The Vaginal Microbiota, Bacterial Biofilms and Polymeric Drug-Releasing Vaginal Rings

The diversity and dynamics of the microbial species populating the human vagina are increasingly understood to play a pivotal role in vaginal health. However, our knowledge about the potential interactions between the vaginal microbiota and vaginally administered drug delivery systems is still rathe...

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Bibliographic Details
Published in:Pharmaceutics 2021-05, Vol.13 (5), p.751
Main Authors: Carson, Louise, Merkatz, Ruth, Martinelli, Elena, Boyd, Peter, Variano, Bruce, Sallent, Teresa, Malcolm, Robert Karl
Format: Article
Language:English
Subjects:
Asymptomatic
Bacteria
Biofilms
controlled release
drug delivery system
Estrogens
ethylene vinyl acetate copolymers
HIV
Human immunodeficiency virus
Infections
Medical equipment
Microbiota
Microorganisms
Pathogens
Pelvic organ prolapse
Pharmaceutical industry
polyurethanes
Review
silicone elastomer
thermoplastics
Vagina
Virulence
Womens health
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Summary:The diversity and dynamics of the microbial species populating the human vagina are increasingly understood to play a pivotal role in vaginal health. However, our knowledge about the potential interactions between the vaginal microbiota and vaginally administered drug delivery systems is still rather limited. Several drug-releasing vaginal ring products are currently marketed for hormonal contraception and estrogen replacement therapy, and many others are in preclinical and clinical development for these and other clinical indications. As with all implantable polymeric devices, drug-releasing vaginal rings are subject to surface bacterial adherence and biofilm formation, mostly associated with endogenous microorganisms present in the vagina. Despite more than 50 years since the vaginal ring concept was first described, there has been only limited study and reporting around bacterial adherence and biofilm formation on rings. With increasing interest in the vaginal microbiome and vaginal ring technology, this timely review article provides an overview of: (i) the vaginal microbiota, (ii) biofilm formation in the human vagina and its potential role in vaginal dysbiosis, (iii) mechanistic aspects of biofilm formation on polymeric surfaces, (iv) polymeric materials used in the manufacture of vaginal rings, (v) surface morphology characteristics of rings, (vi) biomass accumulation and biofilm formation on vaginal rings, and (vii) regulatory considerations.
ISSN:1999-4923
1999-4923
DOI:10.3390/pharmaceutics13050751