RVVC患者阴道菌群结构及地榆炭醇提取物抑菌效果研究  

The structure of vaginal microbiota in RVVC patients and the antibacterial effect of charred Sanguisorbae Radix alcohol extract

作　　者：葛美玲[1] 宋金云 程旭希 顾薇[3] 赵宏宇[2] GE Meiling;SONG Jinyun;CHENG Xuxi;GU Wei;ZHAO Hongyu(Biobank of Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China;Clinical Research Center,the Second Hospital of Nanjing,Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210003,China;School of Pharmacy,Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210023,China)

机构地区：[1]南京大学医学院附属鼓楼医院生物样本库,江苏南京210008 [2]南京中医药大学附属南京医院(南京市第二医院)临床科研中心,江苏南京210003 [3]南京中医药大学药学院,江苏南京210023

出　　处：《热带医学杂志》2024年第8期1084-1088,1149,I0002,共7页Journal of Tropical Medicine

基　　金：江苏省重大疾病生物资源样本库妇产疾病子库(BM2015004);江苏省重大疾病生物资源样本库妇产疾病子库(南京鼓楼医院生物样本库)开放课题(TC2021B021);南京大学中国医院改革发展研究院课题项目(南京鼓楼医院医学发展医疗救助基金会资助项目)(NDYG2022001)。

摘　　要：目的探讨复发性外阴阴道假丝酵母菌病(RVVC)患者阴道微生物菌群特征以及地榆炭对临床分离的白色念珠菌的抑制作用。方法选取2022年9-12月在南京鼓楼医院就诊的15例RVVC患者(RVVC组),并招募10名健康育龄女性(对照组)作为研究对象,采用16S rRNA和内转录间隔区高通量测序技术分析RVVC患者阴道菌群分布特点,并基于FUNGuild数据库对真菌进行功能预测。另外,对临床样本中的白色念珠菌进行分离培养,采用平板计数法评估地榆炭醇提取物的抑菌效果。结果RVVC患者的细菌菌群以乳酸杆菌属为主,且以惰性乳酸杆菌为优势菌。与对照组相比,RVVC患者阴道真菌菌群α多样性显著降低,差异有统计学意义(P<0.05),NMDS显示两组菌群表现出明显分类,LEfSe分析发现念珠菌属和副球菌属相对丰度升高,且以白色念珠菌为优势菌。FUNGuild功能分类预测未定义腐生菌是RVVC组中最丰富的类群,远高于其在对照组中的丰度。此外,与空白对照组相比,随着地榆炭醇提取物浓度的增加(25、50、100、200μg/mL),白色念珠菌菌落数明显减少,差异均有统计学意义(t=8.350、8.722、9.137、9.144,P均<0.05),而卷曲乳酸杆菌菌落数显著增多,差异均有统计学意义(t=9.952、6.288、10.440、8.742,P均<0.05)。结论RVVC患者阴道菌群发生紊乱,主要以惰性乳酸杆菌和白色念珠菌为优势菌。地榆炭醇提取物对临床分离的白色念珠菌具有抑制作用且促进卷曲乳酸杆菌的生长,可为防治RVVC的中药研发提供新的思路和理论依据。Objective To investigate the characteristics of vaginal microbiota in patients with recurrent vulvovaginal candidiasis(RVVC)and the inhibitory effect of charred Sanguisorbae Radix alcohol extract on clinically isolated Candida albicans.Methods A total of 15 RVVC patients(RVVC group)and 10 healthy women(control group)attending Nanjing Drum Tower Hospital from September to December 2022 were enrolled as the research subjects.The distribution characteristics of vaginal microbiota in RVVC patients were analyzed by 16S rRNA and internal transcribed spacer high throughput sequencing technology and the functional prediction of fungi was based on FUNGuild database.In addition,Candida albicans in clinical samples were isolated and cultured to observe the inhibitory effect of charred Sanguisorbae Radix alcohol extract was determined by plate colony count method.Results The vaginal bacteria of RVVC patients were dominated by Lactobacillus genus,with a predominance of Lactobacillus inert species.Compared with the control group,theαdiversity of vaginal fungal microbiota in RVVC patients was significantly reduced(P<0.05).NMDS showed clear classification of two groups and LEfSe analysis found that the relative abundance of Candida and Paramycosphaerella was increased and Candida albicans was the dominant fungus.FUNGuild functional classification predicted that undefined Saprotrophh was the most abundant group in the RVVC group,higher than its abundance in control group.In addition,compared to the blank control group,the number of Candida albicans colonies decreased,the differences were statistically significant(t=8.350,8.722,9.137,9.144;all P<0.05),while the number of colonies of Lactobacillus curlicus increased with the increase of the concentration of charred Sanguisorbae Radix alcohol extract(25,50,100,200μg/mL),the differences were statistically significant(t=9.952,6.288,10.440,8.742;all P<0.05).Conclusions The vaginal microbiota of RVVC patients was disordered and mainly dominated by Lactobacillus iners and Candida albic

关 键 词：复发性外阴阴道假丝酵母菌病 阴道微生物菌群 白色念珠菌 地榆炭 

分 类 号：R711.31[医药卫生—妇产科学]