阴道萎缩症（VVA）是绝经后女性常见的病症。VVA的症状包括性交疼痛、阴道干燥、阴道和/或阴茎外皮瘙痒、灼痛和酸痛、排尿困难和性交时的阴道出血。这些症状是雌激素水平下降的生理反应，导致阴道上皮萎缩和粘液分泌突然减少。目前VVA的主要治疗方法是激素替代疗法（HRT），主要包括雌激素、孕激素或二者的复合物。然而，使用HRT可能会增加患乳腺和子宫内膜癌、肺部和腿部静脉栓塞、中风和心血管并发症的发病率。本研究评估了马来西亚盖兰蜜作为营养保健品对减轻VVA的替代方法。共有24只8周大的Sprague Dawley大鼠接受了双侧卵巢切除手术，手术后至少14天后开始给予盖兰蜜的第一剂量，以使激素水平降至稳定基线并完全恢复手术。在给予盖兰蜜2周后，收集阴道组织进行免疫组化分析和mRNA表达分析。结果表明，与绝经组相比，盖兰蜜的给予增加了阴道组织中Aqp1、Aqp5、CFTR和Muc1蛋白的定位。盖兰蜜对蛋白表达的影响可概括为Aqp1>CFTR>Aqp5>Muc1。基因表达分析表明，盖兰蜜对Aqp1和CFTR基因没有影响，但会上调Aqp5基因表达，但表达水平低于ERT+Ovx组。此外，盖兰蜜上调阴道中的Muc1，表达水平高于ERT+Ovx组或SC组。总的来说，盖兰蜜对调节阴道组织中水分的基因和蛋白质（Aqp1、Aqp5和CFTR）表现出较弱的雌激素作用，而在影响唾液酸Muc1的基因和蛋白表达方面表现出较强的雌激素能力。Muc1与阴道上皮层的粘液分泌有关。总之，盖兰蜜对阴道组织的蛋白和基因表达变化有助于减少手术诱导的绝经模型中阴道萎缩的发生。 版权所有 © 2023 Ismail、Ibrahim、Mokhtar、Yahaya、Zulkefli、Ankasha和Osman。

Vulvovaginal atrophy (VVA) is a common condition in post-menopausal women. Symptoms of VVA include dyspareunia, vaginal dryness, vaginal and/or vulvar itching, burning and soreness, dysuria and vaginal bleeding accompanying sexual activity. These symptoms are physiological responses to hypoestrogenicity, inducing atrophy of the vagina epithelia and sudden reduction in mucous production. Prevailing therapy for VVA is hormone replacement therapy (HRT), notably estrogen, progesterone or a combination of the two. However, using HRT is associated with an increased incidence of breast and endometrial cancer, venous thromboembolism in the lungs and legs, stroke and cardiovascular complications.This study evaluated Malaysian Gelam honey as a nutraceutical alternative to estrogen HRT (ERT) in alleviating VVA. A total of 24 female 8-weekold Sprague Dawley rats underwent bilateral oophorectomy. A minimum of 14 days elapsed from the time of surgery and administration of the first dose of Gelam honey to allow the female hormones to subside to a stable baseline and complete recovery from surgery. Vaginal tissues were harvested following a 2-week administration of Gelam honey, the harvested vagina tissue underwent immunohistochemistry (IHC) analysis for protein localization and qPCR for mRNA expression analysis.Results indicated that Gelam honey administration had increased the localization of Aqp1, Aqp5, CFTR and Muc1 proteins in vaginal tissue compared to the menopause group. The effect of Gelam honey on the protein expressions is summarized as Aqp1>CFTR>Aqp5>Muc1.Gene expression analysis reveals Gelam honey had no effect on Aqp1 and CFTR genes. Gelam honey had up-regulated Aqp5 gene expression. However, its expression was lower than in the ERT+Ovx group. Additionally, Gelam honey up-regulated Muc1 in the vagina, with an expression level higher than those observed either in the ERT+Ovx or SC groups. Gelam honey exhibits a weak estrogenic effect on the genes and proteins responsible for regulating water in the vaginal tissue (Aqp1, Aqp5 and CFTR). In contrast, Gelam honey exhibits a strong estrogenic ability in influencing gene and protein expression for the sialic acid Muc1. Muc1 is associated with mucous production at the vaginal epithelial layer. In conclusion, the protein and gene expression changes in the vagina by Gelam honey had reduced the occurrence of vaginal atrophy in surgically-induced menopause models.Copyright © 2023 Ismail, Ibrahim, Mokhtar, Yahaya, Zulkefli, Ankasha and Osman.