glycogen and Candidiasis--Vulvovaginal

Topics: Bacteria; Candida; Candidiasis, Vulvovaginal; England; Female; Fungi; Genitalia, Female; Glycogen; Haemophilus; Humans; Hydrogen-Ion Concentration; Lactates; Lactobacillus; Pregnancy; Pregnancy Complications, Infectious; Seasons; Species Specificity; Trichomonas vaginalis; Vagina; Vaginal Smears

Vaginal glycogen is degraded by host α-amylase and then converted to lactic acid by Lactobacilli. This maintains the vaginal pH at ≤4.5 and prevents growth of other bacteria. Therefore, host α-amylase activity may promote dominance of Lactobacilli. We evaluated whether the α-amylase level in vaginal fluid is altered in women with bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) and whether its concentration was associated with levels of lactic acid isomers and host mediators. Vaginal fluid was obtained from 43 women with BV, 50 women with VVC, and 62 women with no vulvovaginal disorders. Vaginal fluid concentrations of α-amylase, secretory leukocyte protease inhibitor (SLPI), hyaluronan, hyaluronidase-1, β-defensin, and elafin were measured by enzyme-linked immunosorbent assay (ELISA). Vaginal concentrations of neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase (MMP) 8, and d- and l-lactic acid levels in these patients were previously reported. The median vaginal fluid α-amylase level was 1.83 mU/mL in control women, 1.45 mU/mL in women with VVC, and 1.07 mU/mL in women with BV. Vaginal levels of α-amylase were correlated with d-lactic acid (P = .003) but not with l-lactic acid (P > .05) and with SLPI (P < .001), hyaluronidase-1 (P < .001), NGAL (P = .001), and MMP-8 (P = .005). The exfoliation of glycogen-rich epithelial cells into the vaginal lumen by hyaluronidase-1 and MMP-8 may increase glycogen availability and promote α-amylase activity. The subsequent enhanced availability of glycogen breakdown products would favor proliferation of Lactobacilli, the primary producers of d-lactic acid in the vagina. Concomitant production of NGAL and SLPI would retard growth of BV-related bacteria.

Topics: Acute-Phase Proteins; Adult; alpha-Amylases; Candidiasis, Vulvovaginal; Case-Control Studies; Epithelial Cells; Female; Glycogen; Humans; Hyaluronoglucosaminidase; Hydrogen-Ion Concentration; Lactic Acid; Lactobacillus; Lipocalin-2; Lipocalins; Matrix Metalloproteinase 8; Proto-Oncogene Proteins; Secretory Leukocyte Peptidase Inhibitor; Vagina; Vaginosis, Bacterial; Young Adult

Our aim was to relate vaginal candidiasis to vaginal oestrogenisation. First, the incidence was determined (subjected to chi-square analysis) of vaginal Candida albicans infection in 339 consecutive dermogynaecology clinic patients aged 55 years and over, of whom 142 were using and 197 were not using oestrogen. Second, the ability of Candida species to utilise glycogen as a sole nutrient source was studied by performing assimilation tests using yeast nitrogen broth as a basal medium. infection on initial presentation compared with 4% in the cohort not using oestrogen (p < 0.001). All 34 isolates of C. albicans assimilated glycogen. Twenty-six non-albicans species of Candida tested did not assimilate glycogen. In this study of postmenopausal women, there was a highly significant relationship between the usage of oestrogen and the occurrence of C. albicans infection. The production of glycogen by oestrogen stimulated epithelial maturation provides an attractive substrate for C. albicans.

Topics: Candida; Candidiasis, Vulvovaginal; Culture Media; Estrogen Replacement Therapy; Female; Glycogen; Humans

We have investigated the possibility of vaginal liquids affecting the transition from a yeast form (Y) to a mycelial one (M) in C. albicans and the possible relation to microbial flora, pH and glycogen. The C. albicans Y----M conversion, "mycelial vaginal test", in 250 specimens of vaginal liquid shows a 70% positivity rate against a test Candida strain. Results of the vaginal test are not related to bacteria, flora and pH, but to Candida infection and to glycogen concentration. Using a Y----M good-responder Candida strain in the vaginal test it is possible to have a global index of the factors affecting the Candida filamentation in the host. It can be advisable to utilize the vaginal test as a virulence test for Candida strains and as an indicative test of phenotypic drug resistance.

Topics: Candida albicans; Candidiasis, Vulvovaginal; Female; Glycogen; Humans; Phenotype; Vagina

A number of different factors have been found to influence the microflora of the vagina. Studies showing an increased rate of colonization associated with pregnancy, menses, oral contraceptive use, and estrogen replacement therapy illustrate the influence of hormones, glycogen content, and pH on vaginal colonization. The microorganisms found in the vagina may also be dependent on the existence of specific attachment sites, which may differ in the various areas of the vagina. Vaginal colonization appears to be altered in patients with diabetes mellitus, those receiving steroid therapy, and immunosuppressed individuals. Surgical manipulation of the vagina and the use of broad-spectrum antibiotics may also contribute to the growth of organisms in the vaginal tract.

Topics: Animals; Bacteria; Candida; Candida albicans; Candidiasis, Vulvovaginal; Contraceptives, Oral; Epithelium; Escherichia coli; Estrogens; Female; Glycogen; Humans; Hydrogen-Ion Concentration; Lactobacillus; Pregnancy; Rats; Recurrence; Streptococcus agalactiae; Vagina

Topics: Candidiasis, Vulvovaginal; Female; Fermentation; Glycogen; Humans; Lactobacillus; Lactobacillus acidophilus; Pregnancy; Pregnancy Complications, Infectious; Vagina