外阴阴道假丝酵母菌病的治疗现状与展望

Current Remedy Condition and Prospect of Vulvovaginal Candidiasis

外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)是影响妇女生活质量的常见疾病,约有75%的妇女一生中至少会感染一次,每年导致约18亿美元的经济负担。目前临床常用的治疗VVC的药物主要是唑类和多烯类。但随着临床抗真菌药物的长期使用,假丝酵母菌出现表型改变、毒力因子突变、非白色假丝酵母菌的感染增加,对传统抗菌药物的治疗效果提出挑战,急需开发新的有效的抗菌药物。对于VVC的治疗,现阶段处于临床试验阶段的疫苗有PEV7和NDV3,处于实验室研发阶段的药物有益生菌类、抗菌肽类、草本植物类、纳米颗粒类,还有一些药物包括VT-1161、CD101、可溶性β-葡聚糖等也在研究阶段表现出抗真菌效果,有望成为治疗VVC的候选药物。总的来说,VVC发生率高,复发率高,临床上急需新的抗菌药物改善患者生活质量,减少医疗经济负担。

Vulvovaginal candidiasis(VVC)is a common disease that affects women′s quality of life.About 75%of women will be infected at least once in their lifetime,and VVC causes an economic burden of$1.8 billion each year.At present,treatment of VVC commonly used in clinic mainly includes azoles and polyenes.However,with the long-term use of clinical antifungal drugs,candida phenotype changes,virulence factor mutates,and non-candida infections increase,which pose challenges to the therapeutic effects of traditional antifungal drugs.We urgently need to develop new effective ones.For the treatment of VVC,the vaccines currently in clinical trials include PEV7 and NDV3,the drugs in the laboratory development stage are probiotics,antimicrobial peptides,herbs,nanoparticles,and some drugs include VT-1161,CD101,solubleβ-glucan etc.have also shown antifungal effects in the research stage and are expected to be candidate drugs for the treatment of VVC.In general,the incidence and recurrence rate of VVC is high,there is an urgent need for new antibacterial drugs to improve the quality of life of patients and reduce the medical economic burden.