The Human Microbiome during Bacterial Vaginosis

Abstract

SUMMARYBacterial vaginosis (BV) is the most commonly reported microbiological syndrome among women of childbearing age. BV is characterized by a shift in the vaginal flora from the dominantLactobacillusto a polymicrobial flora. BV has been associated with a wide array of health issues, including preterm births, pelvic inflammatory disease, increased susceptibility to HIV infection, and other chronic health problems. A number of potential microbial pathogens, singly and in combinations, have been implicated in the disease process. The list of possible agents continues to expand and includes members of a number of genera, includingGardnerella,Atopobium,Prevotella,Peptostreptococcus,Mobiluncus,Sneathia,Leptotrichia,Mycoplasma, and BV-associated bacterium 1 (BVAB1) to BVAB3. Efforts to characterize BV using epidemiological, microscopic, microbiological culture, and sequenced-based methods have all failed to reveal an etiology that can be consistently documented in all women with BV. A careful analysis of the available data suggests that what we term BV is, in fact, a set of common clinical signs and symptoms that can be provoked by a plethora of bacterial species with proinflammatory characteristics, coupled to an immune response driven by variability in host immune function.

Potential contribution of the uterine microbiome in the development of endometrial cancer

“…Given the correlation of these two microorganisms with the disease along with their association with other pathologies, it is possible that they are involved in the etiology or aggravation of conditions leading up to the development of endometrial cancer. Based on the documented association of A. vaginae [32] with bacterial vaginosis, it is possible that this microbe causes a chronic inflammatory profile that eventually leads to local immune dysregulation and facilitates intracellular infection by Porphyromonas species. Porphyromonas species have been found intracellularly [33] and it is conceivable that the microorganism we found is capable of disrupting normal cell regulatory functions that may eventually lead to a carcinogenic trigger.…”

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

“…BV is characterized by a shift in the vaginal microbiome from the dominant Lactobacillus to a polymicrobial dysbiosis, which involves multiple bacterial species that may vary from patient to patient [41]. To investigate the vaginal bacterial composition of BV-positive women, 60 patients with suspected vaginal dysbiosis were enrolled in this study after a clinical diagnosis based on Amsel criteria and Nugent scores.…”

Etiological and pathogenetic aspects of non-specific bacterial vaginosis

“…B. et al [25] the main pro-inflammatory tumour-necrosis factor, as well as the pro-inflammatory cytokines IL8, MIP-3α activation in vaginal epithelial cells under the influence of A. vaginae, plays an important role in the BV pathogenesis (an important pathogenetic aspect). Moreover, in case of Trichomonas vaginalis infection, Atopobium enters into close interaction with this pathogen, and is absorbed by epithelial cells that makes it inaccessible to antibiotics and increases the risk of disease recurrence [25].…”

“…They are found not only in healthy women, but also in patients with endometritis, chorioamnionitis, bacterial vaginosis [25,26], because of Lactobacillus spp. replacement by Mobilincus spp.…”

“…Like A. va ginae, they have a fermentative type of metabolism. The products of glucose fermentation are acetate and succinate [12,25]. They compete with lactobacillus in relation to the glycogen consumption [25].…”