In vitro and in vivo effects of beneficial vaginal lactobacilli on pathogens responsible for urogenital tract infections.

The aim of this work was to evaluate the effects of beneficial human vaginal lactobacilli (Lb) on urogenital pathogens through in vitro and in vivo experiments. Co-aggregative and antimicrobial properties between five vaginal Lb strains and urogenital pathogens or potential pathogens (Streptococcus agalactiae, Staphylococcus aureus and Candida albicans strains) were assayed. Also, associative cultures of Lb strains and S. agalactiae were performed and bacterial growth, pH, lactic acid and hydrogen peroxide (H2O2) were determined at different times. Based on the results obtained, the in vivo studies were assayed in mice with Lactobacillus gasseri CRL 1509 or Lactobacillus salivarius CRL 1328 inoculated intravaginally (i.v.) and then challenged i.v. with S. agalactiae. Results were analysed by ANOVA (repeated measures and general linear models). Most of the Lb strains increased the percentage of aggregation of S. agalactiae strains. Only one strain (Lactobacillus reuteri CRL 1324) positively affected the aggregation of S. aureus and none increased the aggregation of C. albicans. The inhibition of the growth of S. agalactiae strains by production of organic acids by lactobacilli was evidenced. The Lb-S. agalactiae co-cultures showed a significant inhibition of the pathogen after 4 h and 8 h of incubation. Parallel increases in lactic acid and H2O2 levels were observed. However, in the experimental murine model, no significant differences were obtained in the number of streptococci recovered from the vaginal tract of control mice and those inoculated with Lb. In conclusion, vaginal Lb exhibited in vitro co-aggregative and antimicrobial effects on S. agalactiae strains, suggesting that they could be promising candidates for protection against S. agalactiae challenge. However, as these effects were not evidenced in the murine model used, further animal studies under different experimental conditions should be conducted to evaluate the preventive effect of Lb against challenge with S. agalactiae.

Estimation of combined effects of carbon and nitrogen sources on the growth and bacteriocin production of Lactobacillus salivarius from human source.

Vaginal Lactobacillus salivarius CRL 1328 (Centro de Referencia para Lactobacilos Culture Collection) or the bacteriocin that produces could be included in a urogenital probiotic formula to prevent urogenital infections in women. The objective of this work was to determine the effects of different carbon and nitrogen sources on the growth and bacteriocin production of this microorganism. A fractional factorial design 3(5-1) was applied to evaluate the effects of five nutrients (glucose, lactose, yeast extract, tryptone and meat peptone), at three different concentrations (0, 1 and 2%). Results were statistically analyzed for linear and quadratic effects of nutrients, along with their interactions. All the nutrients tested stimulated the cell growth and bacteriocin production, but lactose had not a significant influence on the last response. The linear effects of higher magnitude on biomass and bacteriocin production were those of yeast extract and tryptone. The results demonstrated that there were significant interactions between the different nutrients, depending on the response evaluated. Maximum bacteriocin production was reached in different growth media with a lower cost than conventional culture media used in the laboratory. These findings will contribute to the design of a pharmaceutical product for the restoration of ecological balance of urogenital tract.

[Prevalence and characterization of vaginal lactobacillus species in women at reproductive age without vulvovaginitis]. / Prevalência e caracterização de espécies de lactobacilos vaginais em mulheres em idade reprodutiva sem vulvovaginites.

PURPOSE: to identify species of lactobacillus isolated from the vaginal contents of healthy and asymptomatic women, determining the most prevalent species and characterizing them phenotypically. METHODS: lactobacillus have been isolated in selective milieu from samples of the vaginal contents of 135 women without complaints of vaginal secretion, and with negative laboratorial diagnosis of vaginal infection, followed up at an outpatient clinic. After being identified by multiplex PCR, the isolates have been submitted to RNAr 16S gene sequencing, when necessary. They have also been evaluated concerning the production of lactic acid, H2O2, bacteriocins and the ability to adhere to epithelial cells. RESULTS: eight-three lactobacillus strains were isolated and identified, L. crispatus (30.1%), L. jensenii (26.5%), L. gasseri (22.9%) e L. vaginalis (8.4%), being the prevalent species. Only 20 of those isolates did not present H2O2 production, in detectable amounts. From the 37 strains selected for the test of adhesion to the epithelial cells, 12 presented 50 to 69% of adhesion, 10 presented 70% or more, and the remaining, little or no adhesion at all. None of the tested strains produced bacteriocins. CONCLUSIONS: the lactobacillus species more prevalent in women without vulvovaginitis, isolated in selective culture milieu and identified by molecular methods were L. crispatus, L. jensenii and L. gasseri. Besides the fact of being more prevalent, these strains also presented better production of H2O2, and reached lower pH values in the culture milieu.

Prevalência e caracterização de espécies de lactobacilos vaginais em mulheres em idade reprodutiva sem vulvovaginites / Prevalence and characterization of vaginal lactobacillus species in women at reproductive age without vulvovaginitis

OBJETIVO: identificar espécies de lactobacilos isolados do conteúdo vaginal de mulheres saudáveis e assintomáticas; determinar as espécies mais prevalentes e caracterizá-las fenotipicamente. MÉTODOS: lactobacilos foram isolados em meio seletivo a partir de amostras de conteúdo vaginal de 135 mulheres, sem queixa de corrimento e com diagnóstico laboratorial negativo para infecções vaginais, acompanhadas em um ambulatório de Planejamento Familiar. Os isolados foram identificados por PCR multiplex e, quando necessário, submetidos ao sequenciamento do gene RNAr 16S. Foram também avaliados quanto à acidificação do meio de cultura, à produção de ácido láctico, de H2O2, bacteriocinas e a capacidade de adesão às células epiteliais. RESULTADOS: oitenta e três cepas de lactobacilos foram isoladas e identificadas, sendo as espécies predominantes L. crispatus (30,1%), L. jensenii (26,5%), L. gasseri (22,9%) e L. vaginalis (8,4%). Apenas 20 destes isolados não produziram H2O2 em quantidades detectáveis. Das 37 linhagens selecionadas para teste de adesão a células epiteliais, 12 apresentaram adesão entre 50 a 69%, 10 apresentaram 70% ou mais, e as restantes pouca ou nenhuma adesão. Nenhum dos isolados produziu bacteriocinas. CONCLUSÕES: as espécies de lactobacilos mais prevalentes em mulheres sem vulvovaginites, isoladas em meio de cultura seletivo e identificadas por métodos moleculares, foram L. crispatus, L. jensenii e L. gasseri. Além de mais frequentes, tais linhagens também apresentaram melhor produção de H2O2 e atingiram menores valores de pH em meio de cultura.

PURPOSE: to identify species of lactobacillus isolated from the vaginal contents of healthy and asymptomatic women, determining the most prevalent species and characterizing them phenotypically. METHODS: lactobacillus have been isolated in selective milieu from samples of the vaginal contents of 135 women without complaints of vaginal secretion, and with negative laboratorial diagnosis of vaginal infection, followed up at an outpatient clinic. After being identified by multiplex PCR, the isolates have been submitted to RNAr 16S gene sequencing, when necessary. They have also been evaluated concerning the production of lactic acid, H2O2, bacteriocins and the ability to adhere to epithelial cells. RESULTS: eight-three lactobacillus strains were isolated and identified, L. crispatus (30.1%), L. jensenii (26.5%), L. gasseri (22.9%) e L. vaginalis (8.4%), being the prevalent species. Only 20 of those isolates did not present H2O2 production, in detectable amounts. From the 37 strains selected for the test of adhesion to the epithelial cells, 12 presented 50 to 69% of adhesion, 10 presented 70% or more, and the remaining, little or no adhesion at all. None of the tested strains produced bacteriocins. CONCLUSIONS: the lactobacillus species more prevalent in women without vulvovaginitis, isolated in selective culture milieu and identified by molecular methods were L. crispatus, L. jensenii and L. gasseri. Besides the fact of being more prevalent, these strains also presented better production of H2O2, and reached lower pH values in the culture milieu.

Effect of some pharmaceutical excipients on the survival of probiotic vaginal lactobacilli.

Lactobacilli are the predominant microorganisms of the vaginal bacterial microbiota, and they play a major role in the maintenance of a healthy urogenital tract. In consequence, the interest in their potential use as probiotics has significantly increased during the last decade. In the present study we assessed the influence of different excipients on the survival of 4 probiotic vaginal lactobacilli incorporated into glycerinated gelatin ovules and stored at 5 degrees C for 60 d. Results showed that viability after storage was a strain-dependent characteristic, but inclusion of ascorbic acid significantly increased survival in 3 of the 4 strains tested. The best survival was observed for Lactobacillus salivarius CRL 1328 in ovules containing skimmed milk. No significant differences in viability were observed between control ovules (glycerogelatin base without excipients) and those containing lactose or Tween 80 for any of the strains tested. Lactobacillus acidophilus CRL 1259 and Lactobacillus crispatus CRL 1266 were, respectively, the most resistant and sensitive strains to the storage with the different substances. In conclusion, these results provide a basis for selecting excipients to improve the survival of lactobacilli in a probiotic product, in an attempt to ensure the delivery of an adequate number of viable cells to the urogenital tract.

Production of antimicrobial substances by lactic acid bacteria I: determination of hydrogen peroxide.

Restoration of the balance of different ecological niches has been proposed as a way to control the income of pathogenic microorganisms. The genus Lactobacillus has been used in different human and animal tracts as probiotic microorganisms with this objective in mind. The characteristics of the strains proposed as probiotics have been published or patented under the process of elaboration of different types of products. One of the mechanisms suggested to control the vaginal ecosystem is the production of antagonistic substances (lactic acid, bacteriocins, or H2O2). The H2O2-producing microorganisms present in the vagina of healthy women have been suggested as some of the bacteria responsible for maintenance of ecological balance, mainly in pregnant women. The absence of these microorganisms is related to a higher risk of: bacterial vaginosis, recurrent urinary tract infections by Escherichia coli, and acquisition of human immunodeficiency virus type 1 (HIV-1). Bauer has proposed that H2O2-producing lactobacilli also might exert control over vaginal cancer through specific interactions of reactive oxygen species, such as superoxide anion, hydroxyl radicals, and hypochlorous acid. The conversion of H2O2 into more toxic compounds during the oxidative process is potentiated by peroxidase and halures. This enzyme and some halures, such as chloride and bromide, are present in vaginal washes in sufficient amounts to allow an optimal environment for successful inhibition of pathogens. In vitro tests provide an approach for determining the ability of lactobacilli to produce H2O2. The H2O2 amounts produced in such systems are probably not a direct reflection of what happens in the vaginal tract of women or animals, which is not yet know. However, there is a registered patent with an H2O2-generating L. crispatus strain, also supporting the use of H2O2-producing lactobacilli to restore the vaginal ecosystem.

Statistical models to optimize production of probiotic characteristics.

The use of probiotic microorganisms has been widely promoted in the last 20 years. Probiotics have applied to the gastrointestinal tract as capsules or as fermented milks. The characteristics of the strains proposed as probiotics have been published or patented after elaboration of the product. The first step in designing a probiotic product is to isolate and characterize strains with beneficial properties. Our group has reported the isolation and characterization of 134 strains of lactobacilli from the vagina of women from our city. Surface properties and the production of antagonistic substances has also been published. From these studies, certain strains were selected because they shared probiotic characteristics. The second step in the design of a pharmaceutical product is to determine the optimal conditions for obtaining the highest amount of viable microorganisms, as well as the best conditions to produce antagonistic substances. To perform these types of experiments, laboratory assays can be carried out to determine the optimum conditions in which the microorganisms can be cultured. Growth parameters and optimal growth conditions can be studied by the classical methodology or by the application of alternative methodologies. Alternative methods have been widely used in the food industry, including experimental designs to test multiple conditions at the same time, complemented by the use of statistical models to evaluate and compare all the conditions tested. The object of this chapter is to describe the experimental designs used to study the technological characteristics of vaginal probiotic lactobacilli as well as the application of statistical models for evaluation of the different conditions tested for the production of biomass and antagonistic substances in these bacteria. With this objective in mind, in the present chapter, the following areas are explored: 1. Growth experiments performed to study the effect of temperature, pH, agitation, and culture media on the growth and production of antagonistic substances by vaginal lactobacilli. 2. Fractional and complete factorial experimental designs used to perform the growth experiments. 3. Statistical models applied to evaluate the growth parameters and their modifications under the conditions assayed.

Comparison of the growth and hydrogen peroxide production by vaginal probiotic lactobacilli under different culture conditions.

OBJECTIVE: The purpose of this study was to determine the optimal conditions for the growth and hydrogen peroxide production by vaginal lactobacilli. STUDY DESIGN: Two vaginal lactobacillus strains were cultured under different growth conditions (temperature, pH, agitation, and growth media) with a fractional factorial experimental design. RESULTS: The optimal growth conditions of Lactobacillus paracasei CRL (Centro de Referencia para Lactobacilus Culture Collection) 1289 and Lactobacillus crispatus CRL 1266 were temperature 37 degrees C and initial pH 6.5, nonagitated cultures, in autolysat de levure; peptone, tryptone, Tween 80 et glucose (LAPTg) broth for L paracasei or in de Man-Rogosa-Sharpe (MRS) and LAPTg broths for L crispatus. The hydrogen peroxide production, detected only in agitated cultures, was higher at 37 degrees C and pH 6.5. The oxidative metabolite produced the self-inhibition of the lactobacilli growth. In mixed cultures of lactobacilli and Staphylococcus aureus under the optimal conditions of hydrogen peroxide production, the pathogen growth was inhibited. CONCLUSION: The results provided information about the factors that affect the hydrogen peroxide production and about the most favorable conditions with which to obtain the highest biomass in the shortest possible time.