Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens...Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens new avenues for the treatment of this public health problem. The MAC<sup>®</sup> Methodology, conventional laser light-emitting (LLLT)/LED) methods are based on the biphasic response demonstrated many times in LLLT research and as with other forms of drugs, a “drug” (irradiation parameters) and a “dose” (irradiation times) and the “Arndt-Schulz Law” is often cited as a suitable model to describe the dose-dependent effects of LLLT. This method uses photopharmaceuticals, cell markers and the use of correct parameters for each case to induce the acceleration of tissue repair. The present study shows a case of a 32-year-old patient diagnosed with recurrent candidiasis 4 years ago. Eighteen sessions were performed (every other day) using a photoactivated component (Methylene blue 1% + Clotrimazole 1%) and LED phototherapy (red, blue and violet) with emission times of 60 - 260 seconds for each applicator, according to the dose recommendations of the scar acceleration method (MAC<sup>®</sup>). At the sixth treatment session there was a noticeable decrease in the itching sensation reported by the patient. In session 11 she reported feeling a great improvement, indicating that she no longer felt itching in any area after 18 sessions. The present case demonstrates new methodologies to treat common problems in the population that have a positive impact on the quality of life. This methodology has a promising future because it is non-invasive and requires a great biological transformation for inflammatory, fungal and viral control.展开更多
Therapy of chronic recurrent vulvovaginal can- didiasis (VVC) caused by Candida glabrata is still rare in comparison to C. albicans infection, but therapy remains more difficult. Combination therapy with topical antif...Therapy of chronic recurrent vulvovaginal can- didiasis (VVC) caused by Candida glabrata is still rare in comparison to C. albicans infection, but therapy remains more difficult. Combination therapy with topical antifungals may improve therapy outcome, but still standard agents as fluconazole or itraconazole often fail. Posaconazole is a new systemic triazole with a wide antifungal spectrum including rare Candida species. Up to now, no clinical trials with posa- conazole in chronic recurrent VVC have been undertaken. Here, first results of the application of a new therapy regimen consisting of oral posaconazole in combination with topical ciclopiroxolamine are presented. 15 patients with chronic recurrent VVC caused by C. glabrata have been treated. 14 of these patients experienced successful therapy, clinical and mycological cure 30 days after begin of therapy has been observed. Long-term results are promising, as in 4 patients clinical and mycologic cure persists for more than 1 year up to now.展开更多
Vaginitis is one of the most recurrent conditions that afflict women and require medical care. Vulvovaginal candidiasis (VVC) is frequently related to vaginal carriage of Candida albicans, an opportunistic polymorphic...Vaginitis is one of the most recurrent conditions that afflict women and require medical care. Vulvovaginal candidiasis (VVC) is frequently related to vaginal carriage of Candida albicans, an opportunistic polymorphic fungus, which colonizes the human skin, the mucosa and the reproductive tract. Actually, standard treatments to counteract vaginitis include several topical and oral treatments. The aim of this study was to evaluate the efficacy of a new biguanide compound, polyhexamethylene biguanide (PHMB) in avaginal solution, in women affected by vaginal candidiasis. For this reason, 40 women showing the symptoms previously ascribed to vaginal candidiasis were recruited and treated with a single PHMB dose of vaginal solution. After a single dose of treatment, 80% of them had a complete resolution of the fungal infection;furthermore, all of them reported clinical benefits, statistically significant reduction in both clinical signs and symptoms of candidiasis and a score’s reduction of 50%.展开更多
Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over ...Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over four years from 88 women, ranging in age from 18 to 65 years, from medical centers of Sao Paulo and Mogi das Cruzes, Brazil. Thirty-six of these women were asymptomatic (control group) and 52 presented clinical condition compatible with vulvovaginitis (38 primary or episodic as non-recurrent forms, and 14 recurrent vulvovaginal candidiasis). A portion of each sample was plated on Sabouraud dextrose agar with chloramphenicol and grown on CHROMagar Candida for presumptive characterization. The identification of the species was obtained by sequencing of the ITS1 region of rDNA. α-DF genes were amplified for subsequent evaluation of polymorphisms by endonuclease restriction assay. Results: From 88 samples were isolated 60 Candida albicans and 28 non-albicans Candida spp. Resistant C. albicans strains and non-albicans Candida spp. were more prevalent in recurrence. In all groups, the number of resistant non-albicans Candida spp. was most high than susceptible strains. α-DF1, α-DF3 and α-DF1/α-DF3 genotypes were found in 32 (36.4%), 17 (19.3%), 6 (6.8%) vaginal samples, respectively. About 33 samples were not amplified. Recurrence and severe disease were more observed in homozygous population. Conclusions: Non-albicans Candida spp. and homozygotic α-DF genotipes (α-DF1 and α-DF3) were more related with severe clinical signs and recurrence. Further studies about vulvovaginal candidiasis and α-DF genes are necessary to access the more comprehensive role of defensins in clinical manifestations.展开更多
目的探讨白头翁汤正丁醇提取物(Butyl alcohol extract of Bai Tou Weng decoction,BAEB)对外阴阴道念珠菌病(Vulvovaginal Candidiasis,VVC)白念珠菌临床分离株黏附作用的影响。方法平板法检测与BAEB共培养2 h、4 h时白念珠菌的CFU;XT...目的探讨白头翁汤正丁醇提取物(Butyl alcohol extract of Bai Tou Weng decoction,BAEB)对外阴阴道念珠菌病(Vulvovaginal Candidiasis,VVC)白念珠菌临床分离株黏附作用的影响。方法平板法检测与BAEB共培养2 h、4 h时白念珠菌的CFU;XTT还原法检测与BAEB共培养2 h、4 h的白念珠菌代谢活性;试管法检测白念珠菌絮凝能力;水-烃两相法检测白念珠菌细胞表面疏水性(cell surface hydrophobicity,CSH);荧光显微镜观察菌体活力;扫描电镜观察白念珠菌细胞形态;qRT-PCR法检测黏附相关基因ALS1、CSH1、HWP1、ALS5、ALA1、INT1、MNT2与ALS3的表达。结果 512、1 024μg/m L BAEB可显著抑制黏附2 h、4 h时的白念珠菌的CFU及代谢活性;肉眼和倒置显微镜下观察发现512、1 024μg/m L BAEB可明显延缓絮凝产生的时间;256、512、1 024μg/m L的BAEB均能够显著减少白念珠菌的细胞表面疏水性;qRT-PCR检测表明1 024μg/m L的BAEB作用后,ALS1、CSH1、ALA1、ALS3、INT1、HWP1分别下调18.7%、36%、37.8%、29.6%、19.9%、21.6%,ALS5与MNT2未产生明显变化。结论 BAEB可能通过调节黏附相关基因抑制白念珠菌VVC临床株的黏附作用。展开更多
目的：探讨细菌性阴道病（bacterial vaginosis,BV）和外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）在非妊娠期妇女的发病情况及其危险因素。方法：随机选取800例非妊娠期妇女,通过阴道分泌物检查、需氧菌及假丝酵母菌培养,了...目的：探讨细菌性阴道病（bacterial vaginosis,BV）和外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）在非妊娠期妇女的发病情况及其危险因素。方法：随机选取800例非妊娠期妇女,通过阴道分泌物检查、需氧菌及假丝酵母菌培养,了解BV和VVC患病情况,并结合问卷对可能的危险因素行单因素多变量非条件Logistic回归分析。结果：BV和VVC在受试人群的患病率分别为8.9%和8.1%。BV的危险因素为：阴道冲洗每周≥2次（OR2.438,95%CI1.285-4.626）和丈夫经常出差（OR1.946,95%CI1.046-3.620）;VVC的危险因素为：小学以下文化程度（OR3.217,95%CI1.326-7.805）。细菌培养结果以检出率表示,BV组与对照组比较,加德纳菌显著增加（70.4% vs 13.1%,P〈0.01）,乳杆菌显著减少（18.3% vs 65.4%,P〈0.01）;VVC组与对照组比较,白色假丝酵母菌（52.3% vs 3.1%,P〈0.01）和光滑假丝酵母菌（20.0% vs 3.7%,P〈0.01）均显著增加,乳杆菌减少（53.8% vs 65.4%,P〈0.05）。结论：BV和VVC均与阴道菌群失调有关,BV病原体以加德纳菌为主,阴道冲洗过频和丈夫经常出差是其危险因素;VVC病原体以白色假丝酵母菌和光滑假丝酵母菌为主,低学历是其危险因素;而BV和VVC与性行为的关系尚需进一步研究。展开更多
目的探讨白头翁汤正丁醇提取物（Butyl alcohol extract of Bai Tou Weng decoction,BAEB）对分离自外阴阴道念珠菌病（vulvovaginal candidiasis,VVC）的白念珠菌临床分离株（以下简称VVC临床株）生物膜形成的影响。方法采用微量稀释...目的探讨白头翁汤正丁醇提取物（Butyl alcohol extract of Bai Tou Weng decoction,BAEB）对分离自外阴阴道念珠菌病（vulvovaginal candidiasis,VVC）的白念珠菌临床分离株（以下简称VVC临床株）生物膜形成的影响。方法采用微量稀释法测定BAEB对白念珠菌的最低抑菌浓度（Minimal Inhibitory Concentration,MIC）;甲基四氮盐（XTT）还原法测定BAEB对白念珠菌生物膜代谢活性的影响,Time-kill法检测BAEB对白念珠菌活菌数的影响;结晶紫染色法测定BAEB对白念珠菌生物膜生物量（Biomass）的影响;扫描电镜（SEM）观察BAEB对白念珠菌生物膜形态结构的影响;激光共聚焦显微镜（CLSM）检测BAEB对白念珠菌生物膜荧光信号强度的影响;实时荧光定量PCR（qRT-PCR）检测生物膜相关基因UME6、PES1和HSP90的转录水平变化。结果 BAEB对12株白念珠菌的MIC在64~256μg/mL之间,对白念珠菌生物膜的SMIC80（抑制80%生物膜形成的最低药物浓度）为1 024μg/mL或以上;Time-Kill曲线显示在12h之后,512、1 024μg/mL浓度的BAEB对白念珠菌均具良好的杀伤作用;结晶紫染色法表明512、1 024μg/mLBAEB能够减少其生物膜生物量;SEM观察到1 024μg/mL BAEB能够有效抑制白念珠菌在不同黏附介质上生物膜的完整度;CLSM显示512、1 024μg/mL的BAEB可以明显降低生物膜荧光信号强度;qRT-PCR检测显示在256、512、1 024μg/mL的BAEB作用下,UME6转录水平分别下调了72%、71%、77%,在512、1 024μg/mL的BAEB下HSP90转录水平上调了2.23和3.31倍,而PES1未有明显变化。结论 BAEB可以抑制白念珠菌VVC临床株体外生物膜的形成。展开更多
文摘Candidiasis, also known as candidiasis vulvovaginitis, is an infection caused by different types of Candida fungi, the most frequent being Candida albicans. The present study reports an effective strategy, which opens new avenues for the treatment of this public health problem. The MAC<sup>®</sup> Methodology, conventional laser light-emitting (LLLT)/LED) methods are based on the biphasic response demonstrated many times in LLLT research and as with other forms of drugs, a “drug” (irradiation parameters) and a “dose” (irradiation times) and the “Arndt-Schulz Law” is often cited as a suitable model to describe the dose-dependent effects of LLLT. This method uses photopharmaceuticals, cell markers and the use of correct parameters for each case to induce the acceleration of tissue repair. The present study shows a case of a 32-year-old patient diagnosed with recurrent candidiasis 4 years ago. Eighteen sessions were performed (every other day) using a photoactivated component (Methylene blue 1% + Clotrimazole 1%) and LED phototherapy (red, blue and violet) with emission times of 60 - 260 seconds for each applicator, according to the dose recommendations of the scar acceleration method (MAC<sup>®</sup>). At the sixth treatment session there was a noticeable decrease in the itching sensation reported by the patient. In session 11 she reported feeling a great improvement, indicating that she no longer felt itching in any area after 18 sessions. The present case demonstrates new methodologies to treat common problems in the population that have a positive impact on the quality of life. This methodology has a promising future because it is non-invasive and requires a great biological transformation for inflammatory, fungal and viral control.
文摘Therapy of chronic recurrent vulvovaginal can- didiasis (VVC) caused by Candida glabrata is still rare in comparison to C. albicans infection, but therapy remains more difficult. Combination therapy with topical antifungals may improve therapy outcome, but still standard agents as fluconazole or itraconazole often fail. Posaconazole is a new systemic triazole with a wide antifungal spectrum including rare Candida species. Up to now, no clinical trials with posa- conazole in chronic recurrent VVC have been undertaken. Here, first results of the application of a new therapy regimen consisting of oral posaconazole in combination with topical ciclopiroxolamine are presented. 15 patients with chronic recurrent VVC caused by C. glabrata have been treated. 14 of these patients experienced successful therapy, clinical and mycological cure 30 days after begin of therapy has been observed. Long-term results are promising, as in 4 patients clinical and mycologic cure persists for more than 1 year up to now.
文摘Vaginitis is one of the most recurrent conditions that afflict women and require medical care. Vulvovaginal candidiasis (VVC) is frequently related to vaginal carriage of Candida albicans, an opportunistic polymorphic fungus, which colonizes the human skin, the mucosa and the reproductive tract. Actually, standard treatments to counteract vaginitis include several topical and oral treatments. The aim of this study was to evaluate the efficacy of a new biguanide compound, polyhexamethylene biguanide (PHMB) in avaginal solution, in women affected by vaginal candidiasis. For this reason, 40 women showing the symptoms previously ascribed to vaginal candidiasis were recruited and treated with a single PHMB dose of vaginal solution. After a single dose of treatment, 80% of them had a complete resolution of the fungal infection;furthermore, all of them reported clinical benefits, statistically significant reduction in both clinical signs and symptoms of candidiasis and a score’s reduction of 50%.
基金This study was financially supported by the Brazilian National Council for Scientific and Technological Development(CNPq,Brazil)We thank to Claudia R.C.Porto for support in laboratory tests.
文摘Objective: To evaluate the alpha-defensin (α-DF) genes polymorphism in women with vulvovaginal candidiasis and recurrence. Methods: This observational study included clinical vaginal secretion samples collected over four years from 88 women, ranging in age from 18 to 65 years, from medical centers of Sao Paulo and Mogi das Cruzes, Brazil. Thirty-six of these women were asymptomatic (control group) and 52 presented clinical condition compatible with vulvovaginitis (38 primary or episodic as non-recurrent forms, and 14 recurrent vulvovaginal candidiasis). A portion of each sample was plated on Sabouraud dextrose agar with chloramphenicol and grown on CHROMagar Candida for presumptive characterization. The identification of the species was obtained by sequencing of the ITS1 region of rDNA. α-DF genes were amplified for subsequent evaluation of polymorphisms by endonuclease restriction assay. Results: From 88 samples were isolated 60 Candida albicans and 28 non-albicans Candida spp. Resistant C. albicans strains and non-albicans Candida spp. were more prevalent in recurrence. In all groups, the number of resistant non-albicans Candida spp. was most high than susceptible strains. α-DF1, α-DF3 and α-DF1/α-DF3 genotypes were found in 32 (36.4%), 17 (19.3%), 6 (6.8%) vaginal samples, respectively. About 33 samples were not amplified. Recurrence and severe disease were more observed in homozygous population. Conclusions: Non-albicans Candida spp. and homozygotic α-DF genotipes (α-DF1 and α-DF3) were more related with severe clinical signs and recurrence. Further studies about vulvovaginal candidiasis and α-DF genes are necessary to access the more comprehensive role of defensins in clinical manifestations.
文摘目的：探讨细菌性阴道病（bacterial vaginosis,BV）和外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）在非妊娠期妇女的发病情况及其危险因素。方法：随机选取800例非妊娠期妇女,通过阴道分泌物检查、需氧菌及假丝酵母菌培养,了解BV和VVC患病情况,并结合问卷对可能的危险因素行单因素多变量非条件Logistic回归分析。结果：BV和VVC在受试人群的患病率分别为8.9%和8.1%。BV的危险因素为：阴道冲洗每周≥2次（OR2.438,95%CI1.285-4.626）和丈夫经常出差（OR1.946,95%CI1.046-3.620）;VVC的危险因素为：小学以下文化程度（OR3.217,95%CI1.326-7.805）。细菌培养结果以检出率表示,BV组与对照组比较,加德纳菌显著增加（70.4% vs 13.1%,P〈0.01）,乳杆菌显著减少（18.3% vs 65.4%,P〈0.01）;VVC组与对照组比较,白色假丝酵母菌（52.3% vs 3.1%,P〈0.01）和光滑假丝酵母菌（20.0% vs 3.7%,P〈0.01）均显著增加,乳杆菌减少（53.8% vs 65.4%,P〈0.05）。结论：BV和VVC均与阴道菌群失调有关,BV病原体以加德纳菌为主,阴道冲洗过频和丈夫经常出差是其危险因素;VVC病原体以白色假丝酵母菌和光滑假丝酵母菌为主,低学历是其危险因素;而BV和VVC与性行为的关系尚需进一步研究。
