ABSTRACT Some probiotic strains of lactobacilli appear to be protective against vulvovaginal candidiasis. The vaginal epithelial cell line (VK2 E6/E7) was used as a model to assess the protective mechanisms of probiotic lactobacilli for cells chal- lenged with Candida albicans. Co-culture of VK2 cells with Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 prior to C. albicans challenge showed reduced adherence of C. albicans to the VK2 cells and inhibition of C. albicans growth. H2O2 concentrations of 0.3 μg/ml, produced by lactobacilli and estrogen-primed VK2 cells, were inhi-bitory to C. albicans growth. C. albicans growth was also inhibited by 10 μg/ml lactic acid. C. albicans infection was increased by 17β-estradiol through induction of hyphal germination. L. reuteri RC-14, but not L. rhamnosus GR-1, H2O2, or lactic acid inhibited estrogen-stimulated hyphal germination. The results of this study support a role for H2O2 and lactic acid from probiotic bacteria in vaginal epithelial protection from candidiasis and a role for 17β-estradiol in the disease by induction of C. albicans hyphal germination.
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