Trends in Microbiology
History and new insights into host defense against vaginal candidiasis
Section snippets
Review of protective mechanisms against vaginal candidiasis
Mucosal candidiasis includes oropharyngeal, esophageal, gastrointestinal and vaginal infections. Before the AIDS epidemic, all mucosal sites were considered equally susceptible to infection. Therefore, early hypotheses for studies involving susceptibility to primary RVVC were derived from this broad definition. Accordingly, because mucosal candidiasis occurred most frequently in those patients with T cell immunosuppression 5, 6, 7 and experimental models showed a strong role for T cells in
Many questions left unanswered
Although numerous studies have been conducted over the past two decades to identify the protective host defense mechanisms that are used against vaginitis, what actually protects women from vaginitis and what events occur or are associated with acute or recurrent symptomatic infection are still not understood. These issues, along with several other facts and myths regarding vaginitis, are highlighted in a recent review by Mardh et al. [64]. The clinical studies and animal models have, however,
Development of a human live challenge model
In light of all the findings to date, we reasoned that the experimental design that would probably provide the most valuable information regarding putative vaginal protective host defenses against C. albicans was a live challenge model that offers controlled but natural conditions under which immunoreactivity can be properly monitored. Live challenge models in humans are not new. Currently there are live challenge models for Haemophilus ducreyi and Neisseria gonorrheae 66, 67. The primary
Concluding remarks
There has been an extensive history of studies that have attempted to understand the pathogenesis of VVC and RVVC, as well as the natural protective immune mechanisms against the infection. All the studies, both clinical and using animal models, have had an impact on our understanding of the complex events that are associated with protection and susceptibility to vaginitis. However, although the studies using animal models and clinical studies of women with RVVC have been invaluable, it has
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Weekly fluconazole therapy for recurrent vulvovaginal candidiasis: A systematic review and meta-analysis
2013, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :There are differing opinions on how aggressive maintenance therapy should be – weekly or monthly treatments [19,20]. The long-term antifungal regimen aims to prevent two essential pathogenetic mechanisms: increased risk of recolonization and increased risk of transformation to a symptomatic state primarily as a function of pathologic host intolerance of the candida [21]. Ketoconazole was used for suppressive treatment [18] but is no longer used for long term therapy because of its increased risk profile compared to the more modern azoles or triazoles.
The vaginal microbiome in health and disease
2011, Trends in Endocrinology and MetabolismCitation Excerpt :The cost of BV-related pregnancy complications in the United States alone is nearly $1 billion annually [3]. Similar statistics can be found for fungal vaginitis [12]. Approximately three out of four women experience at least one episode of vaginal candidiasis, whereas 20% of healthy women are asymptomatically colonized with Candida [13].
Identification and pattern of antifungal susceptibility of Candida species isolated from cases of vaginitis in a tertiary care hospital in India
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