Metabolomics as a clinical testing method for the diagnosis of vaginal dysbiosis

Watson, Emiley; Reid, Gregor

doi:10.1111/aji.12979

Cited by 22 publications

(21 citation statements)

References 40 publications

(57 reference statements)

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“…In a validation cohort of 45 pregnant women, 2 HV: tyrosine ratios proved to be the most specific (94%) and sensitive (89%) for BV diagnosis (AUC = 0.946). The combination of a vaginal pH level of more than 4.5 with the detection of specific polyamines has been proposed as diagnostic criteria for BV diagnosis and to assess whether treatment is necessary (Watson and Reid, 2018 ). The use of high-throughput technologies to screen for biomarkers is still in its infancy (mostly regarding the ease of data analysis) and most of the proposed biomarkers have yet to be validated in different resource-limited settings where they could be implemented as POC tests for BV.…”

Section: Alternative Approaches As Potential Diagnostic Avenues For Tmentioning

confidence: 99%

Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities

Redelinghuys

Geldenhuys

Jung

et al. 2020

Front. Cell. Infect. Microbiol.

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A healthy female genital tract harbors a microbiome dominated by lactic acid and hydrogen peroxide producing bacteria, which provide protection against infections by maintaining a low pH. Changes in the bacterial compositions of the vaginal microbiome can lead to bacterial vaginosis (BV), which is often associated with vaginal inflammation. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STIs) like human immunodeficiency virus (HIV) and affects women's reproductive health negatively. In pregnant women, BV can lead to chorioamnionitis and adverse pregnancy outcomes, including preterm premature rupture of the membranes and preterm birth. In order to manage BV effectively, good diagnostic procedures are required. Traditionally clinical and microscopic methods have been used to diagnose BV; however, these methods require skilled staff and time and suffer from reduced sensitivity and specificity. New diagnostics, including highly sensitive and specific point-of-care (POC) tests, treatment modalities and vaccines can be developed based on the identification of biomarkers from the growing pool of vaginal microbiome and vaginal metabolome data. In this review the current and future diagnostic avenues will be discussed.

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Section: Alternative Approaches As Potential Diagnostic Avenues For Tmentioning

confidence: 99%

Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities

Redelinghuys

Geldenhuys

Jung

et al. 2020

Front. Cell. Infect. Microbiol.

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“…The most common vaginal dysbiosis worldwide is bacterial vaginosis (BV), which is characterized by a shift in the microbial composition from the normally Lactobacillus -dominated to a high-complexity, polymicrobial community. It has been largely established that BV condition is characterized by the presence of anaerobic bacteria, such as Gardnerella vaginalis , Atopobium spp., Prevotella spp., and high concentrations of various biogenic amines (putrescine, cadaverine and trimethylamine), short chain fatty acids (especially acetate and succinate) and low levels of some amino acids (tyrosine, glutamate) 7–9 . In several epidemiological studies it has been reported that BV represents a risk factor for the acquisition of STIs 10,11 .…”

Section: Introductionmentioning

confidence: 99%

Diversity of vaginal microbiome and metabolome during genital infections

Ceccarani

Foschi

Parolin

et al. 2019

Sci Rep

221

276

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We characterized the vaginal ecosystem during common infections of the female genital tract, as vulvovaginal candidiasis (VVC, n = 18) and Chlamydia trachomatis infection (CT, n = 20), recruiting healthy (HC, n = 21) and bacterial vaginosis-affected (BV, n = 20) women as references of eubiosis and dysbiosis. The profiles of the vaginal microbiome and metabolome were studied in 79 reproductive-aged women, by means of next generation sequencing and proton based-nuclear magnetic resonance spectroscopy. Lactobacillus genus was profoundly depleted in all the genital infections herein considered, and species-level analysis revealed that healthy vaginal microbiome was dominated by L. crispatus. In the shift from HC to CT, VVC, and BV, L. crispatus was progressively replaced by L. iners. CT infection and VVC, as well as BV condition, were mainly characterised by anaerobe genera, e.g. Gardnerella, Prevotella, Megasphaera, Roseburia and Atopobium. The changes in the bacterial communities occurring during the genital infections resulted in significant alterations in the vaginal metabolites composition, being the decrease of lactate a common marker of all the pathological conditions. In conclusion, according to the taxonomic and metabolomics analysis, we found that each of the four conditions is characterized by a peculiar vaginal microbiome/metabolome fingerprint.

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“…The human microbiome, including the vaginal ecosystem, executes a wide range of metabolic activities, producing a plethora of metabolites in the process, which may underlie important microbe‐host driven mechanisms distinguishing phenotypic traits. Advancements in both targeted and comprehensive untargeted metabolomics have already provided evidence for divergent metabolic activity associated with vaginal dysbiotic states, including abnormalities in sugar compound, short chain fatty acid, lipid, biogenic amine and amino acid metabolism . However, little is known about vaginal metabolic profile disturbances in the context of STIs or metabolite biomarkers that may be associated with infection risk .…”

Section: Introductionmentioning

confidence: 99%

The genital tract and rectal microbiomes: their role in HIV susceptibility and prevention in women

et al. 2019

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Introduction Young women in sub‐Saharan Africa are disproportionately affected by HIV, accounting for 25% of all new infections in 2017. Several behavioural and biological factors are known to impact a young woman's vulnerability for acquiring HIV. One key, but lesser understood, biological factor impacting vulnerability is the vaginal microbiome. This review describes the vaginal microbiome and examines its alterations, its influence on HIV acquisition as well as the efficacy of HIV prevention technologies, the role of the rectal microbiome in HIV acquisition, advances in technologies to study the microbiome and some future research directions. Discussion Although the composition of each woman's vaginal microbiome is unique, a microbiome dominated by Lactobacillus species is generally associated with a “healthy” vagina. Disturbances in the vaginal microbiota, characterized by a shift from a low‐diversity, Lactobacillus ‐dominant state to a high‐diversity non‐ Lactobacillus ‐dominant state, have been shown to be associated with a range of adverse reproductive health outcomes, including increasing the risk of genital inflammation and HIV acquisition. Gardnerella vaginalis and Prevotella bivia have been shown to contribute to both HIV risk and genital inflammation. In addition to impacting HIV risk, the composition of the vaginal microbiome affects the vaginal concentrations of some antiretroviral drugs, particularly those administered intravaginally, and thereby their efficacy as pre‐exposure prophylaxis (PrEP) for HIV prevention. Although the role of rectal microbiota in HIV acquisition in women is less well understood, the composition of this compartment's microbiome, particularly the presence of species of bacteria from the Prevotellaceae family likely contribute to HIV acquisition. Advances in technologies have facilitated the study of the genital microbiome's structure and function. While next‐generation sequencing advanced knowledge of the diversity and complexity of the vaginal microbiome, the emerging field of metaproteomics, which provides important information on vaginal bacterial community structure, diversity and function, is further shedding light on functionality of the vaginal microbiome and its relationship with bacterial vaginosis (BV), as well as antiretroviral PrEP efficacy. Conclusions A better understanding of the composition, structure and function of the microbiome is needed to identify opportunities to alter the vaginal microbiome and prevent BV and reduce the risk of HIV acquisition.

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Metabolomics as a clinical testing method for the diagnosis of vaginal dysbiosis

Cited by 22 publications

References 40 publications

Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities

Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities

Diversity of vaginal microbiome and metabolome during genital infections

The genital tract and rectal microbiomes: their role in HIV susceptibility and prevention in women

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