Probiotyki z estriolem w terapii ostrych oraz nawrotowych zakażeń pochwy i sromu u kobiet Artykuł przeglądowy
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Opublikowane:
gru 31, 2021
Słowa kluczowe:
mikroflora pochwy, mikrobom, menopauza, probiotyki, hormonoterapia, antybiotykoterapia
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Abstrakt
W różnych okresach życia kobiety mikrobiom ulega zmianom jakościowym oraz ilościowym, a ich charakter wynika z licznych czynników, takich jak: wiek, aktywność seksualna, choroby współistniejące itd. W ich efekcie w pochwie może dochodzić do suchości pochwy i jej zapaleń. Problem ten jest szczególnie nasilony w okresie menopauzy, kiedy następuje zmniejszenie wydzielania estrogenów, co indukuje kaskadę niekorzystnych zjawisk biologicznych. Można mu zapobiegać przez dodanie do standardowej w menopauzie hormonoterapii probiotyków, które zapewnią odbudowę i utrzymanie właściwego stanu mikrobiologicznego pochwy. Zastosowanie probiotyków zmniejsza ryzyko rozwoju dolegliwości wymagających antybiotykoterapii, która jest również niekorzystna dla mikrobiomu pochwy.
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Jak cytować
Tomaszewski, J. (2021). Probiotyki z estriolem w terapii ostrych oraz nawrotowych zakażeń pochwy i sromu u kobiet. Medycyna Faktów , 14(4(53), 393-399. https://doi.org/10.24292/01.MF.0421.Y
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Bibliografia
1. Goldin BR, Gorbach SL. Clinical indications for probiotics: an overview. Clin Infect Dis. 2008; 46: 96-100.
2. Pines A. Microbiotica in women. Climacteric. 2015; 18: 1-3.
3. Borges S, Silva J, Teixeira P. The role lactobacilli and probiotics in maintaining vaginal health. Arch Gynecol Obstet. 2014; 289: 479-89.
4. Macklaim JM, Clemente JC, Knight R et al. Changes in vaginal microbiota following antimicrobial and probiotic therapy. Microb Ecol Health Dis. 2015; 26: 27799. http://doi.org/10.3402/mehd.v26.27779.
5. O’Hanlon DE, Lanier BR, Moench TR et al. Cervicovaginal fluid and semen block the microbicidal activity of hydrogen peroxide produced by vaginal lactobacilli. BMC Infect Dis. 2010; 10: 1-8.
6. Karaoglu SA, Aydin F, Kilic SS et al. Antimicrobial activity and characteristics of bacteriocins produced by vaginal lactobacilli. Turk J Med Sci. 2002; 33: 7-13.
7. Luthje P, Hirschberg AL, Brauner A. Estrogenic action on innate defense mechanism in the urinary tract. Maturitas. 2014; 77: 32-6.
8. Galhardo CK, Soares JM Jr, Simoes RS et al. Estrogen effects on the vaginal pH, flora nad cytology in late postmenopause after a long period without hormone therapy. Clin Exp Obstet Gynecol. 2006; 33: 85-9.
9. Brotman RM, Shardell MD, Gajer P et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2014; 21: 450-8.
10. Hummelen R, Macklaim JM, Bisanz JE et al. Vaginal microbiome and epithelial gene array in post-menopasusal women with moderate to severe dryness. PLoS One. 2011; 6: e26602.
11. Reid G, Bruce AW. Selection of Lactobacillus strains for urogenital probiotic applications. J Infect Dis. 2001; 183: 77-80.
12. Reid G, Beuerman D, Heinemann C et al. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol Med Microbiol. 2001; 32: 37-41.
13. Ngugi BM, Hemmerling A, Bukusi EA et al. Effects of bacterial vaginosis – associated bacteria and sexual intercourse on vaginal colonization with the probiotic Lactobacillus crispatus CTV-05. Sex Transm Dis. 2011; 38: 1020-7.
14. Alvarez-Olmos MI, Barousse MM, Rajan L et al. Vaginal lactobacilli in adolescents: presence and relationship to local and systemic immunity, and to bacterial vaginosis. Sex Transm Dis. 2004; 31: 393-400.
15. Andersson H, Asp NG, Bruce A et al. Health effects of probiotics and prebiotics: a literature review on human studies. Food Nutr Res. 2001; 45: 58-75.
16. Karlsson M, Scherbak N, Khalaf H et al. Substances released from probiotic Lactobacillus rhamnosus GR-1 potentiate NF-κB activity in Escherichia coli-stimulated urinary bladder cells. FEMS Immunol Med Microbiol. 2012; 66(2): 147-56. http://doi.org/10.1111/j.1574-695X.2012.00994.x.
17. Wagner RD, Johnson SJ. Probiotic lactobacillus and estrogen effects on vaginal epithelial gene expression responses to Candida albicans. J Biomed Sci. 2012: 19: 58.
18. Pendharkar S, Brandsborg E, Hammarstrom L et al. Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection. BMC Infect Dis. 2015; 15: 255. http://doi.org/10.1186/212879-015-0971-3.
19. Parent D, Bossens M, Bayot D et al. Therapy of bacterial vaginosis using exogenously-applied Lactobacillus aciophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneimittelforschung. 1996; 46: 68-73.
20. Gardiner GE, Heinemann C, Baroja ML et al. Oral administration of the probiotic combination Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 for human intestinal applications. Int Dairy J. 2002; 12: 191-6.
21. Donders G, Bellen G, Neven P et al. Effect of ultra-low-dose estriol and lactobacilli vaginal tablets (Gynoflor) on inflammatory and infectious markers of the vaginal ecosystem in postmenopausal women with breast cancer on aromatase inhibitors. Eur J Clin Microbiol Infect Dis. 2015; 34: 2023-8.
22. Ashcroft GS, Ashworth JJ. Potential role of estrogens in wound healing. Am J Clin Dermatol. 2003; 4: 737-43.
23. Ashcroft GS, Dodsworth J, van Boxtel E et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-beta 1 levels. Nature Med. 1997; 3: 1209-15.
24. Ashcroft GS, Greenwell-Wild T, Horan MA et al. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol. 1999; 155: 1137-46.
25. Engeland CG, Sabzehei B, Marucha PT. Sex hormones and mucosal healing. Brain Behav Immun. 2009; 23: 629-35.
26. Archer DF. Postmenopausal skin and estrogen. Gynecol Endocrinol. 2012; 28: 2-6.
27. Sator PG, Schmidt JB, Rabe T et al. Skin aging and sex hormones in women – clinical perspectives for intervention by hormone replacement therapy. Exp Dermatol. 2004; 13: 36-40.
28. Sator PG, Schmidt JB, Sator MO et al. The influence of hormone replacement therapy on skin ageing: a pilot study. Maturitas. 2001; 39: 43-55.
29. Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci. 2005; 38: 1-7.
30. Fujimoto J, Hori M, Ichigo S et al. Ovarian steroids regulate the expression of basic fibroblast growth factor and its mRNA in fibroblasts derived from uterine endometrium. Ann Clin Biochem. 1997; 34: 91-6.
31. Kovacs EJ, Duffner LA, Plackett TP. Immunosuppression after injury in aged mice is associated with a TH1-TH2 shift, which can be restored by estrogen treatment. Mech Ageing Dev. 2004; 125: 121-3.
32. Kovacs EJ, Messingham KA, Gregory MS. Estrogen regulation of immune responses after injury. Mol Cell Endocrinol. 2002; 193: 129-35.
33. Kovacs EJ, Plackett TP, Witte PL. Estrogen replacement, aging, and cell-mediated immunity after injury. J Leukoc Biol. 2004; 76: 36-41.
34. Rechberger T, Adamiak A, Skorupski P et al. Collagen metabolism in women suffering from stress urinary incontinence. Polish J Gynecol Invest. 1999; 2: 21-4.
35. Rechberger T, Postawski K, Jakowicki JA et al. Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol. 1998; 179: 1511-4.
36. Falconer C, Ekman G, Malmstrom A et al. Decreased collagen synthesis in stress-incontinent women. Obstet Gynecol. 1994; 84: 583-6.
37. Jackson S, James M, Abrams P. The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG. 2002; 109: 339-44.
38. Jackson S, Shepherd A, Brookes S et al. The effect of oestrogen supplementation on post-menopausal urinary stress incontinence: a double-blind, placebo-controlled trial. Br J Obstet Gynaecol. 1999; 106: 711-8.
39. Moalli PA, Klingensmith WL, Meyn LA et al. Regulation of matrix metalloproteinase expression by estrogen in fibroblasts that are derived from the pelvic floor. Am J Obstet Gynecol. 2002; 187: 72-9.
40. Shackelford DP, Lalikos JF. Estrogen replacement therapy and the surgeon. Am J Surg. 2000; 179: 333-6.
41. Jaisamram U, Triratanachat S, Chaikittsilpa S et al. Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy: a double-blind randomized trial followed by open-label maintenance therapy. Climacteric. 2013; 16: 347-55.
42. Gaspar C, Donders GG, Palmeira-de-Oliveira R et al. BActeriocim production of the probiotic Lactobacillus acidophillus KS400. AMB Expr. 2018; 8: 153. http://doi.org/10.1186/s13568-018-0679-z.
43. Donders GG, van Bulck B, van de Walle P et al. Effect of lyophylized lactobacilli and 0.03 mg estriol (Gynoflor) on vaginitis and vaginosis with disrupted vaginal microflora: a multi-centre, randomized, single-blind, active-controlled pilot study. Gynecol Obstet Invest. 2010, 70: 264-72.
44. Unzeitig V, Al Awad H. New options of stabilization of disturbed vaginal environment balance. Prakt Gyn. 2006: 10: 170-3.
45. Ozkinay E, Terek MC, Yayci M et al. The effectiveness of live lactobacilli in combination with low dose oestriol (Gynoflor) to restore the vaginal flora after treatment of vaginal infections. BJOG. 2005; 112: 234-40.
46. Ehrström S, Daroczy K, Rylander E et al. Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. Microbes Infect. 2010; 12: 691-9.
2. Pines A. Microbiotica in women. Climacteric. 2015; 18: 1-3.
3. Borges S, Silva J, Teixeira P. The role lactobacilli and probiotics in maintaining vaginal health. Arch Gynecol Obstet. 2014; 289: 479-89.
4. Macklaim JM, Clemente JC, Knight R et al. Changes in vaginal microbiota following antimicrobial and probiotic therapy. Microb Ecol Health Dis. 2015; 26: 27799. http://doi.org/10.3402/mehd.v26.27779.
5. O’Hanlon DE, Lanier BR, Moench TR et al. Cervicovaginal fluid and semen block the microbicidal activity of hydrogen peroxide produced by vaginal lactobacilli. BMC Infect Dis. 2010; 10: 1-8.
6. Karaoglu SA, Aydin F, Kilic SS et al. Antimicrobial activity and characteristics of bacteriocins produced by vaginal lactobacilli. Turk J Med Sci. 2002; 33: 7-13.
7. Luthje P, Hirschberg AL, Brauner A. Estrogenic action on innate defense mechanism in the urinary tract. Maturitas. 2014; 77: 32-6.
8. Galhardo CK, Soares JM Jr, Simoes RS et al. Estrogen effects on the vaginal pH, flora nad cytology in late postmenopause after a long period without hormone therapy. Clin Exp Obstet Gynecol. 2006; 33: 85-9.
9. Brotman RM, Shardell MD, Gajer P et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2014; 21: 450-8.
10. Hummelen R, Macklaim JM, Bisanz JE et al. Vaginal microbiome and epithelial gene array in post-menopasusal women with moderate to severe dryness. PLoS One. 2011; 6: e26602.
11. Reid G, Bruce AW. Selection of Lactobacillus strains for urogenital probiotic applications. J Infect Dis. 2001; 183: 77-80.
12. Reid G, Beuerman D, Heinemann C et al. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol Med Microbiol. 2001; 32: 37-41.
13. Ngugi BM, Hemmerling A, Bukusi EA et al. Effects of bacterial vaginosis – associated bacteria and sexual intercourse on vaginal colonization with the probiotic Lactobacillus crispatus CTV-05. Sex Transm Dis. 2011; 38: 1020-7.
14. Alvarez-Olmos MI, Barousse MM, Rajan L et al. Vaginal lactobacilli in adolescents: presence and relationship to local and systemic immunity, and to bacterial vaginosis. Sex Transm Dis. 2004; 31: 393-400.
15. Andersson H, Asp NG, Bruce A et al. Health effects of probiotics and prebiotics: a literature review on human studies. Food Nutr Res. 2001; 45: 58-75.
16. Karlsson M, Scherbak N, Khalaf H et al. Substances released from probiotic Lactobacillus rhamnosus GR-1 potentiate NF-κB activity in Escherichia coli-stimulated urinary bladder cells. FEMS Immunol Med Microbiol. 2012; 66(2): 147-56. http://doi.org/10.1111/j.1574-695X.2012.00994.x.
17. Wagner RD, Johnson SJ. Probiotic lactobacillus and estrogen effects on vaginal epithelial gene expression responses to Candida albicans. J Biomed Sci. 2012: 19: 58.
18. Pendharkar S, Brandsborg E, Hammarstrom L et al. Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection. BMC Infect Dis. 2015; 15: 255. http://doi.org/10.1186/212879-015-0971-3.
19. Parent D, Bossens M, Bayot D et al. Therapy of bacterial vaginosis using exogenously-applied Lactobacillus aciophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneimittelforschung. 1996; 46: 68-73.
20. Gardiner GE, Heinemann C, Baroja ML et al. Oral administration of the probiotic combination Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 for human intestinal applications. Int Dairy J. 2002; 12: 191-6.
21. Donders G, Bellen G, Neven P et al. Effect of ultra-low-dose estriol and lactobacilli vaginal tablets (Gynoflor) on inflammatory and infectious markers of the vaginal ecosystem in postmenopausal women with breast cancer on aromatase inhibitors. Eur J Clin Microbiol Infect Dis. 2015; 34: 2023-8.
22. Ashcroft GS, Ashworth JJ. Potential role of estrogens in wound healing. Am J Clin Dermatol. 2003; 4: 737-43.
23. Ashcroft GS, Dodsworth J, van Boxtel E et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-beta 1 levels. Nature Med. 1997; 3: 1209-15.
24. Ashcroft GS, Greenwell-Wild T, Horan MA et al. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol. 1999; 155: 1137-46.
25. Engeland CG, Sabzehei B, Marucha PT. Sex hormones and mucosal healing. Brain Behav Immun. 2009; 23: 629-35.
26. Archer DF. Postmenopausal skin and estrogen. Gynecol Endocrinol. 2012; 28: 2-6.
27. Sator PG, Schmidt JB, Rabe T et al. Skin aging and sex hormones in women – clinical perspectives for intervention by hormone replacement therapy. Exp Dermatol. 2004; 13: 36-40.
28. Sator PG, Schmidt JB, Sator MO et al. The influence of hormone replacement therapy on skin ageing: a pilot study. Maturitas. 2001; 39: 43-55.
29. Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci. 2005; 38: 1-7.
30. Fujimoto J, Hori M, Ichigo S et al. Ovarian steroids regulate the expression of basic fibroblast growth factor and its mRNA in fibroblasts derived from uterine endometrium. Ann Clin Biochem. 1997; 34: 91-6.
31. Kovacs EJ, Duffner LA, Plackett TP. Immunosuppression after injury in aged mice is associated with a TH1-TH2 shift, which can be restored by estrogen treatment. Mech Ageing Dev. 2004; 125: 121-3.
32. Kovacs EJ, Messingham KA, Gregory MS. Estrogen regulation of immune responses after injury. Mol Cell Endocrinol. 2002; 193: 129-35.
33. Kovacs EJ, Plackett TP, Witte PL. Estrogen replacement, aging, and cell-mediated immunity after injury. J Leukoc Biol. 2004; 76: 36-41.
34. Rechberger T, Adamiak A, Skorupski P et al. Collagen metabolism in women suffering from stress urinary incontinence. Polish J Gynecol Invest. 1999; 2: 21-4.
35. Rechberger T, Postawski K, Jakowicki JA et al. Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol. 1998; 179: 1511-4.
36. Falconer C, Ekman G, Malmstrom A et al. Decreased collagen synthesis in stress-incontinent women. Obstet Gynecol. 1994; 84: 583-6.
37. Jackson S, James M, Abrams P. The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG. 2002; 109: 339-44.
38. Jackson S, Shepherd A, Brookes S et al. The effect of oestrogen supplementation on post-menopausal urinary stress incontinence: a double-blind, placebo-controlled trial. Br J Obstet Gynaecol. 1999; 106: 711-8.
39. Moalli PA, Klingensmith WL, Meyn LA et al. Regulation of matrix metalloproteinase expression by estrogen in fibroblasts that are derived from the pelvic floor. Am J Obstet Gynecol. 2002; 187: 72-9.
40. Shackelford DP, Lalikos JF. Estrogen replacement therapy and the surgeon. Am J Surg. 2000; 179: 333-6.
41. Jaisamram U, Triratanachat S, Chaikittsilpa S et al. Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy: a double-blind randomized trial followed by open-label maintenance therapy. Climacteric. 2013; 16: 347-55.
42. Gaspar C, Donders GG, Palmeira-de-Oliveira R et al. BActeriocim production of the probiotic Lactobacillus acidophillus KS400. AMB Expr. 2018; 8: 153. http://doi.org/10.1186/s13568-018-0679-z.
43. Donders GG, van Bulck B, van de Walle P et al. Effect of lyophylized lactobacilli and 0.03 mg estriol (Gynoflor) on vaginitis and vaginosis with disrupted vaginal microflora: a multi-centre, randomized, single-blind, active-controlled pilot study. Gynecol Obstet Invest. 2010, 70: 264-72.
44. Unzeitig V, Al Awad H. New options of stabilization of disturbed vaginal environment balance. Prakt Gyn. 2006: 10: 170-3.
45. Ozkinay E, Terek MC, Yayci M et al. The effectiveness of live lactobacilli in combination with low dose oestriol (Gynoflor) to restore the vaginal flora after treatment of vaginal infections. BJOG. 2005; 112: 234-40.
46. Ehrström S, Daroczy K, Rylander E et al. Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. Microbes Infect. 2010; 12: 691-9.