Diagnosis and therapy for urinary tract infections
International Journal of Probiotics and Prebiotics
The ability of intravaginally administered lactobacilli to cure bacterial vaginosis (BV) has recently been shown. BV is a condition that has been associated with increased risk of urinary and sexually transmitted infections and preterm labor. Displacement or killing of BV pathogens is believed to be one mode of action of probiotic therapy, but the following study was undertaken to examine host factors that may also play a role, or be markers for the effects induced by lactobacilli treatment. Using a 54,675 gene transcript Affymetrix HGU133 Plus 2.0 GeneChip microarray to analyze RNA extracted from vaginal scrapings, samples from two women with a history of BV were taken before and 7days after 5 days of intravaginal therapy with Lactobacillus rhamnosus GR-1. There were 3,536 gene expression changes of which 444 were at the five fold or more level, consistent for both subjects' between day 0 and 7. The genes potentially relevant to vaginal changes and those altered by lactobacilli, included keywords related to antimicrobial peptides, pattern recognition receptors (PRR) and cytokines. Twenty-six genes fell within the criteria, all of which were up-regulated including the antimicrobial peptide psoriasin, the PRR TLR-1 and 2, mucin 4, cytokine receptors for IL-1β, IL-8, and IL-18. Caspase-8, a proapoptotic protease with an essential role in lymphocyte activation and protective immunity, was the most prominently up-regulated factor (22 fold). This is the first study to show that probiotic lactobacilli can modulate constitutive expression of innate defenses in the vaginal mucosa. A larger study is warranted to confirm these preliminary findings. Copyright © 2008 by New Century Health Publishers, LLC.