Lactobacillus acidophilus is probably the best well-known species of Lactobacillus, this microorganism is naturally found in the human and animal gastrointestinal tract, mouth and vagina (DerMarderosian & Beutler 2002).
Lactobacillus crispatus is one of the predominant vaginal lactobacillus species in European, American and Asian women, and has been developed as a vaginal probiotic. Germs of Lactobacillus crispatus are plump, mostly short rods
Lactobacillus crispatus produces H2O2, adheres to the vaginal epithelial cells of healthy women and blocks the adherence of pathogens to vaginal epithelial cells. Thus, Lactobacillus crispatus has been proposed as a vaginal probiotic, intended to restore the normal microbiotic flora in women with recurrent urinary tract infections by Escherichia coli (Atassi 2006, Kwok 2006).
In a study by Marrazzo (2006), women aged 14-35 years with bacterial vaginosis were randomized to receive either a vaginal capsule containing human-derived, H2O2-producing Lactobacillus crispatus or a placebo twice daily for 3 days monthly for 3 months. Four hundred twenty-four women were randomized at enrolment, and 232 (55%) provided data on satisfaction at the final visit. Satisfaction with an intravaginal capsule and positive beliefs about its usefulness in the treatment of bacterial vaginosis were prevalent, especially among women with a clinical and microbiological response to bacterial vaginosis therapy. However, regardless of clinical response , most women expressed willingness to use the product again. There is considerable interest in alternative bacterial vaginosis treatments, such as Lactobacillus crispatus intravaginal applications and these treatments are well accepted.
Compared with vaginal colonization alone, both vaginal and rectal colonization by H202 producing Lactobacilli reduces the risk of BV 4-fold. Of women vaginally colonized by L crispatus , 43 % are also colonized rectally (Antonio 2005)
Administration of vaginal suppositories containing Lactobacillus crispatus GAI 98332 may be a safe and promising strategy for restoring the normal vaginal flora, providing a competitive bacterial barrier, and thus for the prevention of recurrent urogenital infections (Uehara 2006).
In this study we show that the amounts of H2O2 produced by lactobacilli vary widely and that the presence of strong H2O2- producing lactobacilli in the vagina of pregnant women is associated with a reduced risk of BV at 20 weeks’ gestational age and subsequent chorioamnionitis (Wilks, 2004).
Lactobacillus crispatus modulates epithelial cell defense against Candida albicans (Rizzo 2013)
High level vaginal colonization with L. crispatus throughout the follow-up was associated with a significant reduction in recurrent UTI (Kwok 2006, Czaja 2007). L. crispatus can be given to restore the normal microbiotic flora in women with recurrent urinary tract infections by E.coli.
A study identified that lactobacilli species have adapted to the niche colonization of the vagina with L. crispatus having the most advanced colonization performance. Moreover, this study also highlighted that L. crispatus has a high genetic variability in terms of antimicrobial activity and against human vaginal pathogens which clearly supports the notion that L. crispatus is an important driver of the vaginal microbiota. (Argentini et al., 2022)
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