• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.2
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• pp.29-43
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• 2020

Objectives: The purpose of this study is to review and evaluate the effectiveness of oriental medicine per oral for recurrent vulvovaginal candidiasis (RVVC). Methods: We searched articles from Korean journal databases including Journal of Korean Obstetrics and Gynecology, Korean studies Information Service Studies, and Chinese National Knowledge Infrastructure, Cochrane Library, PubMed. Searched keywords were "재발성 칸디다성 외음질염", "recurrent vulvovaginal candidiasis", "㚆发性外阴阴道假丝酵母菌病", "中藥". Results: 10 randomized controlled trials with 700 patients were identified and reviewed. 8 studies compared combination of oriental medicine and anti-fungal agent with anti-fungal agent, and 6 of them reported that treatment group (TG) showed statistically higher total effective rate or cure rate and lower recurrence rate. One study compared oriental medicine and anti-fungal agent and TG showed statistically higher total effective rate and lower recurrence rate after 1 month. One study compared combination of oriental medicine and lacto bacillus capsule with lacto bacillus capsule, and TG showed statistically higher total effective rate and lower positive fungul test rate after 6 months. No severe adverse response was reported. Conclusions: Our review found that oriental medicine per oral is effective for alleviating symptoms, lowering recurrence rate and positive fungal test in RVVC patients. We recommend standardized randomized controlled trial guideline should be made to obtain stronger evidence and well designed trials with larger sample sizes are needed.

• Journal of Pharmacopuncture
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• v.24 no.4
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• pp.191-195
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• 2021

Objectives: Vulvovaginal candidiasis (VVC) treatment is advised for all women due to its symptoms and complications. In this study, the standard treatment, clotrimazole, was compared with chamomile extract cream in outpatient clinics. Methods: We recruited 73 women with VVC, who were randomly allocated into two groups, clotrimazole versus chamomile extract cream. After two weeks of treatment with the same criteria, cheese-like vaginal discharge, itching and burning sensations, strawberry cervix, and recovery percentage was evaluated. Results: Thirty patients in each group were analyzed. There was no significant difference in age and number of pregnancies between groups (p = 0.85 and 0.09, respectively). Comparing before and after treatment, cheese like discharge (p < 0.001), itching (p < 0.001), burning (p < 0.001) had significantly improved in both groups. Further, the recovery percentage was not significantly different between groups (88.9% vs 75% in the chamomile vs clotrimazole groups, respectively). Conclusion: Chamomile is as effective as clotrimazole in VVC treatment; a higher percentage of women who used this medication recovered, although this did not reach significance. In addition, no complications were reported in either group.

• Journal of Microbiology and Biotechnology
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• v.25 no.10
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• pp.1734-1741
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• 2015

Few research had investigated the secretion of phospholipase and aspartyl proteinase from Candida spp. causing infection in females with type 2 diabetes mellitus. This research aimed to investigate the prevalence of vulvovaginal candidiasis (VVC) in diabetic versus non-diabetic women and compare the ability of identified Candida isolates to secrete phospholipases and aspartyl proteinases with characterization of their genetic profile. The study included 80 females with type 2 diabetes mellitus and 100 non-diabetic females within the child-bearing period. Candida strains were isolated and identified by conventional microbiological methods and by API Candida. The isolates were screened for their extracellular phospholipase and proteinase activities by culturing them on egg yolk and bovine serum albumin media, respectively. Detection of aspartyl proteinase genes (SAP1 to SAP8) and phospholipase genes (PLB1, PLB2) were performed by multiplex polymerase chain reaction. Our results indicated that vaginal candidiasis was significantly higher among the diabetic group versus nondiabetic group (50% versus 20%, respectively) (p = 0.004). C. albicans was the most prevalent species followed by C. glabrata in both groups. No significant association between diabetes mellitus and phospholipase activities was detected (p = 0.262), whereas high significant proteinase activities exhibited by Candida isolated from diabetic females were found (82.5%) (p = 0.000). Non-significant associations between any of the tested proteinase or phospholipase genes and diabetes mellitus were detected (p > 0.05). In conclusion, it is noticed that the incidence of C. glabrata causing VVC is increased. The higher prevalence of vaginal candidiasis among diabetics could be related to the increased aspartyl proteinase production in this group of patients.

• Journal of Menopausal Medicine
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• v.23 no.3
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• pp.139-145
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• 2017

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

• KSBB Journal
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• v.32 no.2
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• pp.146-152
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• 2017

Vulvovaginal candidiasis (VVC) is one of the urogenital infections occurring in women worldwide. Candida albicans is generally observed among various types of microorganisms causing VVC. Antibiotic therapy is typical, and the use of Lactobacilli probiotics is to be recognized as a promising alternative. The aim of this study was to select vaginal lactobacilli with probiotic properties against C. albicans. In a previous study, we isolated 38 lactobacilli from vagina of Korean women and 20 isolates were shown to inhibit C. albicans. We further selected 10 isolates which were able to inhibit C. albicans less than $10^5CFU/mL$. Among these selected strains, Lactobacillus salivarius MG242 (identified by 16s rRNA sequencing) was finally selected based on its strong anti-candidal activity, acid/bile salt resistance and adhesion property. Indirect adhesion activity of MG242 measured by auto-aggregation assay showed more than 60% auto-aggregation after 5 h standing. Taken these results together, the selected strain MG242 may have potential for application in vagina health related products.

• Journal of Dairy Science and Biotechnology
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• v.37 no.1
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• pp.49-56
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• 2019

Vulvovaginal candidiasis is a major urogenital infection in women. Lactobacilli are important in maintaining vaginal health. In the present study, the effect of heat adaptation at $47{\sim}52^{\circ}C$ prior to heat stress at $60^{\circ}C$ in improving the viability of Lactobacillus salivarius MG242 was examined. L. salivarius MG242 has antifungal effects against Candida albicans. Heat-adapted cells had a higher survival rate than non-adapted cells during the subsequent heat stress. When chloramphenicol was added during the adaptation process, heat tolerance was abolished, suggesting the involvement of de novo protein synthesis with the heat adaptation of L. salivarius MG242 strain. Exopolysaccharide quantification and scanning election microscopy did not reveal any appreciable changes during heat adaptation. The antifungal activity of L. salivarius MG242 against C. albicans was maintained during the heat adaptation. These results suggest that heat adaptation can be applied for the development of probiotic products using L. salivarius MG242 to improve its stress tolerance during processing.

• Korean Journal of Pharmacognosy
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• v.53 no.3
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• pp.119-124
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• 2022

Vaginal microbiome deeply influences vaginal health via production of messenger molecules. The healthy vaginal pH ranges between 3.5 and 4.5. However, dysbiosis of vaginal microbiome increases the pH level, leading to the incidence of vaginitis. The commensal vaginal bacterium Dermabacter vaginalis-which was isolated from the vaginal fluid of a Korean female-was incubated in acidic and neutral pH to simulate healthy and vaginitis conditions, respectively. The chemical profiles of the two different cultures were compared using HPLC. The compound showing distinctive difference between the two sets of data was presumed to be a chemical messenger, which was identified as cyclo(L-pro-L-met) by analysis of NMR, MS, and specific rotation data. Synthesis was achieved in three steps (overall yield 15%), enabling structure confirmation and antimicrobial evaluation against vaginal pathogens. Cyclo(L-pro-L-met) showed antifungal activity against Candida albicans, a major cause of vulvovaginal candidiasis.