## 3 Results  
### Inhibition of Vaginal Pathogenic Bacteria by Different GMNL Lactobacillus Strains  
To understand the suitability of _Lactobacillus_ strains (_L. rhamnosus_ GMNL-74, L. acidophilus GMNL-185, _L. rhamnosus_ GMNL-680, L. plantarum GMNL-682) for clinical evaluation of BV, we first examined the growth inhibition ability of these _Lactobacillus_ strains against vagina pathogenic bacteria, including _E. coli_, _S. aureus_, _G. vaginalis_, and _S. agalaciae_, by measuring the diameter of the inhibition zone (Table 1) and using _L. rhamnosus_ GR-1 (GR-1) or _L. reuteri_ RC-14 (RC-14)--which are well-recognized _Lactobacillus_ strains with previously demonstrated beneficial effects of BV [15; 16]--as controls. The results revealed that GMNL-680 or GMNL-682 displayed a greater inhibitory effect on _S. aureus_ or _S. agalaciae_ growth (Table 1), whereas GMNL-74 or GMNL-185 displayed a greater inhibitory effect on _G. vaginalis_ (Table 1). GR-1 and RC-14 displayed a greater inhibitory effect on _G. vaginalis_ but not on _E. coli_ (Supplementary Table S5). RC-14 did not present any antibacterial activity against the two _S. agalaciae_ strains (Supplementary Table S5). All four GMNL _Lactobacillus_ strains showed comparable or better capabilities in comparison with the known strains of GR-1 or RC-14. Next, we examined the adherence ability of these _Lactobacillus_ strains on the HeLa cervical epithelial cells, in accordance with a previous report [20]. The results revealed that GMNL-185 displayed the best adherent ability to HeLa cells, followed by GMNL-682 and GMNL-74 (Figure 1). GMNL-680 showed the lowest adherence to HeLa cells. \begin{table}
\begin{tabular}{c c c c c c} \hline \multirow{2}{*}{\ \begin{tabular}{c} _Lactobacillus_ \\ **Strain** \\ \end{tabular}  } & \multicolumn{4}{c}{**Antimicrobial Activity of Probiotics (A.U./mL) \({}^{\text{a}}\)**} \\ \cline{2-6}  & _E. coli_ & _S. aureus_ & _G. vaginalis_ & _S. agalaciae_ & _S. agalaciae_ \\  & **(BCRC 11634)** & **(BCRC 10451)** & **(BCRC 17040)** & **(BCRC 10787)** & **(BCRC 10902)** \\ \hline \hline \multirow{2}{*}{ \begin{tabular}{c} _L. rhamnosus_ \\ GMNL-74 \\ _L. acidophilus_ \\ GMNL-185 \\ _L. rhamnosus_ \\ GMNL-680 \\ _L. plantarum_ \\ GMNL-682 \\ \end{tabular}  } & 19.85 \(\pm\) 0.49 & 6.90 \(\pm\) 2.69 \({}^{\text{d}}\) & 16.99 \(\pm\) 1.15 & 17.57 \(\pm\) 1.03 \({}^{\text{c}}\) & 10.39 \(\pm\) 1.73 \({}^{\text{c}}\) \\  & 19.65 \(\pm\) 4.31 & 10.05 \(\pm\) 1.06 & 18.27 \(\pm\) 3.02 \({}^{\text{c}}\) & 18.13 \(\pm\) 0.71 & 22.25 \(\pm\) 0.76 \\  & 18.33 \(\pm\) 0.50 & 58.7 Next, we examined the effects of GMNL _Lactobacillus_ strains on the adherence of three BV pathogenic bacteria, including _G. vaginalis_ (Figure 2A-C, and Supplementary Results Figure S2) or _S. agalacliae_ (Figure 2D-F, and Supplementary Results Figure S3), to the HeLa cervical epithelial cells with microscopy counting, after the Giemsa staining. The experimental protocols were further divided into three categories--exclusion, displacement, or competition (Figure S1). We observed that the GMNL-74 or GMNL-185 _Lactobacillus_ strain displayed a similar effect on the inhibition of adherence of _G. vaginalis_, when compared to GR-1 or RC-14 under the exclusion method (Figure 2A). Whereas, the GMNL-680 or GMNL-682 _Lactobacillus_ strain displayed a comparable adherence-inhibitory effect under the competition method (Figure 2C). The inhibitions of the adherence of _S. agalacliae_ on HeLa cells for all four GMNL _Lactobacillus_ strains were comparable to those of GR-1 or RC-14, under the exclusion (Figure 2D) or competition (Figure 2F) method. For displacement of _S. agalacliae_ adherence to HeLa cells, all four GMNL _Lactobacillus_ strains displayed inhibitory effects but GMNL-682 was the weakest one (Figure 2E). We further examined the effects of GMNL _Lactobacillus_ in _S. agalacliae_-induced proinflammatory cytokines of the HeLa cells. The pre-incubation of GMNL _Lactobacillus_ inhibited _S.