Диагностическая роль Lactobacillus spp. как представителей нормального микробиома нижних отделов урогенитального тракта

В настоящее время активно расширяются научные знания о различных Lactobacillus spp., представителей резидентной флоры влагалища. Как известно, Lactobacillus spp. являются неотъемлемой составляющей женских половых путей. В настоящее время известно около 20 различных Lactobacillus spp. Большинство из уже изученных Lactobacillus spp. способствуют поддержанию здоровья влагалища, обеспечивая защиту от патогенных микроорганизмов, развития состояния дисбиоза, осложнений беременности, в том числе преждевременных родов (ПР). Защитная функция обеспечивается в первую очередь за счет образования Dи L-форм молочной кислоты, поддерживающей оптимальный кислый pH среды, из гликогена вагинального эпителия. Также Lactobacillus spp. предотвращают адгезию и инвазию патогенов в эпителиальные клетки, синтезируют бактериоцины, ингибируют высвобождение провоспалительных цитокинов. Однако на сегодняшний день уже имеются сведения о том, что не все представители Lactobacillus spp. имеют положительное влияние на здоровье женского организма. Так, пациентки с морфотипом CSTIII, в котором доминируют L. iners, особенно предрасположены к развитию дисбиоза влагалища, а доминирование L. acidophilus у пациенток, вероятно, ассоциировано с бесплодием. В настоящее время не имеется достоверных доказательств положительного и/или отрицательного влияния на женский организм многих Lactobacillus spp., а уже имеющиеся исследования по ряду бактерий ограниченны и противоречивы. В связи с этим актуальным является дальнейшее изучение характеристик и свойств Lactobacillus spp., колонизирующих влагалище, для более точного понимания их роли и применения полученных знаний в клинической практике для лечения и профилактики различных нарушений нормального микробиома влагалища.

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