Lobo Maria, Cerqueira Catarina, Rodrigues Acácio Gonçalves, Lisboa Carmen
RISE-Health, Department of Pathology, Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Department of Dermatology and Venereology, ULS Braga, 4710-243 Braga, Portugal.
J Fungi (Basel). 2025 May 5;11(5):357. doi: 10.3390/jof11050357.
Recurrent vulvovaginal candidosis (RVVC), defined as three or more episodes of vulvovaginal candidosis (VVC) within a 12-month period, is a common and debilitating condition that affects a significant percentage of reproductive-aged women, negatively impacting their quality of life. This review aimed to synthesize the most recent scientific data on the pathophysiological mechanisms triggering primary or idiopathic RVVC. Three databases (PubMed, Scopus, and Web of Science) were searched for studies published between 2014 and 2024. Twelve studies were included, covering prospective cohort, cross-sectional, and case-control studies conducted in different countries. The results indicate that recurrence may be related to both intrinsic characteristics of the pathogen, such as increased virulence attributes of spp., and host immune system dysregulation, including alterations in Th1/Th17 and Th2/Treg cytokine levels, decreased levels of mannose-binding lectin (MBL), impaired neutrophil and lymphocyte function, and overexpression of CD163+ macrophages and NLRP3 inflammasome. Additionally, genetic factors, such as polymorphisms in the , , , and genes, are associated with increased susceptibility to RVVC. In conclusion, RVVC appears to involve a complex interaction between pathogen virulence and an altered host immune response, which reinforces the need for further investigations to develop personalized therapeutic strategies.
复发性外阴阴道念珠菌病（RVVC）定义为在12个月内发生三次或更多次外阴阴道念珠菌病（VVC），是一种常见且使人衰弱的疾病，影响着相当比例的育龄妇女，对她们的生活质量产生负面影响。本综述旨在综合关于引发原发性或特发性RVVC的病理生理机制的最新科学数据。检索了三个数据库（PubMed、Scopus和Web of Science）中2014年至2024年发表的研究。纳入了12项研究，涵盖在不同国家进行的前瞻性队列研究、横断面研究和病例对照研究。结果表明，复发可能与病原体的内在特征有关，如某些菌种的毒力属性增加，也与宿主免疫系统失调有关，包括Th1/Th17和Th2/Treg细胞因子水平的改变、甘露糖结合凝集素（MBL）水平降低、中性粒细胞和淋巴细胞功能受损以及CD163+巨噬细胞和NLRP3炎性小体的过度表达。此外，基因因素，如某些基因的多态性，与RVVC易感性增加有关。总之，RVVC似乎涉及病原体毒力与宿主免疫反应改变之间的复杂相互作用，这进一步强调了开展进一步研究以制定个性化治疗策略的必要性。
