The role of the vaginal microbiota in the preservation of female reproductive health: literature review (part 1)
DOI:
https://doi.org/10.37800/RM.1.2022.52-59Keywords:
microbiome, vaginal microbiota, community state type (CST), vaginal dysbiosis, bacterial vaginosis (BV), vulvovaginal candidiasis, probioticsAbstract
Relevance: The vaginal microbiota plays an important role in protecting the host from various gynecological infectious and noninfectious diseases. The emergence of new molecular genetic testing methods and the development of computer technology significantly expand our understanding of the vaginal microbiome. The recent classification of community state types (CST) opens up new perspectives in diagnosing and treating female genital tract diseases.
Purpose of the study – analysis of current data on the state of vaginal microbiota, the community state types, and their impact on female reproductive health.
Methods: For the review (parts 1 and 2), the scientific literature of the past decade was searched on PubMed for the following keywords: “vaginal microbiome,” “vaginal microbiota,” “vaginal dysbiosis,” “bacterial vaginosis,” “bacterial vaginosis and age,” “bacterial vaginosis and ethnicity,” “bacterial vaginosis and stress,” “bacterial vaginosis and pelvic inflammatory disease,” “bacterial vaginosis, pregnancy, premature delivery,” “probiotics and vaginal microbiota,” “menopausal hormone therapy and vaginal microbiota.” The article includes original articles and reviews from peer-reviewed publications indexed in PubMed. Part 1 of this review was published in No. 1_2022 of this journal.
Results: Part One of this review describes the vaginal microbiota CST and risk factors for vaginal dysbiosis.
The vaginal microflora is grouped into a limited number of communities, but the community structure is constantly changing. Certain CSTs are associated with reproductive failures and sexually transmitted infections (STIs), while balanced CSTs, dominated by Lactobacillus species, especially Lactobacillus crispatus, are optimal for health. This article examines the effects on normal vaginal microbiota homeostasis of modifiable and unmodifiable risk factors, including age, sexual behavior, ethnicity, and hygiene.
Conclusion: Despite considerable progress in characterizing the vaginal CSTs, many questions remain unclear: the functioning of the microbiome, the transcription of microbial proteins, the metabolic interaction of microbiota members both among themselves and with the host organism, and the optimization of interventions aimed at maintaining or restoring a healthy microbiome.
References
Marchesi J.R., Ravel J. The vocabulary of microbiome research: A proposal. Microbiome. 2015;3:31. https://doi.org/10.1186/s40168-015-0094-5.
Barrientos-Durán A., Fuentes-López A., de Salazar A., Plaza-Díaz J., García F. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis // Nutrients. – 2020. – Vol. 12(2). – P. 419. https://doi.org/10.3390/nu12020419.
Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. РОАГ, 2019 [Klinicheskie rekomendacii po diagnostike i lecheniyu zabolevanij, soprovozhdayushhixsya patologicheskimi vydeleniyami iz polovyx putej zhenshhin. ROAG, 2019 (in Russ.)] // www.medkirov.ru/docs/id/4F7915/$File/Клинические%20рекомендации%20по%20диагностике%20и%20лечению%20заболеваний%2C%20сопровождающихся%20патологическими%20выделениями.pdf (30.01.2022).
Ravel J., Gajer P., Abdo Z., Schneider G.M., Koenig S.S., McCulle S.L., Karlebach S., Gorle R., Russell J., Tacket C.O., et al. Vaginal microbiome of reproductive-age women. Proc. Natl. Acad. Sci. USA. 2011;108(Suppl. 1):4680–4687. https://doi.org/10.1073/pnas.1002611107.
Ravel et al; Aldunate M., Srbinovski D., Hearps A.C., Latham C.F., Ramsland P.A., Gugasyan R., Cone R.A., Tachedjian G. Antimicrobial and immune modulatory effects of lactic acid and short chain fatty acids produced by vaginal microbiota associated with eubiosis and bacterial vaginosis. Front. Physiol. 2015;6:164. https://doi.org/10.3389/fphys.2015.00164.
France MT, Ma B, Gajer P, Brown S, Humphrys MS, Holm JB, Waetjen LE, Brotman RM, Ravel J. VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition. Microbiome. 2020 Nov 23; 8(1):166. https://doi.org/10.1186/s40168-020-00934-6.
Holm JB, France MT, Ma B, McComb E, Robinson CK, Mehta A, Tallon LJ, Brotman RM, Ravel J. Comparative Metagenome-Assembled Genome Analysis of "Candidatus Lachnocurva vaginae", Formerly Known as Bacterial Vaginosis-Associated Bacterium-1 (BVAB1). Front Cell Infect Microbiol. 2020 Mar 31;10:117. https://doi.org/10.3389/fcimb.2020.00117.
France M. Vaginal Community State Type Nearest Centroid Classifier // github.com/ravel-lab/VALENCIA (03.02.2022).
Smith S.B., Ravel J. The vaginal microbiota, host defence and reproductive physiology. J. Physiol. 2017;595:451–463. https://doi.org/10.1113/JP271694.
Bradshaw C.S., Brotman R.M. Making inroads into improving treatment of bacterial vaginosis—Striving for long-term cure. BMC Infect. Dis. 2015;15:292. https://doi.org/10.1186/s12879-015-1027-4.
Romero R., Hassan S.S., Gajer P., Tarca A.L., Fadrosh D.W., Bieda J., Chaemsaithong P., Miranda J., Chaiworapongsa T., Ravel J. The vaginal microbiota of pregnant women who subsequently have spontaneous preterm labor and delivery and those with a normal delivery at term // Microbiome. – 2014. – Vol. 2. – P. 18. https://doi.org/10.1186/2049-2618-2-18.
Han Y, Liu Z, Chen T. Role of Vaginal Microbiota Dysbiosis in Gynecological Diseases and the Potential Interventions. Front Microbiol. 2021;12:643422. Published 2021 Jun 18. https://doi.org/10.3389/fmicb.2021.643422.
Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. https://doi.org/10.15585/mmwr.rr7004a1.
Miller E.A., Beasley D.E., Dunn R.R., Archie E.A. Lactobacilli dominance and vaginal pH: Why is the human vaginal microbiome unique? Front. Microbiol. 2016;7:1936. https://doi.org/10.3389/fmicb.2016.01936.
Fettweis J.M., Brooks J.P., Serrano M.G., Sheth N.U., Girerd P.H., Edwards D.J., Strauss J.F., the Vaginal Microbiome C., Jefferson K.K., Buck G.A. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology. 2014;160:2272–2282. https://doi.org/10.1099/mic.0.081034-0.
Jespers V., van de Wijgert J., Cools P., Verhelst R., Verstraelen H., Delany-Moretlwe S., Mwaura M., Ndayisaba G.F., Mandaliya K., Menten J., et al. The significance of Lactobacillus crispatus and L. vaginalis for vaginal health and the negative effect of recent sex: A cross-sectional descriptive study across groups of African women. BMC Infect. Dis. 2015;15:115. https://doi.org/10.1186/s12879-015-0825-z.
Borgdorff H., van der Veer C., van Houdt R., Alberts C.J., de Vries H.J., Bruisten S.M., Snijder M.B., Prins M., Geerlings S.E., Schim van der Loeff M.F., et al. The association between ethnicity and vaginal microbiota composition in Amsterdam, the Netherlands. PLoS ONE. 2017;12:e0181135. https://doi.org/10.1371/journal.pone.0181135.
Nelson T.M., Borgogna J.C., Michalek R.D., Roberts D.W., Rath J.M., Glover E.D., Ravel J., Shardell M.D., Yeoman C.J., Brotman R.M. Cigarette smoking is associated with an altered vaginal tract metabolomic profile. Sci. Rep. 2018;8:852. https://doi.org/10.1038/s41598-017-14943-3.
Amabebe E., Anumba D.O.C. Psychosocial stress, cortisol levels, and maintenance of vaginal health. Front. Endocrinol. 2018;9:568. https://doi.org/10.3389/fendo.2018.00568.
Jespers V., Crucitti T., Menten J., Verhelst R., Mwaura M., Mandaliya K., Ndayisaba G.F., Delany-Moretlwe S., Verstraelen H., Hardy L., et al. Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: A cross-sectional study. PLoS ONE. 2014;9:e109670. https://doi.org/10.1371/journal.pone.0109670.
Forcey D.S., Vodstrcil L.A., Hocking J.S., Fairley C.K., Law M., McNair R.P., Bradshaw C.S. Factors associated with bacterial vaginosis among women who have sex with women: A systematic review. PLoS ONE. 2015;10:e0141905. https://doi.org/10.1371/journal.pone.0141905.
Fashemi B., Delaney M.L., Onderdonk A.B., Fichorova R.N. Effects of feminine hygiene products on the vaginal mucosal biome. Microb. Ecol. Health Dis. 2013;24. https://doi.org/10.3402/mehd.v24i0.19703.
Hickey R.J., Abdo Z., Zhou X., Nemeth K., Hansmann M., Osborn T.W., III, Wang F., Forney L.J. Effects of tampons and menses on the composition and diversity of vaginal microbial communities over time. BJOG Int. J. Obstet. Gynaecol. 2013;120:695–704. https://doi.org/10.1111/1471-0528.12151.
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