@article {3596, title = {Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study.}, journal = {Eur J Obstet Gynecol Reprod Biol}, volume = {182}, year = {2014}, month = {2014 Nov}, pages = {136-9}, abstract = {

BACKGROUND: Recurrence is a frequent complaint of patients with vulvovaginal candidiasis (VVC). Although the pathogenesis of VVC remains a controversial issue, disruption of the balance between the vaginal microbiota may facilitate overgrowth by Candida. Some probiotic bacterial strains can suppress Candida albicans; Lactobacillus plantarum P17630 is able to attach to vaginal epithelial cells and significantly reduce the adhesion of C. albicans.

OBJECTIVE: To evaluate the effect of the application of Lactobacillus plantarum P17630 in restoring the vaginal microbiota and prevention of relapses among women with acute VVC undergoing conventional (azole) local and main therapy.

METHODS: Retrospective comparative study. We recruited 89 women with a diagnosis of VVC, who were placed into two groups on the basis of reported treatment. The control group was treated with a daily dose of 2\% clotrimazole vaginal cream at bedtime for 3 days, followed by vaginal application of a capsule containing lubricant once a day for 6 days and then once a week for another 4 weeks. The probiotic group was treated with the same azole-based protocol but followed by vaginal application of a capsule containing Lactobacillus plantarum P17630 (>10$_{8}$ CFU) once a day for 6 days and then once a week for another 4 weeks beginning the day following clotrimazole discontinuation. Clinical and diagnostic patterns were monitored for three months of follow-up.

RESULTS: At the end of study the probiotic-treated women showed a statistically significant increase in Lactobacillus values "+++" (80\% versus 40\%, p<0.001) and a better subjective resolution of symptoms such as vaginal discomfort described as burning or itching (90\% versus 67.5\%, p<0.03). Among controls there was a non-significant increase at 3 months of recurrence of infection, but a significant increase of women with value of pH=5 or >5.

CONCLUSION: Although the results of different studies are controversial, most have suggested use of probiotics in the prevention or treatment of VVC, and no adverse effects have been reported. Our data with L. plantarum P17630 (Gyno-Canesflor - Bayer) confirm the role of this specific strain as a potential empirical preventive agent for reducing vaginal discomfort after conventional treatment of acute VVC and shifting the vaginal milieu toward a predominance of lactobacilli with an improvement of the vaginal pH value.

}, keywords = {Administration, Intravaginal, Adolescent, Adult, Antifungal Agents, Candidiasis, Vulvovaginal, Clotrimazole, Female, Humans, Lactobacillus plantarum, Microbiota, Middle Aged, Probiotics, Recurrence, Retrospective Studies, Secondary Prevention, Vagina, Vaginal Creams, Foams, and Jellies, Young Adult}, issn = {1872-7654}, doi = {10.1016/j.ejogrb.2014.09.018}, author = {De Seta, F and Parazzini, F and De Leo, R and Banco, R and Maso, G P and De Santo, D and Sartore, A and Stabile, G and Inglese, S and Tonon, M and Restaino, S} } @article {1978, title = {Pelvic inflammatory disease (PID) from Chlamydia trachomatis versus PID from Neisseria gonorrhea: from clinical suspicion to therapy.}, journal = {G Ital Dermatol Venereol}, volume = {147}, year = {2012}, month = {2012 Oct}, pages = {423-30}, abstract = {

Pelvic inflammatory disease (PID) is the most significant complication of sexually transmitted infections in childbearing-age women and it represents an important public health problem because of its long-term sequelae (chronic pelvic pain, tubal infertility, ectopic pregnancy). Prior to the mid 1970s PID was considered a monoetiologic infection, due primarily to Neisseria gonorrhea. Now it is well documented as a polymicrobial process, with a great number of microrganisms involved. In addition to Neisseria gonorrhea and Chlamydia trachomatis, other vaginal microrganisms (anaerobes, Gardnerella vaginalis, Haemophilus influenzae, enteric Gram negative rods, Streptococco agalactie, Mycoplasma genitalium) also have been associated with PID. There is a wide variation in PID clinical features; the type and severity of symptoms vary by microbiologic etiology. Women who have chlamydial PID seem more likely than women who have gonococcal PID to be asymptomatic. Since clinical diagnosis is imprecise, the suspicion of PID should be confirmed by genital assessment for signs of inflammation or infection, blood test and imaging evaluation. Laparoscopic approach is considered the gold standard. According to the polymicrobial etiology of PID, antibiotic treatment must provide broad spectrum coverage of likely pathogens. Early administration of antibiotics is necessary to reduce the risk of long-term sequelae.

}, keywords = {Chlamydia Infections, Chlamydia trachomatis, Female, Gonorrhea, Humans, Neisseria gonorrhoeae, Pelvic Inflammatory Disease}, issn = {0392-0488}, author = {De Seta, F and Banco, R and Turrisi, A and Airoud, M and De Leo, R and Stabile, G and Ceccarello, M and Restaino, S and De Santo, D} } @article {1608, title = {[Proteomic applications in gynecology-obstetrics].}, journal = {Minerva Ginecol}, volume = {63}, year = {2011}, month = {2011 Feb}, pages = {39-46}, abstract = {

Proteomics has recently emerged as a powerful approach both for discovering biomarkers as well as for understanding the physiopathology of unclear gynecological-obstetrical disorders. Currently, several biological fluids and fetal tissues were successfully tested, including maternal plasma, amniotic fluid, cervical-vaginal fluid, urine, saliva, placental trophoblast, amnio-chorionic membranes and cord blood. The potential of proteomics on the polycystic ovary syndrome (PCOS) involves biomarkers discovery for a more accurate diagnosis of the syndrome and identification, within the patients with PCOS, those who respond more easily to treatment and those who will be at increased risk for future metabolic complications. The proteomic approach applied to patients with endometriosis would allow not only a non-invasive early diagnosis, but also a staging of the disease and a prediction of infertility risk. Proteomics also involves oncological field, in order to discover biomarkers that allow early diagnosis and prognosis of female genital malignancies. In addition to this, proteomics could be used to understand and predict obstetrical complications such as recurrent spontaneous abortion, preterm birth and preeclampsia. However, further studies are needed on a larger cohort of patients to introduce these biomarkers in clinical practice.

}, keywords = {Endometriosis, Female, Genital Diseases, Female, Genital Neoplasms, Female, Humans, Polycystic Ovary Syndrome, Pregnancy, Pregnancy Complications, Proteomics}, issn = {0026-4784}, author = {De Seta, F and Banco, R and Guaschino, S and De Santo, D and Turrisi, A and Piva, C} } @article {1630, title = {Mannose-binding lectin is produced by vaginal epithelial cells and its level in the vaginal fluid is influenced by progesterone.}, journal = {Mol Immunol}, volume = {48}, year = {2010}, month = {2010 Nov-Dec}, pages = {281-6}, abstract = {

Mannose-binding lectin (MBL) is a recognition molecule of the complement (C) system and binds to carbohydrate ligands present on a wide range of pathogenic bacteria, viruses, fungi, and parasites. MBL has been detected in the cervico-vaginal cavity where it can provide a first-line defence against infectious agents colonizing the lower tract of the reproductive system. Analysis of the cervico-vaginal lavage (CVL) obtained from 11 normal cycling women at different phases of the menstrual cycle revealed increased levels of MBL in the secretive phase. Part of this MBL derives from the circulation as indicated by the presence of transferrin in CVL tested as a marker of vascular and tissue permeability. The local synthesis of MBL is suggested by the finding that its level is substantially higher than that of transferrin in the secretive phase. The contribution of endometrium is negligible since the MBL level did not change before and after hysterectomy. RT-PCR and in situ RT-PCR analysis showed that the vaginal tissue, and in particular the basal layer of the epithelium, is a source of MBL which binds to the basal membrane and to cells of the outer layers of the epithelium. In conclusion, we have shown that MBL detected in CVL derives both from plasma as result of transudation and from local synthesis and its level is progesterone dependent increasing in the secretive phase of the menstrual cycle.

}, keywords = {Adolescent, Adult, Body Fluids, Enzyme-Linked Immunosorbent Assay, Epithelial Cells, Female, Humans, Immunohistochemistry, Mannose-Binding Lectin, Menstrual Cycle, Progesterone, Reverse Transcriptase Polymerase Chain Reaction, Vagina, Young Adult}, issn = {1872-9142}, doi = {10.1016/j.molimm.2010.07.016}, author = {Bulla, R and De Seta, F and Radillo, O and Agostinis, C and Durigutto, P and Pellis, V and De Santo, D and Crovella, S and Tedesco, F} }