Reproductive tract infection is a major initiator of preterm birth (PTB). The objective of this prospective cohort study of 88 participants was to determine whether PTB correlates with the vaginal microbiome during pregnancy. Total DNA was purified from posterior vaginal fornix swabs during gestation. The 16S ribosomal RNA gene was amplified using polymerase chain reaction primers, followed by chain-termination sequencing. Bacteria were identified by comparing contig consensus sequences with the Ribosomal Database Project. Dichotomous responses were summarized via proportions and continuous variables via means ± standard deviation. Mean Shannon Diversity index differed by Welch t test (P = .00016) between caucasians with PTB and term gestation. Species diversity was greatest among African Americans (P = .0045). Change in microbiome/Lactobacillus content and presence of putative novel/noxious bacteria did not correlate with PTB. We conclude that uncultured vaginal bacteria play an important role in PTB and race/ethnicity and sampling location are important determinants of the vaginal microbiome.

This project was supported by NIH AI083050-04 (W.C.G./L.C.G.); NIH U54HD 055764 (L.C.G.); NIH 1F32HD074423-02 (J.C.C.); DOD W81XWH-11-1-0562 (W.C.G.); NIH 5K12-DK083021-04, NIH 1K99AI104262-01A1, The UCSF Hellman Award (N.R.R.). The authors have nothing to disclose.

To understand the relative dietary value of forage fish as prey in the Bering Sea and Gulf of Alaska, whole organisms of 13 species were analysed for proximate composition (protein, oil, ash and moisture content). Eulachon (Thaleichthys pacificus) were high in oil (total lipid) (16.8% to 21.4%) and low in moisture (64.6% to 70.8%). Oil in capelin (Mallotus villosus) ranged from 2.1% to 14.0%. Juveniles of walleye pollock (Theragra chalcogramma), Atka mackerel (Pleurogrammus monopterygius), Pacific herring (Clupea pallasii), and prowfish (Zaprora silenus) had low oil contents (< 1.8%) and high moisture contents (> 80.3%). Rankings of median proximate values illustrate the similarities. Surf smelt (Hypomesus pretiosus), rainbow smelt (Osmerus mordax), pricklebacks (Lumpenus spp.), Atka mackerel, Pacific sand lance (Ammodytes hexapterus) and Pacific sandfish (Trichodon trichodon) ranked high in median protein content (> 15.4%). Median ash content for all species ranged from 0.6% to 3.3%. Total wet mass caloric content (kcal g–1) was calculated for the four main species and a linear model was developed for caloric content as a function of moisture. The linear models (caloric content = b0 + b1 × moisture) were Pacific sand lance and Pacific sandfish (b0 = 7.82, b1 = – 0.09); eulachon (b0 = 7.97, b1 = – 0.08); and capelin (b0 = 9.70, b1 = – 0.11).

Intravaginal anti-HIV microbicides could provide women with a self-controlled means for HIV prevention, but results from clinical trials have been largely disappointing. We postulated that unrecognized effects of intravaginal gels on the upper female reproductive tract might contribute to the lower-than-expected efficacy of HIV microbicides. Our objective was to study the effects of intravaginal gels on the immune microenvironment of the cervix and uterus. In this randomized crossover study, 27 healthy female volunteers used a nightly application of intravaginal nonoxynol-9 (N9) gel as a “failed” microbicide or the universal placebo gel (UPG) as a “safe” gel (intervention cycles), or nothing (control cycle) from the end of menses to the mid-luteal phase. At a specific time-point following ovulation, all participants underwent sample collection for measurements of T-cell phenotypes, gene expression, and cytokine/chemokine protein concentrations from 3 anatomic sites above the vagina: the cervical transformation zone, the endocervix and the endometrium. We used hierarchical statistical models to estimate mean (95% CI) intervention effects, for N9 and UPG relative to control. Exposure to N9 gel and UPG generated a common “harm signal” that included transcriptional up-regulation of inflammatory genes chemokine (C-C motif) ligand 20 (macrophage inflammatory factor-3alpha) and interleukin 8 in the cervix, decreased protein concentrations of secretory leukocyte protease inhibitor, and transcriptional up-regulation of inflammatory mediators glycodelin-A and osteopontin in the endometrium. These results need to be replicated with a larger sample, but underscore the need to consider the effects of microbicide agents and gel excipients on the upper female reproductive tract in studies of vaginal microbicides.