVC were instructed to use the device twice daily for 3 days. Vulvovaginal symptoms were monitored and scored for each use, followed by pelvic examination at 30 days. A mouse model of VVC employed cooled micro stir rods to evaluate the cooling effect on fungal morphology and vaginal immunopathology.
Clinical cure was achieved in all women. In the mouse model, the insertion of pre-cooled magnetic rods intravaginally for short periods over 3 days, reduced the immunopathogenic neutrophil infiltration and hyphae.
Intravaginal cooling provides clinical cure for VVC and proof of principle in an animal model.
外阴阴道念珠菌病（VVC）主要由白色念珠菌引起，通常使用抗真菌药物治疗，但其疗效往往因人而异且易复发。因此需要新的治疗策略，包括无药物替代方案。在过度生长或环境触发因素作用下，共生的白色念珠菌酵母会转变为菌丝，导致异常的免疫病理中性粒细胞反应，进而引发阴道炎的典型体征和症状。本研究的目的是评估一种阴道内冷却装置（Vlisse）对VVC女性患者的疗效，即通过使白色念珠菌菌丝逆转回酵母状态来缓解症状，并在动物模型中提供额外的原理验证。
五名VVC女性患者被指导每天使用该装置两次，持续3天。每次使用后监测并记录外阴阴道症状评分，30天时进行盆腔检查。VVC小鼠模型采用冷却的微型搅拌棒来评估冷却对真菌形态和阴道免疫病理学的影响。
所有女性患者均实现临床治愈。在小鼠模型中，连续3天短时间经阴道插入预冷的磁棒，可减少免疫病理中性粒细胞浸润和菌丝。
阴道内冷却可为VVC提供临床治愈效果，并在动物模型中验证其原理。
