Microbiological Assessment of Glycyrrhizic Acid Effectiveness in Bacterial Vaginosis – A Comparative Study
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Keywords

Bacterial Vaginosis
Vaginal Microflora
Facultative Anaerobic Bacteria
Lactobacilli
Glycyrrhizic Acid

How to Cite

Ostafiichuk, S., Polishchuk, I., Perkhulyn, O., Kusa, O., Henyk, N., Makarchuk, O., Kurovets, L., & Kutsyk, R. (2022). Microbiological Assessment of Glycyrrhizic Acid Effectiveness in Bacterial Vaginosis – A Comparative Study. Galician Medical Journal, 29(4), E202243. https://doi.org/10.21802/gmj.2022.4.3

Abstract

Background. Bacterial vaginosis (BV) is one of the most common female diseases, which is currently characterized by an increasing rate of clinical sign reccurence, the appearance of asymptomatic carriers, and atypical forms.

This study was aimed to evaluate the effectiveness of glycyrrhizic acid administration in the prevention of BV recurrence.

Materials and Methods. The study involved 88 women after BV treatment (metronidazole per os for seven days). Participants were randomly divided into two groups: the main group included 46 patients who were administered 0.1% glycyrrhizic acid intravaginally for three months after the main treatment; the control group comprised 42 women who received no anti-recurrence BV course. The effectiveness was assessed three and six months after the beginning of treatment and included gynecological examination and laboratory assessments (pH, amine test, microbiological investigation).

Results. After recommended BV treatment without anti-recurrence course, the recurrence of laboratory criteria for BV increased three months after the treatment, including the increase in vaginal pH to > 4.5 in all subjects, positive amine test in 35.7% of patients, the presence of Gardnerella vaginalis at a concentration of 104-105 CFU/ml in 31.0% of women, reduction in the frequency of Lactobacillus detection with worsening of the condition and the onset of clinical manifestations of the disease six months later. In the main group, after glycyrrhizic acid administration, laboratory criteria of BV recovery three months after the treatment, and clinical and laboratory markers of BV recovery six months after the treatment were lower as compared to the control group.

Conclusions. The anti-recurrence course of BV (vaginal administration of 0.1% glycyrrhizic acid) demonstrated a decrease in the frequency of complaints, clinical and laboratory markers, stabilization of the species composition of Lactobacillus, and a decrease in facultative anaerobe concentration in the vaginal microbiome as compared to group without anti-recurrence treatment.

https://doi.org/10.21802/gmj.2022.4.3
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References

Greenbaum S, Greenbaum G, Moran-Gilad J, Weintraub AY. Ecological dynamics of the vaginal microbiome in relation to health and disease. American Journal of Obstetrics and Gynecology. 2019;220(4):324–335. Available from: https://doi.org/10.1016/j.ajog.2018.11.1089

Jones A. Bacterial vaginosis: a review of treatment, recurrence, and disparities. The Journal for Nurse Practitioners. 2019;15(6):420–423. Available from: https://doi.org/10.1016/j.nurpra.2019.03.010

Russo R, Karadja E, De Seta F. Evidence-based mixture containing Lactobacillus strains and lactoferrin to prevent recurrent bacterial vaginosis: a double blind, placebo controlled, randomised clinical trial. Beneficial Microbes. 2019;10(1):19–26. Available from: https://doi.org/10.3920/BM2018.0075

Muzny CA, Taylor CM, Swords WE, Tamhane A, Chattopadhyay D, Cerca N, et al. An updated conceptual model on the pathogenesis of bacterial vaginosis. The Journal of Infectious Diseases. 2019;220(9):1399–1405. Available from: https://doi.org/10.1093/infdis/jiz342

Han C, Li H, Han L, Wang C, Yan Y, Qi W, et al. Aerobic vaginitis in late pregnancy and outcomes of pregnancy. European Journal of Clinical Microbiology & Infectious Diseases. 2018;38(2):233–239. Available from: https://doi.org/10.1007/s10096-018-3416-2

Peebles K, Velloza J, Balkus JE, McClelland RS, Barnabas RV. High global burden and costs of bacterial vaginosis: a systematic review and meta-analysis. Sexually Transmitted Diseases. 2019;46(5):304–311. Available from: https://doi.org/10.1097/OLQ.0000000000000972

Skafte-Holm A, Humaidan P, Bernabeu A, Lledo B, Jensen JS, Haahr T. The association between vaginal dysbiosis and reproductive outcomes in sub-fertile women undergoing IVF-treatment: A Systematic PRISMA Review and Meta-Analysis. Pathogens. 2021;10(3):295. Available from: https://doi.org/10.3390/pathogens10030295

Vodstrcil LA, Muzny CA, Plummer EL, Sobel JD, Bradshaw CS. Bacterial vaginosis: drivers of recurrence and challenges and opportunities in partner treatment. BMC Medicine. 2021;19(1):194. Available from: https://doi.org/10.1186/s12916-021-02077-3

Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports. 2021;70(4):1–187. Available from: https://doi.org/10.15585/mmwr.rr7004a1

Javed A, Parvaiz F, Manzoor S. Bacterial vaginosis: an insight into the prevalence, alternative treatments regimen and it’s associated resistance patterns. Microbial Pathogenesis. 2019;127:21–30. Available from: https://doi.org/10.1016/j.micpath.2018.11.046

Polishchuk IP. Clinical and laboratory evaluation of the secnidazole and clindamycin effects on bacterial vaginosis in the women of reproductive age. Bukovinian Medical Herald. 2020;24(3 (95)):73–79. Available from: https://doi.org/10.24061/2413-0737.XXIV.3.95.2020.75

Chieng WK, Abdul Jalal MI, Bedi JS, Zainuddin AA, Mokhtar MH, Abu MA, et al. Probiotics, a promising therapy to reduce the recurrence of bacterial vaginosis in women? A systematic review and meta-analysis of randomized controlled trials. Frontiers in Nutrition. 2022;9:938838. Available from: https://doi.org/10.3389/fnut.2022.938838

Liu H.-F, Yi N. A systematic review and meta-analysis on the efficacy of probiotics for bacterial vaginosis. European Review for Medical and Pharmacological Sciences. 2022;26:90–98. Available from: https://doi.org/10.26355/eurrev_202201_27752

Wu S, Hugerth LW, Schuppe-Koistinen I, Du J. The right bug in the right place: opportunities for bacterial vaginosis treatment. npj Biofilms and Microbiomes. 2022;8(1):34. Available from: https://doi.org/10.1038/s41522-022-00295-y

Nascimento MHM do, de Araújo DR. Exploring the pharmacological potential of glycyrrhizic acid: from therapeutic applications to trends in nanomedicine. Future Pharmacology. 2022;2(1):1–15. Available from: https://doi.org/10.3390/futurepharmacol2010001

Kowalska A, Kalinowska‐Lis U. 18β‐glycyrrhetinic acid: its core biological properties and dermatological applications. International Journal of Cosmetic Science. 2019;41: 325–331. Available from: https://doi.org/10.1111/ics.12548

Saeedi M, Morteza‐Semnani K, Ghoreishi M. The treatment of atopic dermatitis with licorice gel. Journal of Dermatological Treatment. 2003;14(3):153–157. Available from: https://doi.org/10.1080/09546630310014369

Pagano C, Perioli L, Calarco P, Di Michele A, Tiralti MC, Ricci M. New technological approach for glycyrrethic acid oral and topical administration. Current Pharmaceutical Design. 2020;26(6):664–674. Available from: https://doi.org/10.2174/1381612826666191226112249

Weaver AJ, Borgogna TR, O’Shea-Stone G, Peters TR, Copié V, Voyich J, et al. 18β-glycyrrhetinic acid induces metabolic changes and reduces Staphylococcus aureus bacterial cell-to-cell interactions. Antibiotics. 2022;11(6):781. Available from: https://doi.org/10.3390/antibiotics11060781

Rodino S, Butu A, Butu M, Cornea PC. Comparative studies on antibacterial activity of licorice, elderberry and dandelion. Digest Journal of Nanomaterials and Biostructures. 2015;10(3):947–955. Available from: https://chalcogen.ro/947_Rodino.pdf

Authier H, Bardot V, Berthomier L, Bertrand B, Blondeau C, Holowacz S, et al. Synergistic effects of licorice root and walnut leaf extracts on gastrointestinal candidiasis, inflammation and gut microbiota composition in mice. Microbiology Spectrum. 2022;10(2):e02355-21. Available from: https://doi.org/10.1128/spectrum.02355-21

Dodangeh N, Kheirkhah M, Abolghasemi J, Mojab F, Farshad F. Comparison of the effects of glycyrrhiza glabra vaginal cream and clotrimazole on the symptoms of fungal vulvovaginitis. Iran Journal of Nursing. 2019;32(117):22–30. Available from: https://doi.org/10.29252/ijn.32.117.22

Pellati D, Fiore C, Armanini D, Rassu M, Bertoloni G. In vitro effects of glycyrrhetinic acid on the growth of clinical isolates of Candida albicans. Phytotherapy Research. 2009;23(4):572–574. Available from: https://doi.org/10.1002/ptr.2693

Wang X-Y, Fan Y-H, Li Y-Y, Jiao Z, Li X-J, Jin H, Guo J. Based on the Chinese medical canon to excavate the medicine law of yellowish leucorrhea disease. Medical Data Mining. 2020;3(4):141–151. Available from: https://doi.org/10.12032/MDM2020123001

De Seta F, Stabile G, Antoci G, Zito G, Nappi RE. Provoked vestibulodynia and topical treatment: a new Option. Healthcare. 2022;10(5):830. Available from: https://doi.org/10.3390/healthcare10050830

McKinnon LR, Achilles SL, Bradshaw CS, Burgener A, Crucitti T, Fredricks DN, et al. The evolving facets of bacterial vaginosis: implications for HIV transmission. AIDS Research and Human Retroviruses. 2019;35(3):219–228. Available from: https://doi.org/10.1089/aid.2018.0304

Wang Z, He Y, Zheng Y. Probiotics for the treatment of bacterial vaginosis: a meta-analysis. International Journal of Environmental Research and Public Health. 2019;16(20):3859. Available from: https://doi.org/10.3390/ijerph16203859

Happel A-U, Singh R, Mitchev N, Mlisana K, Jaspan HB, Barnabas SL, et al. Testing the regulatory framework in South Africa – a single-blind randomized pilot trial of commercial probiotic supplementation to standard therapy in women with bacterial vaginosis. BMC Infectious Diseases. 2020;20(1):491. Available from: https://doi.org/10.1186/s12879-020-05210-4

Mainini G, Rotondi M, Scaffa C. A new approach in the first-line treatment of bacterial and mycotic vulvovaginitis with topical lipohydroperoxides and glycyrrhetic acid: a comparative study. Clinical and Experimental Obstetrics & Gynecology. 2011;38(3):243-246. Available from: https://pubmed.ncbi.nlm.nih.gov/21995156/

Bedford L, Parker SE, Davis E, Salzman E, Hillier SL, Foxman B, et al. Characteristics of the vaginal microbiome in women with and without clinically confirmed vulvodynia. American Journal of Obstetrics and Gynecology. 2020;223(3):406.e1-406.e16. Available from: https://doi.org/10.1016/j.ajog.2020.02.039

Han S, Sun L, He F, Che H. Anti-allergic activity of glycyrrhizic acid on IgE-mediated allergic reaction by regulation of allergy-related immune cells. Scientific Reports. 2017;7(1):7222. Available from: https://doi.org/10.1038/s41598-017-07833-1

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