51
|
Cobo T, Vergara A, Collado MC, Casals-Pascual C, Herreros E, Bosch J, Sánchez-García AB, López-Parellada R, Ponce J, Gratacós E. Characterization of vaginal microbiota in women with preterm labor with intra-amniotic inflammation. Sci Rep 2019; 9:18963. [PMID: 31831820 PMCID: PMC6908687 DOI: 10.1038/s41598-019-55611-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/04/2019] [Indexed: 12/28/2022] Open
Abstract
This study aims to investigate the relation between vaginal microbiota and exposition to intra-amniotic inflammation (IAI). We conducted a prospective cohort study in women with preterm labor <34 weeks who had undergone amniocentesis to rule out IAI. Vaginal samples were collected after amniocentesis. Women with IAI included those with positive amniotic fluid (AF) for a microorganism identified by specific culture media and Sanger sequencing 16S ribosomal RNA gene and/or high AF interleukin (IL)-6 levels. Vaginal microbiota was characterized by 16S ribosomal RNA gene amplicon sequencing. Specific quantitative PCR targeted to Lactobacillus spp. was also performed. Regression models were used to evaluate associations between vaginal microbiota and exposition to IAI. Concerning our results, 64 women were included. We observed an inverse association between AF IL-6 levels and load of Lactobacillus spp. Depletion in Lactobacillus spp. load was significantly associated with an early gestational age at delivery and a short latency to delivery. Microbial-diversity was found to be a risk factor for the subsequent occurrence of clinical chorioamnionitis. To the contrary, higher Lactobacillus spp. load had a protective role. In conclusion, the study identifies reduced bacterial load of Lactobacillus spp. in women exposed to IAI and found microbial-diversity and Lactobacillus spp. depletion to be associated with a worse perinatal outcome.
Collapse
Affiliation(s)
- Teresa Cobo
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain. .,Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
| | - Andrea Vergara
- Microbiology, Biomedical Diagnostic Center, Hospital Clínic and ISGlobal (Barcelona Institute for Global Health), University of Barcelona, Barcelona, Spain
| | - Maria Carmen Collado
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-Spanish National Research Council (IATA-CSIC), Paterna, Valencia, Spain
| | - Climent Casals-Pascual
- Microbiology, Biomedical Diagnostic Center, Hospital Clínic and ISGlobal (Barcelona Institute for Global Health), University of Barcelona, Barcelona, Spain
| | - Eduardo Herreros
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jordi Bosch
- Microbiology, Biomedical Diagnostic Center, Hospital Clínic and ISGlobal (Barcelona Institute for Global Health), University of Barcelona, Barcelona, Spain
| | - Ana B Sánchez-García
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rosa López-Parellada
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Júlia Ponce
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain.,Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| |
Collapse
|
52
|
Li C, Wang T, Li Y, Zhang T, Wang Q, He J, Wang L, Li L, Yang N, Fang Y. Probiotics for the treatment of women with bacterial vaginosis: A systematic review and meta-analysis of randomized clinical trials. Eur J Pharmacol 2019; 864:172660. [PMID: 31562865 DOI: 10.1016/j.ejphar.2019.172660] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/03/2019] [Accepted: 09/09/2019] [Indexed: 12/17/2022]
Abstract
This systematic review and meta-analysis systematically evaluated the efficacy of probiotic monotherapy and combination therapy for bacterial vaginosis (BV). Published randomized controlled trials were searched in the Cochrane Library, PubMed, EMBASE, OVID Database and ClinicalTrials.gov from the inception dates to 12 July 2019. The literature was screened and evaluated according to the inclusion criteria, and the data were analysed by a random effect model. A chi-square test was used to test heterogeneity between trials. This study included 13 randomized controlled trials (RCTs), which included 1258 patients, and the cure rate of BV was analysed. Three RCTs compared probiotics with a placebo (control) [risk ratios (RR) = 4.39, 95% CI (2.05, 9.41), P = 0.0001]. Two RCTs compared probiotics with antibiotics (control) [RR = 1.03, 95% CI (0.38, 2.81), P = 0.95]. Nine of 13 RCTs compared the combination of probiotics and antibiotics with antibiotics alone [RR = 1.28, 95% CI (1.05, 1.56), P = 0.02]. Despite the high heterogeneity of the pooled analysis, neither the subgroup analysis results nor the sensitivity analysis results were statistically significant. Probiotics may have a positive effect on the treatment of BV, but there is a lack of strong evidence.
Collapse
Affiliation(s)
- Chen Li
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China
| | - Tenghua Wang
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China
| | - Yongmei Li
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China
| | - Tan Zhang
- Department of Pharmacy, Peking University People's Hospital, Beijing, 100871, China
| | - Qi Wang
- Department of Pharmacy, Peking University People's Hospital, Beijing, 100871, China
| | - Jin He
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China
| | - Li Wang
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China
| | - Lujin Li
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ning Yang
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China
| | - Yi Fang
- Key Laboratory of Molecular Target and Clinical Pharmacology, The Fifth Affiliated Hospital & School Pharmaceutical Sciences, Guangzhou Medical University, Guangdong, 511436, China; Department of Pharmacy, Peking University People's Hospital, Beijing, 100871, China.
| |
Collapse
|
53
|
The Impact of Lactoferrin on the Growth of Intestinal Inhabitant Bacteria. Int J Mol Sci 2019; 20:ijms20194707. [PMID: 31547574 PMCID: PMC6801499 DOI: 10.3390/ijms20194707] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/16/2019] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
Lactoferrin (Lf) is an iron-binding milk glycoprotein that promotes the growth of selected probiotic strains. The effect of Lf on the growth and diversification of intestinal microbiota may have an impact on several issues, including (i) strengthening the permeability of the epithelial cell monolayer, (ii) favoring the microbial antagonism that discourages the colonization and proliferation of enteric pathogens, (iii) enhancing the growth and maturation of cell-monolayer components and gut nerve fibers, and (iv) providing signals to balance the anti- and pro-inflammatory responses resulting in gut homeostasis. Given the beneficial role of probiotics, this contribution aims to review the current properties of bovine and human Lf and their derivatives in in vitro probiotic growth and Lf interplay with microbiota described in the piglet model. By using Lf as a component in pharmacological products, we may enable novel strategies that promote probiotic growth while conferring antimicrobial activity against multidrug-resistant microorganisms that cause life-threatening diseases, especially in neonates.
Collapse
|
54
|
Evaluation of the vaginal microbiome in clinical diagnosis and management of vaginal infectious diseases. Chin Med J (Engl) 2019; 132:1100-1103. [PMID: 30896565 PMCID: PMC6595874 DOI: 10.1097/cm9.0000000000000211] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
|
55
|
Carda-Diéguez M, Cárdenas N, Aparicio M, Beltrán D, Rodríguez JM, Mira A. Variations in Vaginal, Penile, and Oral Microbiota After Sexual Intercourse: A Case Report. Front Med (Lausanne) 2019; 6:178. [PMID: 31440511 PMCID: PMC6692966 DOI: 10.3389/fmed.2019.00178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/22/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Bacterial vaginosis is the most common infection in women and it has been proved that dysbiosis of vaginal microbiota can promote the infectious status. This case report shows the effect of oral and vaginal sex over the microbiota of a heterosexual couple who reported repeated problems of vaginal and oral infections after sexual intercourse. Case Presentation: A woman (32) reported to have vaginal infections and gingivitis after she had started a relationship with a man (34) and associated them with unprotected sex. No treatments successfully removed the problem and it repeated every time they had sexual encounters. Vaginal, penile and oral swabs were collected before and after sexual encounters in order to analyze changes in the respective microbiotas. DNA was extracted from all samples and the bacterial 16S rRNA gene was sequenced using Illumina MiSeq. Conclusions: Lactobacillus occupied the great majority of the vaginal microbiota in all scenarios except after unprotected sex, which caused a bacterial dysbiosis that lasted at least for a week. Similarly, the penile microbiota changed significantly after unprotected sexual relationships. Interestingly, both oral and vaginal sex increased the abundance of Lactobacillus in the male oral and penile microbiota, respectively. In conclusion, unprotected sexual intercourse influenced the genital microbiota in the couple studied and future studies with larger sample sizes should study if sex may be a factor promoting vaginal infection through dysbiosis and hampered protection by the resident microbiota.
Collapse
Affiliation(s)
- Miguel Carda-Diéguez
- Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO, Valencia, Spain
| | - Nívia Cárdenas
- Department of Nutrition and Food Science, Complutense University of Madrid, Madrid, Spain
| | - Marina Aparicio
- Department of Nutrition and Food Science, Complutense University of Madrid, Madrid, Spain
| | - David Beltrán
- Centro de Diagnóstico Médico, Ayuntamiento de Madrid, Madrid, Spain
| | - Juan M Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, Madrid, Spain
| | - Alex Mira
- Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO, Valencia, Spain.,Network of Epidemiology and Public Health, CIBERESP, Madrid, Spain
| |
Collapse
|
56
|
Sobel JD, Kaur N, Woznicki NA, Boikov D, Aguin T, Gill G, Akins RA. Conventional oral and secondary high dose vaginal metronidazole therapy for recurrent bacterial vaginosis: clinical outcomes, impacts of sex and menses. Infect Drug Resist 2019; 12:2297-2307. [PMID: 31413606 PMCID: PMC6661983 DOI: 10.2147/idr.s213853] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose Oral metronidazole therapy is the standard of care for bacterial vaginosis (BV), yet it has alarming rates of recurrence and refractory responses among recurrent BV (RBV) patients. This study addresses whether high dose vaginal metronidazole therapy (HDM) is beneficial in RBV patients who fail after standard of care (SOC) therapy, whether diagnostic test scores proximal to the HDM predict clinical outcome, and whether menses, coitus, or race influences therapy outcome. Patients and methods A total of 90 patients with RBV were given SOC and tracked 74 for up to 9 months. Refractory or recurrent patients (57) with symptomatic BV were given HDM and followed for up to 8 months. Patients were evaluated by Amsel criteria, Nugent score, and a qPCR assay that assesses the Lactobacillus content. Results HDM achieved at least short-term remission in 68% of the patients who were refractory to or recurred after SOC and provided a 10-day increase in the mean duration of remission among patients who eventually recurred (p=0.027). Patients with prolonged dysbiosis (pH >5 or Amsel 4) before symptomatic recurrence were more likely to recur after subsequent HDM. Most recurrence happened within 10 days of menses, but sex in this cohort was not associated with clinical outcome. Mean diagnostic BV scores of African American patients in remission were inferior to scores of a small cohort of Caucasian patients in remission. Conclusion Encouraging results obtained with HDM justify a prospective, randomized study to determine if follow-up HDM is beneficial among a broader cohort of women failing conventional oral metronidazole therapy.
Collapse
Affiliation(s)
- Jack D Sobel
- Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA
| | - Navkiranjot Kaur
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit MI, USA
| | - Nicole A Woznicki
- Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA
| | - Dina Boikov
- Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tina Aguin
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Gurveer Gill
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit MI, USA
| | - Robert A Akins
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit MI, USA
| |
Collapse
|