Efficacy Comparison of Oral and Intravaginal Lactobacillus plantarum Administration on Secreted Aspartyl Protease-5 (SAP5) Levels in Vulvovaginal Candidiasis
DOI:
https://doi.org/10.48048/tis.2024.7225Keywords:
Vulvovaginal candidiasis, Lactobacillus plantarum, SAP5, Candida albicansAbstract
Vulvovaginal candidiasis (VVC) is the most common fungal infection in the vaginal mucosa caused by an overgrowth of Candida albicans. The pathogenesis of C. albicans is determined by the presence of virulence secretory factors. Secreted Aspartyl Protease 5 (SAP5) is the dominant virulence factor that plays a critical role in the morphology switching of yeast cells into hyphae which causes tissue invasion and induces an immunopathological response. Levels of SAP5 are often associated with the severity various types of infection. As a potential supportive therapy to treat VVC, identification of the probiotic’s administration route determines the level of efficacy of probiotics. This study aims to compare the decrease in SAP5 levels between oral and intravaginal administration of L. plantarum. The study was true experimental using a completely randomized pretest-posttest group design. There were 32 female rats were divided into 8 groups i.e negative control, positive control, 3 groups of oral and 3 of intravaginal administration. Positive control and 6 treatment group were injected with estradiol valerate 0.5 mg and then inoculated with suspension of C. albicans 2×107 CFU to create VVC model. L. plantarum was administered orally and intravaginally with 3 concentration variants i.e. 2.25×1010, 4.5×1010 and 9×1010 CFU. Both of oral and intravaginal group were given with probiotics for 14 days. SAP5 levels were measured by ELISA from vaginal lavage sample. The statistical analysis used was the Paired T-Test to measure SAP5 levels pre-post oral and intravaginal administration of L. plantarum. The results showed a significant decrease in SAP5 levels in oral administration (p = 0.001 < 0.05) and intravaginal administration (p = 0.000 < 0.05). From the results of the statistical analysis, it can be concluded that both oral and intravaginal administration of the probiotic L. plantarum has the same efficacy in reducing the virulence factor of C. albicans in cases of VVC.
HIGHLIGHTS
- Lactobacillus plantarum is potential supportive therapy for Vulvovaginal Candidiasis
- Efficacy plantarum identified through oral and intravaginal administration
- SAP5 is an important virulence factor in pathogenesis of Vulvovaginal Candidiasis
- Efficacy’s rate plantarum was analyzed based on SAP5 levels in vaginal fluid
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P Czechowicz, J Nowicka and G Gościniak. Virulence factors of Candida spp. and host immune response important in the pathogenesis of vulvovaginal candidiasis. Int. J. Mol. Sci. 2022; 23, 5895.
DW Denning, M Kneale, JD Sobel and R Rautemaa-Richardson. Global burden of recurrent vulvovaginal candidiasis: A systematic review. Lancet Infect. Dis. 2018; 18, e339-e347.
X Zeng, Y Zhang, T Zhang, Y Xue, H Xu and R An. Risk factors of vulvovaginal candidiasis among women of reproductive age in Xi’an: A cross-sectional study. Biomed. Res. Int. 2018; 2018, 9703754.
SD Waikhom, I Afeke, GS Kwawu, HK Mbroh, GY Osei, B Louis, JG Deku, ES Kasu, P Mensah, CY Agede, C Dodoo, EA Asiamah, J Tampuori, J Korbuvi and JA Opintan. Prevalence of vulvovaginal candidiasis among pregnant women in the Ho municipality, Ghana: Species identification and antifungal susceptibility of Candida isolates. BMC Pregnancy Childbirth 2020; 20, 266.
DS Arfiputri, AN Hidayati, S Handayani and E Ervianti. Risk factors of vulvovaginal candidiasis in dermato-venereology outpatients clinic of Soetomo General Hospital, Surabaya, Indonesia. Afr. J. Infect. Dis. 2018; 12, 90-4.
MT Yassin, AAF Mostafa and AA Al-Askar. In vitro anticandidal potency of Syzygium aromaticum (clove) extracts against vaginal candidiasis. BMC Compl. Med. Ther. 2020; 20, 25.
PG Pappas, MS Lionakis, MC Arendrup, L Ostrosky-Zeichner and BJ Kullberg. Invasive candidiasis. Nat. Rev. Dis. Primers 2018; 4, 18026.
M Henriques and S Silva. Candida albicans virulence factors and its pathogenicity. Microorganisms 2021; 9, 704.
HME Willems, SS Ahmed, J Liu, Z Xu and BM Peters. Vulvovaginal candidiasis: A current understanding and burning questions. J. Fungi 2020; 6, 27.
J Talapko, M Juzbašić, T Matijević, E Pustijanac, S Bekić, I Kotris and I Škrlec. Candida albicans-the virulence factors and clinical manifestations of infection. J. Fungi 2021; 7, 1-19.
P Tam, K Gee, M Piechocinski and I Macreadie. Candida glabrata, friend and foe. J. Fungi 2015; 1, 277-92.
A Hartanto, FG Naibaho, D Panjaitan, A Lutfia and E Munir. Molecular docking analysis of allium Chinense compounds as secreted aspartyl proteinase-5 (SAP5) inhibitor. IOP Conf. Ser. Earth Environ. Sci. 2022; 977, 012017.
MY Joo, JH Shin, HC Jang, ES Song, SJ Kee, MG Shin, SP Suh and DW Ryang. Expression of SAP5 and SAP9 in Candida albicans biofilms: Comparison of bloodstream isolates with isolates from other sources. Med. Mycol. 2013; 51, 892-6.
J Norenhag, J Du, M Olovsson, H Verstraelen, L Engstrand and N Brusselaers. The vaginal microbiota, human papillomavirus and cervical dysplasia: A systematic review and network meta-analysis. BJOG An Int. J. Obstet. Gynaecol. 2020; 127, 171-80.
K Godha, KM Tucker, C Biehl, DF Archer and S Mirkin. Human vaginal pH and microbiota: An update. Gynecol. Endocrinol. 2018; 34, 451-5.
Y Han and QL Ren. Does probiotics work for bacterial vaginosis and vulvovaginal candidiasis. Curr. Opin. Pharmacol. 2021; 61, 83-90.
Z Vahedpoor, M Abastabar, M Sehat, P Talebian, TF Fini, Z Dastanpour, I Haghani, R Chelongarian and M Nazeri. Vaginal and oral use of probiotics as adjunctive therapy to fluconazole in patients with vulvovaginal candidiasis: A clinical trial on Iranian women. Curr. Med. Mycol. 2021; 17, 36-43.
G Wang, Y Chen, Y Xia, X Song and L Ai. Characteristics of probiotic preparations and their applications. Foods 2022; 11, 2472.
N Azizah, U Qonitun, TYM Raras and SR Prawiro. Probiotics lactobacillus reuteri increase levels of β-Defensin1, sIgA and decrease number of staphylococcus aureus bacteria colonies in vaginal mucosa on puerperal mice model infected with Staphylococcus aureus. Jurnal Kebidanan 2020; 9, 71.
M Dibo, MS Ventimiglia, N Valeff, MDLÁ Serradell and F Jensen. An overview of the role of probiotics in pregnancy-associated pathologies with a special focus on preterm birth. J. Reprod. Immunol. 2022; 150, 103493.
HR Conti, AR Huppler, N Whibley and SL Gaffen. Animal models for candidiasis. Curr. Protocol. Immunol. 2014; 105, 19.6.1-19.6.17.
AF Ajayi and RE Akhigbe. Staging of the estrous cycle and induction of estrus in experimental rodents: An update. Fertil. Res. Pract. 2020; 6, 5.
J Rahayu, S Salmah, M Yusuf, B Ramadhan and DK Sari. The profile and percentage of vaginal epithelial cell numbers during the estrous cycle in Bali cattle. IOP Conf. Ser. Earth Environ. Sci. 2019; 247, 012006.
V Gupta, K Abhisheik, S Balasundari, NK Devendra, K Shadab and M Anupama. Identification of Candida albicans using different culture media and its association in leukoplakia and oral squamous cell carcinoma. J. Oral. Maxillofac. Pathol. 2019; 23, 28-35.
TK Mohammed, KM Wahab and MA Jawad. Isolation and identification of Candida albicans in different clinical samples. Al-Nisour J. Med. Sci. 2019; 1, 85-97.
R Fevria and I Hartanto. Isolation and characterization of lactic acid bacteria (Lactobacillus sp) from strawberry (Fragaria vesca). J. Phys. Conf. Ser. 2019; 1317, 012086.
A Ngamsomchat, T Kaewkod, M Konkit, Y Tragoolpua, S Bovonsombut and T Chitov. Characterisation of Lactobacillus plantarum of dairy-product origin for probiotic chèvre cheese production. Foods 2022; 11, 934.
SN Balakrishnan, H Yamang, MC Lorenz, SY Chew and LTL Than. Role of vaginal mucosa, host immunity and microbiota in vulvovaginal candidiasis. Pathogens 2022; 11, 618.
V Mandujano-González, L Villa-Tanaca, MA Anducho-Reyes and Y Mercado-Flores. Secreted fungal aspartic proteases: A review. Rev. Iberoamericana Micología 2016; 33, 76-82.
B Hube and J Naglik. Candida albicans proteinases: Resolving the mystery of a gene family. Microbiology 2001; 147, 1997-2005.
LJD Silva, FDD Barroso, LS Vieira, DRC Mota, BKDS Firmino, CRD Silva, VPDF Cabral, TM Cândido, LGDAV Sá, WMBD Silva, J Silva, ES Marinho, BC Cavalcanti, MOD Moraes, HVN Júnior and JBDA Neto. Diazepam’s antifungal activity in fluconazole-resistant Candida spp. and biofilm inhibition in C. albicans: Evaluation of the relationship with the proteins ALS3 and SAP5. J. Med. Microbiol. 2021; 70, 001308.
A Fahim, WH Himratul-Aznita, PS Abdul-Rahman and MK Alam. Efficacy of bakuchiol-garlic combination against virulent genes of Candida albicans. PeerJ 2022; 10, e12251.
AT Permata, AA Prasetyo and R Dharmawan. Molecular and immunological characteristics of Candida secreted aspartyl proteinase 5. J. Phys. Conf. 2019; 1153, 012141.
P Gurumallesh, K Alagu, B Ramakrishnan and S Muthusamy. A systematic reconsideration on proteases. Int. J. Biol. Macromol. 2019; 128. 254-67.
M Rapala-Kozik, O Bochenska, D Zajac, J Karkowska-Kuleta, M Gogol, M Zawrotniak and A Kozik. Extracellular proteinases of Candida species pathogenic yeasts. Mol. Oral Microbiol. 2018; 33. 113-24.
W Wang, Z Deng, H Wu, Q Zhao, T Li, W Zhu, X Wang, L Tang, C Wang, SZ Cui, H Xiao and J Chen. A small secreted protein triggers a TLR2/4-dependent inflammatory response during invasive Candida albicans infection. Nat. Comm. 2019; 10, 1015.
F Siddique, K Akram, ES Alghamdi, Q Arshad and A Siddique. The immunomodulatory role of probiotics. In: EF Robles (Ed.). Prebiotics and probiotics - from food to health. IntechOpen, London, 2022.
WJY Chee, SY Chew and LTL Than. Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health. Microb. Cell Factories 2020; 19, 203.
L Monin, EM Whettlock and V Male. Immune responses in the human female reproductive tract. Immunology 2020; 160, 106-15.
D Duluc, R Banchereau, J Gannevat, L Thompson-Snipes, JP Blanck, S Zurawski, G Zurawski, S Hong, J Rossello-Urgell, V Pascual, N Baldwin, J Stecher, M Carley, M Boreham and SK Oh. Transcriptional fingerprints of antigen-presenting cell subsets in the human vaginal mucosa and skin reflect tissue-specific immune microenvironments. Genome Med. 2014; 6, 98.
R Vladareanu, D Mihu, M Mitran, C Mehedintu, A Boiangiu, M Manolache and S Vladareanu. New evidence on oral L. plantarum P17630 product in women with history of recurrent vulvovaginal candidiasis (RVVC): A randomized double-blind placebo-controlled study. Eur. Rev. Med. Pharmacol. Sci. 2018; 22, 262-7.
FC Ribeiro, RD Rossoni, PPD Barros, JD Santos, LRO Fugisaki, MPV Leão and JC Junqueira. Action mechanisms of probiotics on Candida spp. and candidiasis prevention: An update. J. Appl. Microbiol. 2020; 129, 175-85.
VR Alonso and F Guarner. Linking the gut microbiota to human health. Br. J. Nutr. 2013; 109, S21-S26.
V Cruzat, MM Rogero, KN Keane, R Curi and P Newsholme. Glutamine: Metabolism and immune function, supplementation and clinical translation. Nutrients 2018; 10, 1564.
E Parlindungan, BK May and OAH Jones. Metabolic insights into the effects of nutrient stress on Lactobacillus plantarum B21. Front. Mol. Biosci. 2019; 6, 75.
TM Darby and RM Jones. Beneficial influences of Lactobacillus plantarum on human health and disease. In: MH Floch, Y Ringel and WA Walker (Eds.). The microbiota in gastrointestinal pathophysiology: Implications for human health, prebiotics, probiotics, and dysbiosis. Elsevier Science, Netherlands, 2017, p. 109-17.
N Garcia-Gonzalez, N Battista, R Prete and A Corsetti. Health-promoting role of Lactiplantibacillus plantarum isolated from fermented foods. Microorganisms 2021; 9, 349.
R Mändar, G Sõerunurk, J Štšepetova, I Smidt, T Rööp, S Kõljalg, M Saare, K Ausmees, DD Le, M Jaagura, S Piiskop, H Tamm and A Salumets. Impact of Lactobacillus crispatus-containing oral and vaginal probiotics on vaginal health: A randomised double-blind placebo controlled clinical trial. Beneficial Microbes 2023; 14, 143-52.
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