妊娠期外阴阴道假丝酵母菌病发病机制的研究概述
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摘要
外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)是由假丝酵母菌引起的常见外阴阴道炎症。VVC在妊娠期有较高的发病率。妊娠期VVC的常见病原体主要是白色假丝酵母菌,其发病机制包括菌体本身的致病因素、妊娠期激素的升高及免疫功能下降。菌体的致病因素包括粘附力、细胞外酶及形态转换。同时VVC对妊娠有一定影响,主要导致宫内感染、胎膜早破、早产、低体质量儿出生、流产、死胎、假丝酵母菌性肺炎等疾病。本文就国内外妊娠期外阴阴道假丝酵母菌病的发病机制进行综述。
Vulvovaginal candidiasis(VVC) is a common vulvovaginal inflammation caused by Candida which has higher incidence during pregnancy. Candida albicans is the major pathogenic bacteria of VVC during pregnancy. The pathogenesis includes the pathogenic factors of the bacteria, increased hormones during pregnancy and decreased immune function. The pathogenic factors of Candida includes adhesion, extracellular enzymes and morphological changes. At the same time, VVC has a certain impact on pregnancy, mainly leading to intrauterine infection, premature rupture of membranes, premature birth, low birth weight children, abortion, stillbirth, Candida pneumonia and other diseases. In this article we will discuss the pathogenesis of vulvovaginal candidiasis in pregnancy.
Vulvovaginal candidiasis(VVC) is a common vulvovaginal inflammation caused by Candida which has higher incidence during pregnancy. Candida albicans is the major pathogenic bacteria of VVC during pregnancy. The pathogenesis includes the pathogenic factors of the bacteria, increased hormones during pregnancy and decreased immune function. The pathogenic factors of Candida includes adhesion, extracellular enzymes and morphological changes. At the same time, VVC has a certain impact on pregnancy, mainly leading to intrauterine infection, premature rupture of membranes, premature birth, low birth weight children, abortion, stillbirth, Candida pneumonia and other diseases. In this article we will discuss the pathogenesis of vulvovaginal candidiasis in pregnancy.
引文
[1] Khan M,Ahmed J,Gul A,et al.Antifungal susceptibility testing of vulvovaginal Candida species among women attending antenatal clinic in tertiary care hospitals of Peshawar[J].Infect Drug Resist,2018,11:447-456
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[3] Sangaré I,Sirima C,Bamba S,et al.Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso[J].J Mycol Med,2018,28(1):186-192.
[4] Sherin M,Ahmed WA.Exoenzymes production and antifungal susceptibility of Candida species isolated from pregnant women with vulvovaginitis[J].J Am Sci,2012,8(12):l392-1399.
[5] Chen HF,Lan CY.Role of SFP1 in the regulation of Candida albicans biofilm formation[J].PLoS One,2015,10(6):e0129903.doi:10.1371/ journal.pone.0129903.
[6] Noori M,Dakhili M,Sepahvand A,et al.Evaluation of esterase and hemolysin activities of different Candida species isolated from vulvovaginitis cases in Lorestan Province,Iran[J].Curr Med Mycol,2017,3(4):1-5.
[7] Linhares P,Viana-Pereira M,Ferreira M,et al.Genetic variants of vascular endothelial growth factor predict risk and survival of gliomas[J].Tumour Biol,2018,40(3):1010428318766273.
[8] Li L,Pan Y,Dai L,et al.Association of genetic polymorphisms on vascular endothelial growth factor and its receptor genes with susceptibility to coronary heart disease[J].Med Sci Monit,2016,22:31-40.
[9] 王娜,韩琦,桑建利.白色念珠菌的形态类型及致病性[J].生物学通报,2015,50(10):3-8.
[10] PAN Lina,CAO Chengjun,WEI Yujia,et al.Phenotypic transitions and their regulatory mechanisms in the human fungal pathogen Candida albicans[J].Chin J Cell Biol,2016,38(9):1049-1059.(in Chinese) 潘丽娜,曹承俊,魏羽佳,等.白色念珠菌形态转换及其调控机制的研究进展[J].中国细胞生物学学报,2016,38(9):1049-1059.
[11] Dennerstein GJ,Ellis DH.Oestrogen,glycogen and vaginal candidiasis[J].Aust N Z J Obstet Gynaecol,2001,41(3):326-328.
[12] Barousse MM,Espinosa T,Dunlap K,et al.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J].Infect Immunol,2005,73(11):7765-7767.
[13] DAI Qianling,WANG Wei.Changes of estrogen and progesterone in patients with recurrent candidal vaginitis and its clinical significance[J].J Hainan Med Univ,2014,20(2):229-233.(in Chinese) 代倩苓,王薇.复发性念珠菌性阴道炎患者雌激素和孕激素水平变化测定及其临床意义[J].海南医学院学报,2014,20(2):229-233.
[14] Alves CT,Silva S,Pereira L,et al.Effect of progesterone on Candida albicans vaginal pathogenicity[J].Int J Med Microbiol,2014,304(8):1011-1017.
[15] Abitzsch S,Stepan H,Sack U,et al.Detection of cervicalimmunoglobulin A in normal pregnancy[J].J Perinat Med,2001,29(1):36-41.
[16] Wong SL,Demers M,Martinod K,et al.Diabetes primes neutrophils to undergo NETosis,which impairs wound healing[J].Nat Med,2015,21(7):815-819.
[17] LIN Zhenyun,FEI Xiaoyang,CHEN Hao,et al.Expression and significance of neutrophil extracellular traps in patients with Candida vaginitis[J].Chin J Gen Pract,2018,5(16):792-794.(in Chinese) 林珍云,费小阳,陈豪,等.中性粒细胞胞外陷阱在念珠菌性阴道炎患者中的表达及意义[J].中华全科医学,2018,5(16):792-794.
[18] Holzerl I,Farrl A,Kiss H,et al.The colonization with Candida species is more harmful in the second trimester of pregnancy[J].Arch Gynecol Obstet,2017,295(4):891-895.
[2] Kamath P,Pais M,Nayak MG,et al.Risk of vaginal candidiasis among pregnant women[J].Int J Curr Microbiol Appl Sci,201,2(9):141-146.
[3] Sangaré I,Sirima C,Bamba S,et al.Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso[J].J Mycol Med,2018,28(1):186-192.
[4] Sherin M,Ahmed WA.Exoenzymes production and antifungal susceptibility of Candida species isolated from pregnant women with vulvovaginitis[J].J Am Sci,2012,8(12):l392-1399.
[5] Chen HF,Lan CY.Role of SFP1 in the regulation of Candida albicans biofilm formation[J].PLoS One,2015,10(6):e0129903.doi:10.1371/ journal.pone.0129903.
[6] Noori M,Dakhili M,Sepahvand A,et al.Evaluation of esterase and hemolysin activities of different Candida species isolated from vulvovaginitis cases in Lorestan Province,Iran[J].Curr Med Mycol,2017,3(4):1-5.
[7] Linhares P,Viana-Pereira M,Ferreira M,et al.Genetic variants of vascular endothelial growth factor predict risk and survival of gliomas[J].Tumour Biol,2018,40(3):1010428318766273.
[8] Li L,Pan Y,Dai L,et al.Association of genetic polymorphisms on vascular endothelial growth factor and its receptor genes with susceptibility to coronary heart disease[J].Med Sci Monit,2016,22:31-40.
[9] 王娜,韩琦,桑建利.白色念珠菌的形态类型及致病性[J].生物学通报,2015,50(10):3-8.
[10] PAN Lina,CAO Chengjun,WEI Yujia,et al.Phenotypic transitions and their regulatory mechanisms in the human fungal pathogen Candida albicans[J].Chin J Cell Biol,2016,38(9):1049-1059.(in Chinese) 潘丽娜,曹承俊,魏羽佳,等.白色念珠菌形态转换及其调控机制的研究进展[J].中国细胞生物学学报,2016,38(9):1049-1059.
[11] Dennerstein GJ,Ellis DH.Oestrogen,glycogen and vaginal candidiasis[J].Aust N Z J Obstet Gynaecol,2001,41(3):326-328.
[12] Barousse MM,Espinosa T,Dunlap K,et al.Vaginal epithelial cell anti-Candida albicans activity is associated with protection against symptomatic vaginal candidiasis[J].Infect Immunol,2005,73(11):7765-7767.
[13] DAI Qianling,WANG Wei.Changes of estrogen and progesterone in patients with recurrent candidal vaginitis and its clinical significance[J].J Hainan Med Univ,2014,20(2):229-233.(in Chinese) 代倩苓,王薇.复发性念珠菌性阴道炎患者雌激素和孕激素水平变化测定及其临床意义[J].海南医学院学报,2014,20(2):229-233.
[14] Alves CT,Silva S,Pereira L,et al.Effect of progesterone on Candida albicans vaginal pathogenicity[J].Int J Med Microbiol,2014,304(8):1011-1017.
[15] Abitzsch S,Stepan H,Sack U,et al.Detection of cervicalimmunoglobulin A in normal pregnancy[J].J Perinat Med,2001,29(1):36-41.
[16] Wong SL,Demers M,Martinod K,et al.Diabetes primes neutrophils to undergo NETosis,which impairs wound healing[J].Nat Med,2015,21(7):815-819.
[17] LIN Zhenyun,FEI Xiaoyang,CHEN Hao,et al.Expression and significance of neutrophil extracellular traps in patients with Candida vaginitis[J].Chin J Gen Pract,2018,5(16):792-794.(in Chinese) 林珍云,费小阳,陈豪,等.中性粒细胞胞外陷阱在念珠菌性阴道炎患者中的表达及意义[J].中华全科医学,2018,5(16):792-794.
[18] Holzerl I,Farrl A,Kiss H,et al.The colonization with Candida species is more harmful in the second trimester of pregnancy[J].Arch Gynecol Obstet,2017,295(4):891-895.