Dual Mechanisms of Action: Anti-Candida and Anti-Inflammatory Potential of Lactobacillus Fermentation Broth in Treating Vulvovaginal Candidiasis Original paper

What was studied?

This study investigated the dual anti-Candida and anti-inflammatory effects of VAGINNE®, a fermentation broth derived from Lactobacillus crispatus, Lactobacillus gasseri, and Lactobacillus jensenii, in treating vulvovaginal candidiasis (VVC). Using a controlled mouse model of Candida albicans-induced vaginal infection, the researchers examined the microbiome composition, cytokine levels, and tissue integrity following treatment with VAGINNE® compared to a standard antifungal agent (nystatin) and untreated controls.

Who was studied?

The experimental subjects were female BALB/c mice, aged seven weeks. The researchers inoculated the mice with Candida albicans to mimic human VVC and then divided them into four groups: a healthy control group, an infected group, a nystatin-treated group, and a group treated with VAGINNE®. They conducted microbiological, immunological, and histological analyses on vaginal lavage samples, plasma, and vaginal tissues.

Most Important Findings

VAGINNE® demonstrated a dual mechanism of action in combating Candida albicans. It significantly reduced the fungal burden in the vagina (from 1.67 × 10⁷ CFU/mL in infected controls to 6.15 × 10⁶ CFU/mL) and simultaneously restored beneficial Lactobacillus populations, reaching 1.19 × 10⁸ CFU/mL compared to just 1.20 × 10⁷ CFU/mL in infected animals. Histologically, mice treated with VAGINNE® exhibited preserved vaginal epithelial structure and reduced tissue invasion by fungal hyphae. Immunologically, VAGINNE® decreased levels of key proinflammatory cytokines associated with Th17-mediated immunity. Specifically, IL-17A, IL-22, and IL-23 were significantly reduced in vaginal tissues, while systemic inflammation markers IL-6 and IL-1β were also suppressed in plasma. These cytokines are crucial in fungal immunity but also contribute to excessive inflammation and tissue damage in VVC.

Thus, VAGINNE® not only restored microbiome balance and modulated the immune response, reducing local and systemic inflammation. This combination of microbial suppression and immune regulation reflects a targeted and multifaceted therapeutic strategy, contrasting the fungistatic nature of conventional azoles, which often leads to recurrence and resistance.

Greatest Implications of the Study

This study offers compelling evidence that microbiome-modulating therapies, particularly those using Lactobacillus-derived products, can effectively treat vulvovaginal candidiasis through both antifungal and anti-inflammatory mechanisms. VAGINNE® holds promise as a probiotic-based alternative to azole antifungals, especially in light of increasing drug resistance and recurrence rates in VVC. By promoting Lactobacillus regrowth, reducing fungal load, and downregulating cytokine-driven inflammation, VAGINNE® could support a paradigm shift in VVC management toward microbiome-friendly interventions. However, further clinical trials in human populations are necessary to confirm its safety and efficacy before widespread application.