Pathobionts in the Vaginal Microbiota: Individual Participant Data Meta-Analysis of Three Sequencing Studies

Wijgert, Janneke van de; Verwijs, Marijn C.; Gill, A. Christina; Borgdorff, Hanneke; Veer, Charlotte van der; Mayaud, Philippe

doi:10.3389/fcimb.2020.00129

Cited by 30 publications

(35 citation statements)

References 26 publications

(31 reference statements)

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“…Of these, CST IV-C1 ( Streptococcus -dominated) and CST IV-C3 ( Bifidobacterium -dominated) were the most common among reproductive age women. The Nugent scoring system was not designed with either of these taxa in mind [ 35 ] and it is not clear how they relate to vaginal health [ 47 ]. While group B Streptococcus is a known neonatal pathogen, it is not known whether its pathogenic potential is at all realized in the vaginal environment [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition

et al. 2020

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Background Taxonomic profiles of vaginal microbial communities can be sorted into a discrete number of categories termed community state types (CSTs). This approach is advantageous because collapsing a hyper-dimensional taxonomic profile into a single categorical variable enables efforts such as data exploration, epidemiological studies, and statistical modeling. Vaginal communities are typically assigned to CSTs based on the results of hierarchical clustering of the pairwise distances between samples. However, this approach is problematic because it complicates between-study comparisons and because the results are entirely dependent on the particular set of samples that were analyzed. We sought to standardize and advance the assignment of samples to CSTs. Results We developed VALENCIA (VAginaL community state typE Nearest CentroId clAssifier), a nearest centroid-based tool which classifies samples based on their similarity to a set of reference centroids. The references were defined using a comprehensive set of 13,160 taxonomic profiles from 1975 women in the USA. This large dataset allowed us to comprehensively identify, define, and characterize vaginal CSTs common to reproductive age women and expand upon the CSTs that had been defined in previous studies. We validated the broad applicability of VALENCIA for the classification of vaginal microbial communities by using it to classify three test datasets which included reproductive age eastern and southern African women, adolescent girls, and a racially/ethnically and geographically diverse sample of postmenopausal women. VALENCIA performed well on all three datasets despite the substantial variations in sequencing strategies and bioinformatics pipelines, indicating its broad application to vaginal microbiota. We further describe the relationships between community characteristics (vaginal pH, Nugent score) and participant demographics (race, age) and the CSTs defined by VALENCIA. Conclusion VALENCIA provides a much-needed solution for the robust and reproducible assignment of vaginal community state types. This will allow unbiased analysis of both small and large vaginal microbiota datasets, comparisons between datasets and meta-analyses that combine multiple datasets.

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Section: Discussionmentioning

confidence: 99%

VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition

et al. 2020

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“…In addition, diseased-state (CST IV) and facilitated-BV state (CST III) vaginal community were more commonly found in sub-Saharan African [ 6 , 10 ]. It is conceivable that genetic factors in these groups may alter the vaginal immune responses which favours the colonisation of L. iners and pathobionts that cause vaginal dysbiosis [ 56 , 57 ]. As has been noted, the characterisation of microbial community in vagina has vastly extended our knowledge on the relationship between healthy and abnormal vaginal microbiota.…”

Section: Indigenous Vaginal Microbiota In Womenmentioning

confidence: 99%

Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health

2020

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Human vagina is colonised by a diverse array of microorganisms that make up the normal microbiota and mycobiota. Lactobacillus is the most frequently isolated microorganism from the healthy human vagina, this includes Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii. These vaginal lactobacilli have been touted to prevent invasion of pathogens by keeping their population in check. However, the disruption of vaginal ecosystem contributes to the overgrowth of pathogens which causes complicated vaginal infections such as bacterial vaginosis (BV), sexually transmitted infections (STIs), and vulvovaginal candidiasis (VVC). Predisposing factors such as menses, pregnancy, sexual practice, uncontrolled usage of antibiotics, and vaginal douching can alter the microbial community. Therefore, the composition of vaginal microbiota serves an important role in determining vagina health. Owing to their Generally Recognised as Safe (GRAS) status, lactobacilli have been widely utilised as one of the alternatives besides conventional antimicrobial treatment against vaginal pathogens for the prevention of chronic vaginitis and the restoration of vaginal ecosystem. In addition, the effectiveness of Lactobacillus as prophylaxis has also been well-founded in long-term administration. This review aimed to highlight the beneficial effects of lactobacilli derivatives (i.e. surface-active molecules) with anti-biofilm, antioxidant, pathogen-inhibition, and immunomodulation activities in developing remedies for vaginal infections. We also discuss the current challenges in the implementation of the use of lactobacilli derivatives in promotion of human health. In the current review, we intend to provide insights for the development of lactobacilli derivatives as a complementary or alternative medicine to conventional probiotic therapy in vaginal health.

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“…A significant decrease in VMB richness (number of species), evenness (relative abundance of each species), and diversity (the overall richness and evenness of species) during pregnancy is associated with PTB ( 43 ). Furthermore, individual vaginal colonization with bacterial pathobionts (symbionts with pathogenic potential, like streptococci, staphylococci, or Enterobacteriaceae species) during pregnancy can associate with adverse pregnancy outcomes ( 44 , 45 ). Son et al ( 46 ) reported that a Klebsiella pneumoniae -dominant VMB might be associated with PTB before 28 weeks of gestational age (GA), Lactobacillus iners with PTB before 34 weeks of GA, and S. agalactiae with late miscarriage ( 46 ).…”

Section: Introductionmentioning

confidence: 99%

The Association Between Vaginal Microbiota Dysbiosis, Bacterial Vaginosis, and Aerobic Vaginitis, and Adverse Pregnancy Outcomes of Women Living in Sub-Saharan Africa: A Systematic Review

Juliana

Suiters

Al‐Nasiry

et al. 2020

Front. Public Health

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Background: Previous studies have described the association between dysbiosis of the vaginal microbiota (VMB) and related dysbiotic conditions, such as bacterial vaginosis (BV) and aerobic vaginitis (AV), and various adverse pregnancy outcomes. There is limited overview of this association from countries in sub-Saharan Africa (SSA), which bear a disproportionally high burden of both vaginal dysbiotic conditions and adverse pregnancy outcomes. This systematic review assesses the evidence on the association between VMB dysbiosis, BV, and AV, and late adverse pregnancy outcomes in women living in SSA.Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis Statement (PRISMA) guidelines were followed. Three databases [PubMed, Embase (Ovid), and Cochrane] were used to retrieve observational and intervention studies conducted in SSA that associated VMB dysbiosis, BV, or AV and preterm birth/labor/delivery, preterm rupture of membranes (PROM), low birthweight, small for gestational age, intrauterine growth restriction, intrauterine infection, intrauterine (fetal) death, stillbirth, perinatal death, or perinatal mortality.Results: Twelve studies out of 693 search records from five SSA countries were included. One study identified a positive association between VMB dysbiosis and low birthweight. Despite considerable differences in study design and outcome reporting, studies reported an association between BV and preterm birth (7/9), low birthweight (2/6), PROM (2/4), intrauterine infections (1/1), and small for gestational age (1/1). None of the retrieved studies found an association between BV and pregnancy loss (5/5) or intrauterine growth retardation (1/1). At least two studies support the association between BV and PROM, low birthweight, and preterm birth in Nigerian pregnant women. No reports were identified investigating the association between AV and late adverse pregnancy outcomes in SSA.Conclusion: Two of the included studies from SSA support the association between BV and PROM. The remaining studies show discrepancies in supporting an association between BV and preterm birth or low birthweight. None of the studies found an association between BV and pregnancy loss. As for the role of VMB dysbiosis, BV, and AV during pregnancy among SSA women, additional research is needed. These results provide useful evidence for prevention efforts to decrease vaginal dysbiosis and its contribution to adverse pregnancy outcomes in SSA.

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Pathobionts in the Vaginal Microbiota: Individual Participant Data Meta-Analysis of Three Sequencing Studies

Cited by 30 publications

References 26 publications

VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition

VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition

Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health

The Association Between Vaginal Microbiota Dysbiosis, Bacterial Vaginosis, and Aerobic Vaginitis, and Adverse Pregnancy Outcomes of Women Living in Sub-Saharan Africa: A Systematic Review

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