FIGURE 1: Interactions between C. albicans and Lactobacillus spp. Production of metabolic products prevent colonization through C. albicans either due to prevention of adhesion to the epithelial cell wall, or due to high concentrations of organic acids, exerting a fungistatic effect. H₂O₂ and acetate probably don't play a role in the vaginal tract. Saturation of adhesion sites and co-aggregation of Lactobacillus spp. prevent adherence of Candida spp. Gene expression in C. albicans gets changed due to presence of Lactobacillus. Expression of genes responsible for adherence and yeast to hyphal formation is reduced. Presence of Lactobacillus can alter the host immune response in case of Candida colonization to attract granulocytes and promote the immune defense. The picture was adapted from Bradford and Ravel.

22. Bradford LL, Ravel J (2017). The vaginal mycobiome: A contemporary perspective on fungi in women's health and diseases. Virulence 8(3): 342-351. 10.1080/21505594.2016.1237332