Effectivity Comparison Between Oral and Intravaginal Administration of Lactobacillus Plantarum on Decreasing Levels of TNF-α And IL-6 in Vulvovaginal Candidiasis

Abstract

Vulvovaginal candidiasis (VVC) is the most common fungal infection in the vaginal mucosa and vulva caused by Candida albicans. C. albicans cell walls recognized as PAMPs by PRR then activate the innate and adaptive immune responses. The components of the innate immune response which has an important role against C. albicans during the acute phase are neutrophils and macrophages which produce proinflammatory cytokines such as TNF-α and IL-6. Probiotic Lactobacillus plantarum is an alternative strategy to treat VVC. Identification of the efficacy of the probiotic administration route determines the level of effectiveness of probiotics used as a supportive therapy in cases of VVC. This study aims to assess the decrease in TNF-α and IL-6 serum levels after administration of L. plantarum in vivo model study with a posttest randomized experimental group design. Group intervention was divided into 8 groups i.e. Negative Control (NC), Positive Control (PC), P1, P2, P3, P4, P5, P6. L. plantarum was administered orally and intravaginally with three concentration variants 2.25x1010, 4.5x1010, and 9x1010 CFU/ml. The statistical analysis used was ANOVA to measure the significant difference between TNF-α and IL-6 serum levels after the administration of L. plantarum. The results showed a significant decrease in both TNF-α (p=0.000<0.05) and IL-6 (p=0.000<0.05). Based on Post Hoc Tukey HSD there are P2, P3 and P6 groups that have significantly decreased levels of TNF-α. In addition, P2, P3, P5 and P6 groups also have significantly decreased levels of IL-6. Following to identification the association decrease of TNF-α and IL-6 due to L. plantarum using Correlation Pearson, the result was -0.836 and -0.685. From the results of the statistical analysis, it can be concluded that both oral and intravaginal administration of the probiotic L. plantarum has the same rate of effectivity to decrease proinflammatory cytokines in cases of VVC.