title: Origins of vaginal acidity: high D/L lactate ratio is consistent with bacteria being the primary source.
abstract: BACKGROUND
  The origin of the lactic acid that acidifies the vagina is not well established. It is widely accepted that during times of high oestrogen (during the neonatal period and again during a woman's reproductive years) large amounts of glycogen are deposited in the vaginal epithelium and that the glycogen is anaerobically metabolized to lactic acid. What is not established is whether lactic acid is primarily produced by vaginal bacteria or by vaginal epithelial cells. Human cells can make only L-lactate, while bacteria can produce both D- and L-, thus the D- to L-lactate ratio can indicate the relative contribution of bacterially derived lactic acid.
  
  
  METHODS
  In this study, we used chiral HPLC to examine the percentages of D- and L-lactate in vaginal secretions, in primary cultures of bacteria from these vaginal secretions, and in cultures of lactobacillus isolates of vaginal origin.
  
  
  RESULTS
  We found that in most vaginal secretion samples, >50% of the lactic acid was the D-isoform (mean 55%, range 6-75%, n = 14).
  
  
  CONCLUSIONS
  Our results thus support the hypothesis that vaginal bacteria, not epithelial cells, are the primary source of lactic acid in the vagina.
authors.affiliation: Thomas C.Jenkins Department of Biophysics, Johns Hopkins University, Baltimore, MD 21218, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Boskey
authors.forename: R A
authors.initials: RA
authors.lastname: Cone
authors.forename: K J
authors.initials: KJ
authors.lastname: Whaley
authors.forename: T R
authors.initials: TR
authors.lastname: Moench
mesh_terms: D000143:Acids / Q000378:metabolism*; D000328:Adult; D001419:Bacteria / Q000378:metabolism*; D002851:Chromatography, High Pressure Liquid / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D007778:Lactobacillus / Q000378:metabolism; D013237:Stereoisomerism; D014621:Vagina / Q000378:metabolism* / Q000382:microbiology*
chemical_list: D000143:Acids; D019344:Lactic Acid