Understanding the role of Lacticaseibacillus rhamnosus in vaginal dysbiosis: in vitro studies and clinical evidence

This narrative review aims to analyze and describe the outcomes of the most recent in vivo and in vitro studies involving L. rhanmosus in vaginal dysbiosis. Vaginal dysbiosis affects many women around the world and antibiotic treatment could not be a long-term solution due to the emergence of multidrug resistant microrganism. Considering that, probiotic treatments could represent an innovative and integrative approach to restore healthy vaginal microbiota. The dominant microbial population associated with vaginal health is represented by Lactobacilli spp.. Among all the Lactobacillus species, an interesting role is played by L. rhamnosus, able to produce several metabolites with antimicrobial properties such as lactic acid, bacteriocines, hydrogen peroxide and a class of molecules named biosurfactants. The in vitro studies on the main pathogens of vaginal dysbiosis (G. vaginalis spp., Candida spp. and HPV, HIV) showed coherent scientific evidence on the inhibitory, immunomodulatory and gene expression alteration effects of L. rhamnosus strains. Moreover, the promising preliminary outcomes were confirmed by clinical trials on infected women suggesting L. rhamnosus could be an interesting treatment in defense, protection and restoring of healthy vaginal microbiota, supporting women health.