Vaginitis, Vaginal Discharge, Bacterial Vaginosis Cure with MegaEl-Dena, Bacterial Vaginosis, Gardnerella Vaginalis, Vaginal Discharge Cure with Dietary Supplement | Vitaminized

BENEFITS OF MEGAEL-DENA FOR PATIENTS WITH BACTERIAL VAGINOSIS AND DURING PREGNANCY AND BREASTFEEDING

The human body is inhabited by at least 10,000 species of microorganisms (commensal microbiota, or microflora), many of which still remain to be identified [1]. They protect the host from invasion by pathogenic microorganisms, either by direct competition or via immunomodulation, and disturbances in the composition of the commensal microbiota (dysbiosis, or dysbacteriosis) are associated with a number of pathological conditions [2, 3]. Although most commensal microorganisms inhabit the gastrointestinal tract, some live in or on other parts of the body, such as the skin, buccal cavity, respiratory tract, and vagina, where they also benefit human health [4].

Various microorgamisms colonize the initially sterile gastrointestinal tract of a newborn baby. This colonization is largely complete in ~1 week [5]; the first exposure to commensal microorganisms occurs during the infant's passage through the birth canal [6] and continues as the baby is breastfed, because breast milk also contains commensal microorganisms, which presumably translocate there from the mother’s gastrointestinal tract via mesenteric lymph nodes [7]. Colonization by “incorrect” sets of microorganisms (which may be due to such factors as antimicrobial medication or sterile food) results in dysbiosis [3, 8, 9]. Dysbiosis is associated with several immunological disorders, including atopic allergy; the gut microbiota differs in healthy and allergic babies [9]. There is increasing evidence that dysbiosis not only in infants but also in expectant mothers is a risk factor for development of atopic allergies, likely because the composition of the vaginal microflora and that of breast milk affects the composition of the infant’s microflora [10]. The importance of the vaginal microflora for establishing the correct microflora in an infant is suggested by a study which found that the incidence of IgE-associated allergic disease was elevated in cesarean-delivered children and could be reduced to a level similar to that in children delivered naturally by administration of probiotics [11].

The correct composition of the vaginal microflora is also important for women’s health regardless of pregnancy. Bacterial vaginosis is a form of dysbiosis characterized by a loss of the normal vaginal microbiota, which is dominated by Lactobacillus species, and their replacement by other bacteria, mainly anaerobes [12]. Lactobacilli are thought to suppress the growth of other bacteria by producing H2O2 and bacteriocins and by lowering the pH [13]. In many cases, bacterial vaginosis is asymptomatic, but it may also cause vaginitis (inflammation of the vagina) and is reportedly associated with an increased risk of Neisseria gonorrhoeae and Chlamydia trachomatis infections [14] and several viral infections, including HIV [15]; it may be both a cause and a consequence of vaginal infections [16]. Bacterial vaginosis may also make it more difficult for women to become pregnant and is associated with an increased risk of miscarriage or preterm delivery [16, 17, 18, 19]. Some examples of studies of the effectiveness of probiotics in patients with bacterial vaginosis and in expectant mothers for prevention of atopic allergies in infants are considered below.

Bacterial vaginosis is treated with antibacterial agents or probiotics (Lactobacillus species), or a combination of both. A collaborative Canadian–Nigerian study conducted in Nigeria compared the effectiveness of bacterial vaginosis treatment with an antibacterial agent (metronidazole) and a probiotic that included two Lactobacillus species, L. rhamnosus (one of the components of MegaEl-Dena) and L. reuteri [20]. This study found that bacterial vaginosis was cured in significantly fewer patients who received metronidazole in comparison with patients who received the probiotic [20]. In a parallel study, the same team compared the effects of combinations of metronidazole with the above probiotic or placebo and found that, among 106 subjects, 88% were cured at the 30-day follow-up in the metronidazole/probiotic group but only 40% were cured in the metronidazole/placebo group [21]. Thus, these studies suggested that bacterial vaginosis can be treated using probiotics alone or as part of combination therapy.

In a study of 18–40-year-old non-pregnant women with no urogenital infections conducted in Italy, Marcone and colleagues [22] found that administration of oral metronidazole followed by vaginal application of L. rhamnosus was more efficient in preventing bacterial vaginosis recurrence than metronidazole alone. However, a double-blind placebo-controlled randomized study conducted in Australia concluded that another Lactobacillus species, L. acidophilus, did not reduce the recurrence when used together with antibacterial therapy [23]. These contrasting results may underscore the importance of the choice of probiotic bacterial species. In fact, not only different species and but even different strains of the same Lactobacillus species colonize the vagina with different efficiency [24]; further research is needed to optimize probiotic formulations used for this purpose. In the absence of detailed information in this respect, the use of formulations that contain several Lactobacillus species, such as MegaEl-Dena (which contains three species of this genus), may be more promising than the use of single-species formulations.

A recent meta-analysis of 12 trials (1,304 patients in total) has confirmed the overall beneficial effect of probiotics for patients with bacterial vaginosis (especially for European populations and in shorter follow-up periods), but concluded that analysis is somewhat hampered by the heterogeneity of study design and that large-scale studies are needed to further ascertain the effectiveness of probiotics for bacterial vaginosis treatment [25].

Atopic dermatitis

There have been multiple clinical studies on the efficiency of probiotics in the prevention and management of atopic allergies, including in expecting mothers (reviewed by Kalliomäki and colleagues [9] and Cabana [26]). A study conducted in Finland found that pre- (one month) and postnatal (six months of age) administration of L. rhamnosus was associated with a significant reduction in the incidence of atopic dermatitis during the first seven years of life [27, 28]. Another study by the same team specifically examined the effect of probiotics on allergic sensitization in children born from allergic mothers and thus presumably genetically predisposed to atopic allergies [29]. The authors found that the risk of sensitization was increased by breastfeeding and that probiotic supplementation during pregnancy and lactation had a protective effect. Although the validity of their conclusion about the effect of breastfeeding on sensitization has been considered controversial by an independent team, the main conclusion, that probiotic supplementation reduces the risk of sensitization, has not been questioned [30].

A more recent study conducted in New Zealand compared supplementation with another strain of L. rhamnosus and supplementation with B. lactis. Supplementation was performed either in mothers (from 35 weeks of gestation until six months after birth) or in infants (from birth until two years of age) [31]. The authors reported that both types of supplementation with L. rhamnosus were associated with a reduced prevalence of eczema, another form of atopic allergy (by ~50%) at the age of two and four years; a significant reduction (by 31–44% depending on the parameter used) persisted at least until the age of six years [31]. In contrast, supplementation with B. lactis had no effect [31].

Overall, since MegaEl-Dena contains 3 species of Lactobacillus (L. acidophilus, L. casei, and L. rhamnosus), supplementation with this formulation may be useful for patients with bacterial vaginosis and expecting mothers, especially those considered at risk of atopic allergies.

References

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