MICROBIOTA VAGINALE

MICROBIOTA VAGINALE

La salute umana è strettamente e dipendente da una relazione simbiotica tra esseri umani e batteri.

Il progetto per lo studio del MICROBIOTA UMANO nasce nel 2007. L’interesse verso la caratterizzazione batterica del sistema genitourinario deriva dal fatto che l’equilibrio dei simbionti presenti a livello vaginale condiziona alterazioni quali: infezioni, cervico-vaginiti, infezioni post chirurgiche ecc. Molte diversità del microbiota vaginale comunque, possono essere considerate normali e non rappresentato necessariamente uno stato patologico.

Il microbiota vaginale è dominato da diverse specie di LATTOBACILLI che aiutano a prevenire le infezioni vaginali producendo acido lattico, perossido d’idrogeno, peptidi antimicrobici e competendo con altri batteri. Gli studi genomici dell’ambiente microbico vaginale hanno evidenziato la dominanza di uno o due specie di LATTOBACILLI la maggior parte dei quali si riconosce in:

  • LACTOBACILLUS JERSENIL
  • LACTOBACILLUS INERS
  • LACTOBACILLUS CRISPATUS
  • LACTOBACILLUS GASSERI

 

Una parte di dinne asintomatiche e sane ospitano in vagina: PREVOTELLA, GARDNERELLA, ATOPOBIUM, MEGASPHAERA.

Molti fattori inoltre influenzano la composizione del microbiota vaginale all’interno della stessa donna: il ciclo mestruale, l’attività sessuale, l’età con le conseguenti variazioni ormonali (adolescenza/menopausa), la razza.

Una riduzione dei lattobacilli vaginali con una crescita di batteri anaerobici è alla base della VAGINOSI BATTERICA che è considerata la causa più comune della vaginite nelle donne sessualmente attive. Dal punto di vista ostetrico la VB (vaginosi batterica) è associata a molte complicazioni tra cui aborto e parto pretermine. Più controversa è l’implicazione della VB nell’infertilità. Un gruppo italiano di ricercatori è riuscito a correlare statisticamente categorie di microbioti denominati COMMUNITY STATE TYPES (CST) con i casi di infertilità SINE CAUSA suggerendo che tale correlazione potrebbe essere imputata alla produzione e al rilascio di lattato.

I risultati confermano i dati di bontà microbica riferibili a L. CRISPATUS ma aggiungono anche elementi a favore di L. INERS. Effetti negativi avrebbero invece cluster con dominanza di L. GASSERI.

Da ciò si deduce che la possibilità di definire in maniera corretta la genomica del microbiota vaginale può essere uno strumento fondamentale nelle mani del ginecologo per meglio accompagnare le donne nel loro percorso di fertilità.

 

Tratto da: BATTERI INTESTINALI, DONNA, FERTILITA’ E VITA

MASSIMO COCCHI E MATTEO PILORASI

e da: ARGOMENTI DI TERAPIA BATTERICA (2° EDIZIONE) FRANCESCO DI PIERRO

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