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"We have read for you": Lactoferrin and lactobacilli

Lactoferrin and lactobacilli: essential elements to protect against vaginal infections

The system of innate defense of the mucous membranes of the female genital tract involves a close and complex interaction between the healthy vaginal microbiota and several proteins that protect the host from pathogens.

This week I have read an article entitled "Role of Lactobacilli and Lactoferrin in the Mucosal Cervicovaginal Defense)", published by the University of Rome La Sapienza, where is underlined the importance of Lactobacilli and Lactoferrin to maintain a healthy vaginal microbiota, essential to prevent and fight infections.

Vaginal lactobacilliand lactoferrin are two essential elements in the vaginal environment. Lactobacillus spp. and Lactoferrin are key components of the first line defense in the genital tract of the female mucosa. They are involved in protection against a multitude of microbial infections and are responsible for the most effective natural mechanism to attenuate inflammatory processes.

The vaginal tract is colonized by microorganisms known as "vaginal microbiota" (VM). These microorganisms, in addition to a complex synergism between proteins, epithelial and immune cells, play a fundamental role in the defense of the female genital tract against infectious and inflammatory processes.

In a healthy vaginal environment, there is a balance between the different components of the vaginal flora.

The rupture of the mucosal balance is determined by the alteration of one of the various elements and often leads to a greater susceptibility of the host to infections. A healthy vaginal microbiota is dominated by Lactobacillus spp., but other microorganisms may also be present to a lesser extent (Gardnerella, Prevotella, Streptococcus, Ureaplasma, Peptostreptococcus, Staphylococcus, Clostridium, Mycoplasma, Enterococco, Bacteroides, Escherichia, Bifidobacterium and Candida).

More than 20 species of Lactobacilli have been detected in the vagina.

However, in most women, the healthy vaginal microflora contains one or two species of Lactobacilli, including Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii, and Lactobacillus iners.

The role of vaginal lactobacilli is to protect the female genital tract through the production of lactic acid responsible for the low vaginal pH that inhibits pathogens. The lactic acid is in equilibrium with the lactate anion. The first is the predominant form in healthy vaginal conditions (low pH <4.5), thus exerting an antimicrobial activity against pathogens. Lactate anion predominates at a higher pH (> 4.5) in women with dysbiosis.

Several mechanisms underlie the protection exerted by lactobacilli: competition for nutrients and greater adherence of tissues, reduction of vaginal pH, modulation of immunity and the production of bioactive compounds. Among the bioactive factors of the cervicovaginal mucosa are lactoferrin, a cationic iron glycoprotein that belongs to the transferrin family. It is defined as multifunctional due to its antibacterial, antifungal, antiviral and antiparasitic activities and has recently been recognized as an important inflammatory modulator.

Lactoferrin is present in abundance in most biological fluids of mammals, is synthesized by the exocrine glands, by many epithelial cells of the mucosa and released by neutrophils during inflammation. The highest level of human lactoferrin (hLf) is found in colostrum. In tears, saliva, small intestine, cerumen, vaginal fluid, amniotic fluid, upper respiratory fluid, seminal plasma and cervical mucus, is found at very low levels. In particular, the concentration of hLf in human vaginal fluid corresponds to 1-3 μg/ml.

In women of childbearing age, the synthesis of antibacterial substances by lactobacilli and the competitive action for the acquisition of lactoferrin iron against microbes represent an effective mechanism of natural defense of the vaginal environment.

Both lactobacilli and lactoferrin can inhibit adhesion and, consequently, the entry of microbes into cells through interaction with the potential receptors of cell surface pathogens. Lactobacilli and lactoferrin appear to be complementary, since lactobacilli inhibit intracellular microbial replication and, together with lactoferrin, hinder the infection of still healthy cells by microbes released extracellularly. This close collaboration is also exercised through its anti-inflammatory function. In this scenario, the mucous environment represents a good model of mutualism and reciprocity against the attack of microbes.

Considering the lack of effective treatments to combat bacterial infections resistant to antibiotics, the oral and intravaginal administration of Lactobacilli and Lactoferrin could be a new efficient therapeutic strategy and a valuable tool to restore the balance of the vaginal bacterial flora. In the market we can find different supplements that contain lactobacilli and lactoferrin that are very effective to rebalance the vaginal microbiome. The best option should be supplements that contain both, even better if they are associated with natural substances with immunostimulating properties such as lapacho.

Also vaginal douchings based on lactoferrin, lattobacillus, N-acetylcysteine and Morinda citrifolia represent a good strategy both to face possible infections and to maintain a normal vaginal eubiosis.

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