Advancements in vaginal microbiota, Trichomonas vaginalis, and vaginal cell interactions: Insights from co-culture...

Vaginal microbiota involves seven communities-state types (CST), four dominated by Lactobacillus. L. crispatus, particularly, offers enhanced protection against infections. Recurrent vulvovaginal candidiasis and trichomoniasis affect millions of people annually, often asymptomatically, facilitating infection spread and leading complications. Co-culture, the technique of cultivating different microbial populations together to mimic real-life conditions, enables the study of microorganism interactions, including inhibitory or promotive effects on pathogens. This review compiles data on co-culture techniques to analyze interactions among Lactobacillus spp., Candida spp., and Trichomonas vaginalis. PubMed was searched using medical subject headings (MESH) terms, 'co-culture', 'coculture,' 'cocultivation,' 'co-incubation,' and 'Trichomonas vaginalis', 'Candida spp.', 'Lactobacillus spp.'. Articles were selected based on relevance to vaginal health, English language, availability, and use of co-culture or co-incubation techniques in the past 24 years. Co-culture and co-incubation studies over the past 24 years have advanced our understanding of microbiota-host, pathogen-host, and pathogen-host-microbiota interactions. These studies reveal that microbiota composition impacts infections, with the microbiota producing substances against pathogens and pathogens developing stress tolerance mechanisms. They elucidate pathogen virulence factors, interactions with immune cells, and how ecological relationships between microorganisms can enhance pathogenicity.