101
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Novak J, Ravel J, Ma B, Ferreira CST, Tristão ADR, Silva MG, Marconi C. Characteristics associated with Lactobacillus iners-dominated vaginal microbiota. Sex Transm Infect 2021; 98:353-359. [PMID: 34497114 DOI: 10.1136/sextrans-2020-054824] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 08/29/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The protective role of Lactobacillus iners in the vaginal microbiota has been questioned. Recent studies have shown that L. iners is the dominating taxon in a large subset of women worldwide. The aim of this study was to identify sociodemographic, behavioural and clinical variables associated with L. iners-dominated community state type (CST) III in Brazilian women of reproductive age. PARTICIPANTS AND METHODS This study leveraged microbiota compositional data generated by sequencing of the V3-V4 16S rRNA gene from vaginal samples collected from 442 participants enrolled in a previous cross-sectional study that included 609 women in five geographical regions of Brazil. A total of 167 (27.4%) participants were excluded from the current study as they did not present a Lactobacillus-dominated vaginal microbiota. Data on sociodemographic and behavioural characteristics of the study population were obtained through face-to-face interviews. Participants were assigned to two study groups: those with L. iners-dominated CST III (n=222) and those with three distinct CSTs (I, II or V) dominated by another Lactobacillus spp. (n=220). Logistic regression analysis using a stepwise method was performed to test association between CST III and participants' characteristics, considering their OR and 95% CIs. RESULTS Among the population characteristics assessed, L. iners-dominated CST III was independently associated with having two or more sexual partners (OR 3.27; 95% CI 1.50 to 7.11) and microscopic detection of Candida sp. on vaginal smears (OR 2.24; 95% CI 1.02 to 4.89). Other characteristics were inversely associated with CST III, including condom use (OR 0.59; 95% CI 0.38 to 0.91), higher educational level (OR 0.61; 95% CI 0.41 to 0.91) and diet containing milk/dairy intake (OR 0.43; 95% CI 0.20 to 0.90). CONCLUSION Unprotected sex practices, number of sexual partners and lower educational levels may be useful for identifying women with L. iners-dominated microbiota and its suboptimal protective properties. L. iners microbiota does not seem to provide optimal protection against Candida sp. colonisation, warranting further investigation.
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Affiliation(s)
- Juliano Novak
- Department of Pathology, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo, Brazil
| | - Jacques Ravel
- Department of Microbiology & Immunology, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Bing Ma
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Andrea da Rocha Tristão
- Department of Gynecology and Obstetrics, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo, Brazil
| | - Marcia Guimaraes Silva
- Department of Pathology, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo, Brazil
| | - Camila Marconi
- Department of Pathology, São Paulo State University (Unesp), Medical School, Botucatu, São Paulo, Brazil.,Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil
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102
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Luo Y, Li L, Chen X, Gou H, Yan K, Xu Y. Effects of lactate in immunosuppression and inflammation: Progress and prospects. Int Rev Immunol 2021; 41:19-29. [PMID: 34486916 DOI: 10.1080/08830185.2021.1974856] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Lactate used to be considered as a waste product of glucose metabolism. However, accumulating evidence has revealed its crucial role in regulating various biological and pathological processes. Hypoxia, inflammation, viral infection, and tumor promote the production of lactate. Then lactate activates G protein-coupled receptor 81 (GPR81) or shuttles across membranes by monocarboxylate-transporters (MCTs) to execute its intricate effects. Many studies highlighted the function of lactate in regulating dendritic cells, monocytes, natural killer cells, mast cells, T cells, tumor cells, fibroblasts, macrophages polarization, and the differentiation of Th1, Th17, MDSCs, Tregs; all of which play a role in maintaining the immune homeostasis of the host when challenged with the noxious stimuli. In this review, we summarized the influence of lactate in diverse tissue-specific cells, and discuss their effects on viral infection, acute inflammation, chronic inflammation, sepsis, and tumor immunosuppression. The goal of this review is to expose that lactate has a double-edged effect on host immunity and accompanying inflammatory reactions, which could be a potentially effective target for treating the tumor and multiple infectious diseases.
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Affiliation(s)
- Ying Luo
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Lu Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Xu Chen
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Huiqing Gou
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Ke Yan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
| | - Yan Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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103
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Juliana NCA, Peters RPH, Al-Nasiry S, Budding AE, Morré SA, Ambrosino E. Composition of the vaginal microbiota during pregnancy in women living in sub-Saharan Africa: a PRISMA-compliant review. BMC Pregnancy Childbirth 2021; 21:596. [PMID: 34479485 PMCID: PMC8418042 DOI: 10.1186/s12884-021-04072-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/20/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The vaginal microbiota (VMB) are the set of microorganisms residing in the human vagina. During pregnancy, their composition is Lactobacillus-dominant in most Caucasian women. Previous studies suggest that the VMB of women with African ancestry is more likely to be non-Lactobacillus dominant (dysbiotic) compared to other populations, and possibly relate to the high incidence of pregnancy complications, such as preterm birth. This work reviewed the literature on VMB composition in pregnant women from sub-Saharan Africa. METHODS A search was conducted in PubMed and Embase databases following PRISMA guidelines. Observational and intervention studies analysing VMB communities from sub-Saharan African pregnant women using molecular techniques were included. RESULTS Ten studies performed in seven sub-Saharan African countries were identified. They independently showed that Lactobacillus-dominant VMB (particularly L. iners or L. crispatus) or VMB containing Lactobacilli are the most prevalent, followed by a more diverse anaerobe-dominant VMB, in the studied populations. The majority of pregnant women with a sexually-transmitted infection had a Lactobacillus-dominant VMB, but with a significantly higher presence of anaerobic species. CONCLUSION In agreement with studies performed in other populations, Lactobacillus species are the most prevalent VMB species during pregnancy in sub-Saharan African women. The frequency of diverse anaerobe-dominant VMB is high in these populations. In Africa, studies on VMB in pregnancy are scant, heterogeneous in methodology, and knowledge remains limited. More insights on VMB composition and their possible sequalae among these populations is needed.
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Affiliation(s)
- Naomi C A Juliana
- Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Research School GROW (School for Oncology & Developmental Biology), Institute for Public Health Genomics, Maastricht University, Maastricht, Netherlands
| | - Remco P H Peters
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.,Department of Medical Microbiology, School for Public Health and Primary Care (CAPRHI), Maastricht University, Maastricht, Netherlands.,Research Unit, Foundation for Professional Development, East London, South Africa
| | - Salwan Al-Nasiry
- Department of Obstetrics and Gynecology, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | | | - Servaas A Morré
- Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Research School GROW (School for Oncology & Developmental Biology), Institute for Public Health Genomics, Maastricht University, Maastricht, Netherlands.,Laboratory of Immunogenetics, Department Medical Microbiology and Infection Control, Location AMC, Amsterdam UMC, Amsterdam, Netherlands
| | - Elena Ambrosino
- Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Research School GROW (School for Oncology & Developmental Biology), Institute for Public Health Genomics, Maastricht University, Maastricht, Netherlands.
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104
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Cheng C, Zhang L, Mu J, Tian Q, Liu Y, Ma X, Fu Y, Liu Z, Li Z. Effect of Lactobacillus johnsonii Strain SQ0048 on the TLRs-MyD88/NF-κB Signaling Pathway in Bovine Vaginal Epithelial Cells. Front Vet Sci 2021; 8:670949. [PMID: 34447797 PMCID: PMC8383737 DOI: 10.3389/fvets.2021.670949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Abstract
Vaginal inflammation is a common disease of the dairy cows' reproductive tract. Lactic acid bacteria can combat purulent inflammation caused by pathogenic bacteria and regulate the NF-κB signaling pathway mediated by toll-like receptors (TLRs) in the inflammatory response. We studied the effect of Lactobacillus johnsonii SQ0048, an isolate with antibacterial activity, on the NF-κB signaling pathway in cow vaginal epithelial cells. The expression levels of serial effectors related to the TLRs-MyD88/NF-κB signaling pathway (TLR2, TLR4, MyD88, IKK, NF-κB, IL-1β, IL-6, TNF-α, and IL-10) were measured with real-time polymerase chain reaction (RT-PCR), ELISA, and Western blot analyses. TLR2 and TLR4 were activated by SQ0048 cells, as noted by increased mRNA expression levels of TLR2 and TLR4 in SQ0048-treated bovine vaginal epithelial cells relative to control cells (P <0.01). SQ0048 treatment also significantly increased MyD88 and IKK expression, and activated NF-κB in vaginal epithelial cells (P <0.01). In addition, SQ0048 treatment also significantly increased mRNA expression levels of IL-1β, IL-6, and TNF-α, but decreased IL-10 mRNA expression levels (P <0.01). These data indicate that strain SQ0048 presence can improve the immune functions of cow vaginal epithelial cells by activating TLRs-MyD88/NF-κB signaling pathways. However, further in vivo studies are required to confirm these findings.
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Affiliation(s)
- Chao Cheng
- College of Life Science and Technology, Jining Normal University, Jining, China
| | | | - Junxiang Mu
- College of Life Science and Technology, Jining Normal University, Jining, China
| | | | - Yanming Liu
- Inner Mongolia Shuangqi Pharmaceutical Co., Ltd., Hohhot, China
| | - Xiaohong Ma
- Inner Mongolia Shuangqi Pharmaceutical Co., Ltd., Hohhot, China
| | - Yanru Fu
- Hohhot Vocational College, Hohhot, China
| | - Zhiguo Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenjun Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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105
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Debray R, Herbert RA, Jaffe AL, Crits-Christoph A, Power ME, Koskella B. Priority effects in microbiome assembly. Nat Rev Microbiol 2021; 20:109-121. [PMID: 34453137 DOI: 10.1038/s41579-021-00604-w] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 11/09/2022]
Abstract
Advances in next-generation sequencing have enabled the widespread measurement of microbiome composition across systems and over the course of microbiome assembly. Despite substantial progress in understanding the deterministic drivers of community composition, the role of historical contingency remains poorly understood. The establishment of new species in a community can depend on the order and/or timing of their arrival, a phenomenon known as a priority effect. Here, we review the mechanisms of priority effects and evidence for their importance in microbial communities inhabiting a range of environments, including the mammalian gut, the plant phyllosphere and rhizosphere, soil, freshwaters and oceans. We describe approaches for the direct testing and prediction of priority effects in complex microbial communities and illustrate these with re-analysis of publicly available plant and animal microbiome datasets. Finally, we discuss the shared principles that emerge across study systems, focusing on eco-evolutionary dynamics and the importance of scale. Overall, we argue that predicting when and how current community state impacts the success of newly arriving microbial taxa is crucial for the management of microbiomes to sustain ecological function and host health. We conclude by discussing outstanding conceptual and practical challenges that are faced when measuring priority effects in microbiomes.
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Affiliation(s)
- Reena Debray
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, USA.
| | - Robin A Herbert
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA, USA. .,Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
| | - Alexander L Jaffe
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA, USA
| | | | - Mary E Power
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Britt Koskella
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, USA
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106
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Abstract
Despite the strikingly high worldwide prevalence of vulvovaginal candidiasis (VVC), treatment options for recurrent VVC (RVVC) remain limited, with many women experiencing failed clinical treatment with frontline azoles. Further, the cause of onset and recurrence of disease is largely unknown, with few studies identifying potential mechanisms of treatment failure. This study aimed to assess a panel of clinical samples from healthy women and those with RVVC to investigate the influence of Candida, the vaginal microbiome, and how their interaction influences disease pathology. 16S rRNA sequencing characterized disease by a reduction in specific health-associated Lactobacillus species, such as Lactobacillus crispatus, coupled with an increase in Lactobacillus iners. In vitro analysis showed that Candida albicans clinical isolates are capable of heterogeneous biofilm formation, and we found the presence of hyphae and C. albicans aggregates in vaginal lavage fluid. Additionally, the ability of Lactobacillus to inhibit C. albicans biofilm formation and biofilm-related gene expression was demonstrated. Using RNA sequencing technology, we were able to identify a possible mechanism by which L. crispatus may contribute to re-establishing a healthy vaginal environment through amino acid acquisition from C. albicans. This study highlights the potential formation and impact of Candida biofilms in RVVC. Additionally, it suggests that RVVC is not entirely due to an arbitrary switch in C. albicans from commensal to pathogen and that understanding interactions between this yeast and vaginal Lactobacillus species may be crucial to elucidating the cause of RVVC and developing appropriate therapies. IMPORTANCE RVVC is a significant burden, both economically and for women's health, but its prevalence is poorly documented globally due to the levels of self-treatment. Identifying triggers for development and recurrence of VVC and the pathogenesis of the microbes involved could considerably improve prevention and treatment options for women with recurrent, azole-resistant cases. This study therefore aimed to examine the interkingdom dynamics from healthy women and those with RVVC using next-generation sequencing techniques and to further investigate the molecular interactions between C. albicans and L. crispatus in a relevant biofilm coculture system.
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107
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Diebold R, Schopf B, Stammer H, Mendling W. Vaginal treatment with lactic acid gel delays relapses in recurrent urinary tract infections: results from an open, multicentre observational study. Arch Gynecol Obstet 2021; 304:409-417. [PMID: 33772330 PMCID: PMC8277613 DOI: 10.1007/s00404-021-06040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/17/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE The main objective of this open, prospective, multicentre, observational study is to investigate the relapse rate and tolerability of lactic acid gels in adult female patients with recurrent urinary tract infections during routine practice. METHODS Data were collected from patients undergoing intermittent short courses of intravaginal treatment with lactic acid gel for prevention of recurrent urinary tract infections. The observation period for individual patients was 4 months, aimed at covering four short courses of intravaginal treatment. Data on UTI relapses, tolerability, handling and satisfaction with the treatment were collected via patient diaries and physician assessments and comprised any adverse events (AEs). RESULTS In total, 72 patients were treated. During the last 12 months prior to the study, patients had on average 4.0 UTIs. In the 4 months after commencing treatment, 63.5% of patients had no recurrence of UTI symptoms. Overall efficacy was rated by physicians as 'excellent/good' for 96.7% of patients. The patients' overall acceptance of local treatment was high with 94.1% being '(very) satisfied'. Similarly, handling was rated as '(very) easy' by 94.2% of patients. The tolerability was assessed as 'highly tolerable/tolerable' by over 98% of patients and physicians alike. Safety analyses reported six AEs of mild intensity, all of which had resolved by the end of the study. CONCLUSION Treatment with lactic acid gel may increase resilience against uropathogens, possibly preventing the need for antibiotic prevention of recurrent urinary tract infections. Treatment was positively assessed by the patients. The physician assessments corroborate these findings. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION DRKS00016760, 18.02.2019.
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Affiliation(s)
- Ruth Diebold
- Dr. Kade Pharmazeutische Fabrik GmbH, Berlin, Germany.
| | - Bettina Schopf
- Pharmalog Institut für klinische Forschung GmbH, Ismaning, Germany
| | - Holger Stammer
- Pharmalog Institut für klinische Forschung GmbH, Ismaning, Germany
| | - Werner Mendling
- German Centre for Infections in Obstetrics and Gynecology, Wuppertal, Germany
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108
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Wahid M, Dar SA, Jawed A, Mandal RK, Akhter N, Khan S, Khan F, Jogiah S, Rai AK, Rattan R. Microbes in gynecologic cancers: Causes or consequences and therapeutic potential. Semin Cancer Biol 2021; 86:1179-1189. [PMID: 34302959 DOI: 10.1016/j.semcancer.2021.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/24/2022]
Abstract
Gynecologic cancers, starting in the reproductive organs of females, include cancer of cervix, endometrium, ovary commonly and vagina and vulva rarely. The changes in the composition of microbiome in gut and vagina affect immune and metabolic signaling of the host cells resulting in chronic inflammation, angiogenesis, cellular proliferation, genome instability, epithelial barrier breach and metabolic dysregulation that may lead to the onset or aggravated progression of gynecologic cancers. While microbiome in gynecologic cancers is just at horizon, certain significant microbiome signature associations have been found. Cervical cancer is accompanied with high loads of human papillomavirus, Fusobacteria and Sneathia species; endometrial cancer is reported to have presence of Atopobium vaginae and Porphyromonas species and significantly elevated levels of Proteobacteria and Firmicutes phylum bacteria, with Chlamydia trachomatis, Lactobacillus and Mycobacterium reported in ovarian cancer. Balancing microbiome composition in gynecologic cancers has the potential to be used as a therapeutic target. For example, the Lactobacillus species may play an important role in blocking adhesions of incursive pathogens to vaginal epithelium by lowering the pH, producing bacteriocins and employing competitive exclusions. The optimum or personalized balance of the microbiota can be maintained using pre- and probiotics, and fecal microbiota transplantations loaded with specific bacteria. Current evidence strongly suggest that a healthy microbiome can train and trigger the body's immune response to attack various gynecologic cancers. Furthermore, microbiome modulations can potentially contribute to improvements in immuno-oncology therapies.
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Affiliation(s)
- Mohd Wahid
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Sajad A Dar
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Arshad Jawed
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Raju Kumar Mandal
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Naseem Akhter
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia
| | - Saif Khan
- Department of Basic Dental and Medical Sciences, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Farah Khan
- Department of Biochemistry, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Sudhisa Jogiah
- Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India
| | - Ashutosh Kumar Rai
- Department of Biochemistry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ramandeep Rattan
- Division of Gynecology Oncology, Women's Health Services, Henry Ford Hospital, Detroit, MI, USA; Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.
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109
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Baldewijns S, Sillen M, Palmans I, Vandecruys P, Van Dijck P, Demuyser L. The Role of Fatty Acid Metabolites in Vaginal Health and Disease: Application to Candidiasis. Front Microbiol 2021; 12:705779. [PMID: 34276639 PMCID: PMC8282898 DOI: 10.3389/fmicb.2021.705779] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022] Open
Abstract
Although the vast majority of women encounters at least one vaginal infection during their life, the amount of microbiome-related research performed in this area lags behind compared to alternative niches such as the intestinal tract. As a result, effective means of diagnosis and treatment, especially of recurrent infections, are limited. The role of the metabolome in vaginal health is largely elusive. It has been shown that lactate produced by the numerous lactobacilli present promotes health by limiting the chance of infection. Short chain fatty acids (SCFA) have been mainly linked to dysbiosis, although the causality of this relationship is still under debate. In this review, we aim to bring together information on the role of the vaginal metabolome and microbiome in infections caused by Candida. Vulvovaginal candidiasis affects near to 70% of all women at least once in their life with a significant proportion of women suffering from the recurrent variant. We assess the role of fatty acid metabolites, mainly SCFA and lactate, in onset of infection and virulence of the fungal pathogen. In addition, we pinpoint where lack of research limits our understanding of the molecular processes involved and restricts the possibility of developing novel treatment strategies.
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Affiliation(s)
- Silke Baldewijns
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Leuven-Heverlee, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
| | - Mart Sillen
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Leuven-Heverlee, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
| | - Ilse Palmans
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Leuven-Heverlee, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
| | - Paul Vandecruys
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Leuven-Heverlee, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
| | - Patrick Van Dijck
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Leuven-Heverlee, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
| | - Liesbeth Demuyser
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, KU Leuven, Leuven-Heverlee, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
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110
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Baldeon-Vaca G, Marathe JG, Politch JA, Mausser E, Pudney J, Doud J, Nador E, Zeitlin L, Pauly M, Moench TR, Brennan M, Whaley KJ, Anderson DJ. Production and characterization of a human antisperm monoclonal antibody against CD52g for topical contraception in women. EBioMedicine 2021; 69:103478. [PMID: 34256345 PMCID: PMC8324805 DOI: 10.1016/j.ebiom.2021.103478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Approximately 40% of human pregnancies are unintended, indicating a need for more acceptable effective contraception methods. New antibody production systems make it possible to manufacture reagent-grade human monoclonal antibodies (mAbs) for clinical use. We used the Nicotiana platform to produce a human antisperm mAb and tested its efficacy for on-demand topical contraception. METHODS Heavy and light chain variable region DNA sequences of a human IgM antisperm antibody derived from an infertile woman were inserted with human IgG1 constant region sequences into an agrobacterium and transfected into Nicotiana benthamiana. The product, an IgG1 mAb ["Human Contraception Antibody" (HCA)], was purified on Protein A columns, and QC was performed using the LabChip GXII Touch protein characterization system and SEC-HPLC. HCA was tested for antigen specificity by immunofluorescence and western blot assays, antisperm activity by sperm agglutination and complement dependent sperm immobilization assays, and safety in a human vaginal tissue (EpiVaginal™) model. FINDINGS HCA was obtained at concentrations ranging from 0.4 to 4 mg/ml and consisted of > 90% IgG monomers. The mAb specifically reacted with a glycan epitope on CD52g, a glycoprotein produced in the male reproductive tract and found in abundance on sperm. HCA potently agglutinated sperm under a variety of relevant physiological conditions at concentrations ≥ 6.25 µg/ml, and mediated complement-dependent sperm immobilization at concentrations ≥ 1 µg/ml. HCA and its immune complexes did not induce inflammation in EpiVaginal™ tissue. INTERPRETATION HCA, an IgG1 mAb with potent sperm agglutination and immobilization activity and a good safety profile, is a promising candidate for female contraception. FUNDING This research was supported by grants R01 HD095630 and P50HD096957 from the National Institutes of Health.
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Affiliation(s)
- Gabriela Baldeon-Vaca
- Division of Medical Sciences, Boston University School of Medicine, Boston, MA 02118, United States
| | - Jai G Marathe
- Department of Medicine, Boston University School of Medicine, 670 Albany St. Rm 516, Boston, MA 02118, United States
| | - Joseph A Politch
- Department of Medicine, Boston University School of Medicine, 670 Albany St. Rm 516, Boston, MA 02118, United States
| | - Emilie Mausser
- Division of Medical Sciences, Boston University School of Medicine, Boston, MA 02118, United States
| | - Jeffrey Pudney
- Department of Medicine, Boston University School of Medicine, 670 Albany St. Rm 516, Boston, MA 02118, United States
| | - James Doud
- Department of Medicine, Boston University School of Medicine, 670 Albany St. Rm 516, Boston, MA 02118, United States
| | - Ellena Nador
- Division of Medical Sciences, Boston University School of Medicine, Boston, MA 02118, United States
| | - Larry Zeitlin
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd., San Diego, CA 92121, United States
| | - Michael Pauly
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd., San Diego, CA 92121, United States
| | - Thomas R Moench
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd., San Diego, CA 92121, United States
| | - Miles Brennan
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd., San Diego, CA 92121, United States; ZabBio, Inc. 6160 Lusk Blvd., San Diego, CA 92121, United States
| | - Kevin J Whaley
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd., San Diego, CA 92121, United States; ZabBio, Inc. 6160 Lusk Blvd., San Diego, CA 92121, United States
| | - Deborah J Anderson
- Department of Medicine, Boston University School of Medicine, 670 Albany St. Rm 516, Boston, MA 02118, United States.
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111
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Abstract
PURPOSE OF REVIEW Herein, we present an overview of the recent microbiome research and findings within the field of reproductive medicine and its relation with the outcome of Assisted reproductive technology (ART). Analyses of the microbiome composition all throughout the female reproductive trace during the process of assisted reproductive techniques are discussed. RECENT FINDINGS Only the vaginal microbiome can be sampled without possible risks of contamination. Although this also seems to apply to the cervical microbiome, collection has to be performed with extreme caution. Because of the high risk of cross contamination, results of microbial composition of all other sites of the female reproductive tract have to be interpreted with caution. The vaginal composition prior to the start of hormonal treatment for ART seems to be predictive of in vitro fertilization/in vitro fertilization-intracytoplasmic sperm injection (IVF/IVF-ICSI) outcome, with mainly a highly negative predictive value. SUMMARY The local microbiota, especially the absence or presence of specific microbes, within parts of the female reproductive tract seem to be associated with the outcome of ART.
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Joseph RJ, Ser HL, Kuai YH, Tan LTH, Arasoo VJT, Letchumanan V, Wang L, Pusparajah P, Goh BH, Ab Mutalib NS, Chan KG, Lee LH. Finding a Balance in the Vaginal Microbiome: How Do We Treat and Prevent the Occurrence of Bacterial Vaginosis? Antibiotics (Basel) 2021; 10:719. [PMID: 34203908 PMCID: PMC8232816 DOI: 10.3390/antibiotics10060719] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/27/2021] [Accepted: 06/10/2021] [Indexed: 12/30/2022] Open
Abstract
Bacterial vaginosis (BV) has been reported in one-third of women worldwide at different life stages, due to the complex balance in the ecology of the vaginal microbiota. It is a common cause of abnormal vaginal discharge and is associated with other health issues. Since the first description of anaerobic microbes associated with BV like Gardnerella vaginalis in the 1950s, researchers have stepped up the game by incorporating advanced molecular tools to monitor and evaluate the extent of dysbiosis within the vaginal microbiome, particularly on how specific microbial population changes compared to a healthy state. Moreover, treatment failure and BV recurrence rate remain high despite the standard antibiotic treatment. Consequently, researchers have been probing into alternative or adjunct treatments, including probiotics or even vaginal microbiota transplants, to ensure successful treatment outcomes and reduce the colonization by pathogenic microbes of the female reproductive tract. The current review summarizes the latest findings in probiotics use for BV and explores the potential of vaginal microbiota transplants in restoring vaginal health.
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Affiliation(s)
- Rebecca Jane Joseph
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Hooi-Leng Ser
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Yi-He Kuai
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Loh Teng-Hern Tan
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru 80100, Malaysia;
| | | | - Vengadesh Letchumanan
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Lijing Wang
- Vascular Biology Research Institute, Guangdong Pharmaceutical University, Guangzhou 510006, China;
| | - Priyia Pusparajah
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
| | - Bey-Hing Goh
- Biofunctional Molecule Exploratory Research Group (BMEX), School of Pharmacy, Monash University Malaysia, Bandar Sunway 47500, Malaysia;
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Nurul-Syakima Ab Mutalib
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
- UKM Medical Molecular Biology Institute (UMBI), UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Kok-Gan Chan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
- International Genome Centre, Jiangsu University, Zhenjiang 212013, China
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbes and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (R.J.J.); (H.-L.S.); (Y.-H.K.); (L.T.-H.T.); (V.L.); (P.P.); (N.-S.A.M.)
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113
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Vaginal microbiome: normalcy vs dysbiosis. Arch Microbiol 2021; 203:3793-3802. [PMID: 34120200 DOI: 10.1007/s00203-021-02414-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022]
Abstract
It has been long understood that the vaginal microflora is crucial in maintaining a normal physiological environment for the host and its involvement is deemed indispensable for reproductive success. A global concept of normalcy vs. dysbiosis of vaginal microbiome is debatable as women of different races have a unique vaginal microflora with regional variations. Vaginal microflora is a dynamic microenvironment affected by gestational status, menstrual cycle, sexual activity, age, and contraceptive use. Normal vaginal flora is dominated by lactobacilli especially in women of European descent vs. African American women. These microbes confer the host vagina protection from potentially pathogenic microbes that may lead to urinary tract infections and sexually transmitted diseases. Changes in the vaginal microbiota including reduced lactobacilli abundance and increased facultative and anaerobic organism populations result in bacterial vaginosis, that predisposes the host to several conditions like low birth weight and increased risk of contracting bacterial infections. On the other hand, the vaginal microbiome is also reshaped during pregnancy, with less microbial diversity with a dominance of Lactobacillus species. However, an altered vaginal microbiota with low lactobacilli abundance especially during pregnancy may result in induction of excessive inflammation and pre-term labor. Since the vaginal microbiome plays an important role during embryo implantation, it is not surprising that bacterial vaginosis is more common in infertile women and associated with reduced rates of conception. Probiotic has great success in treating bacterial vaginosis and restoring the normal microbiome in recent. This report, reviewed the relationships between the vaginal microbiome and women's reproductive health.
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Ong CT, Turni C, Blackall PJ, Boe-Hansen G, Hayes BJ, Tabor AE. Interrogating the bovine reproductive tract metagenomes using culture-independent approaches: a systematic review. Anim Microbiome 2021; 3:41. [PMID: 34108039 PMCID: PMC8191003 DOI: 10.1186/s42523-021-00106-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 06/01/2021] [Indexed: 01/18/2023] Open
Abstract
Undesirable microbial infiltration into the female bovine reproductive tracts, for example during calving or mating, is likely to disturb the commensal microflora. Persistent establishment and overgrowth of certain pathogens induce reproductive diseases, render the female bovine reproductive tract unfavourable for pregnancy or can result in transmission to the foetus, leading to death and abortion or birth abnormalities. This review of culture-independent metagenomics studies revealed that normal microflora in the female bovine reproductive tract is reasonably consistently dominated by bacteria from the phyla Bacteroidetes, Firmicutes, Proteobacteria, following by Actinobacteria, Fusobacteria and Tenericutes. Reproductive disease development in the female bovine reproductive tract was demonstrated across multiple studies to be associated with high relative abundances of bacteria from the phyla Bacteroidetes and Fusobacteria. Reduced bacterial diversity in the reproductive tract microbiome in some studies of cows diagnosed with reproductive diseases also indicated an association between dysbiosis and bovine reproductive health. Nonetheless, the bovine genital tract microbiome remains underexplored, and this is especially true for the male genital tract. Future research should focus on the functional aspects of the bovine reproductive tract microbiomes, for example their contributions to cattle fertility and susceptibility towards reproductive diseases.
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Affiliation(s)
- Chian Teng Ong
- The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, Centre for Animal Science, St Lucia, Brisbane, Queensland Australia
| | - Conny Turni
- The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, Centre for Animal Science, St Lucia, Brisbane, Queensland Australia
| | - Patrick J. Blackall
- The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, Centre for Animal Science, St Lucia, Brisbane, Queensland Australia
| | - Gry Boe-Hansen
- The University of Queensland, School of Veterinary Science, Gatton, Queensland Australia
| | - Ben J. Hayes
- The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, Centre for Animal Science, St Lucia, Brisbane, Queensland Australia
| | - Ala E. Tabor
- The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, Centre for Animal Science, St Lucia, Brisbane, Queensland Australia
- The University of Queensland, School of Chemistry and Molecular Bioscience, St Lucia, Brisbane, Queensland Australia
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Kudela E, Liskova A, Samec M, Koklesova L, Holubekova V, Rokos T, Kozubik E, Pribulova T, Zhai K, Busselberg D, Kubatka P, Biringer K. The interplay between the vaginal microbiome and innate immunity in the focus of predictive, preventive, and personalized medical approach to combat HPV-induced cervical cancer. EPMA J 2021; 12:199-220. [PMID: 34194585 PMCID: PMC8192654 DOI: 10.1007/s13167-021-00244-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022]
Abstract
HPVs representing the most common sexually transmitted disease are a group of carcinogenic viruses with different oncogenic potential. The immune system and the vaginal microbiome represent the modifiable and important risk factors in HPV-induced carcinogenesis. HPV infection significantly increases vaginal microbiome diversity, leading to gradual increases in the abundance of anaerobic bacteria and consequently the severity of cervical dysplasia. Delineation of the exact composition of the vaginal microbiome and immune environment before HPV acquisition, during persistent/progressive infections and after clearance, provides insights into the complex mechanisms of cervical carcinogenesis. It gives hints regarding the prediction of malignant potential. Relative high HPV prevalence in the general population is a challenge for modern and personalized diagnostics and therapeutic guidelines. Identifying the dominant microbial biomarkers of high-grade and low-grade dysplasia could help us to triage the patients with marked chances of lesion regression or progression. Any unnecessary surgical treatment of cervical dysplasia could negatively affect obstetrical outcomes and sexual life. Therefore, understanding the effect and role of microbiome-based therapies is a breaking point in the conservative management of HPV-associated precanceroses. The detailed evaluation of HPV capabilities to evade immune mechanisms from various biofluids (vaginal swabs, cervicovaginal lavage/secretions, or blood) could promote the identification of new immunological targets for novel individualized diagnostics and therapy. Qualitative and quantitative assessment of local immune and microbial environment and associated risk factors constitutes the critical background for preventive, predictive, and personalized medicine that is essential for improving state-of-the-art medical care in patients with cervical precanceroses and cervical cancer. The review article focuses on the influence and potential diagnostic and therapeutic applications of the local innate immune system and the microbial markers in HPV-related cancers in the context of 3P medicine.
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Affiliation(s)
- Erik Kudela
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Alena Liskova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Marek Samec
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Lenka Koklesova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Veronika Holubekova
- Jessenius Faculty of Medicine, Biomedical Centre Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Tomas Rokos
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Erik Kozubik
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Terezia Pribulova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
| | - Kevin Zhai
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, 24144 Doha, Qatar
| | - Dietrich Busselberg
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, 24144 Doha, Qatar
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
- European Association for Predictive, Preventive and Personalised Medicine, EPMA, 1160 Brussels, Belgium
| | - Kamil Biringer
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Kollarova 2, 036 01 Martin, Slovakia
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116
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Becerra AM, Parra D, Trujillo CG, Azuero J, García S, Daza F, Plata M. Infección de vías urinarias no complicada en mujeres. UROLOGÍA COLOMBIANA 2021. [DOI: 10.1055/s-0040-1721323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
ResumenLa infección de vías urinarias (IVU) es una patología común, que afecta a gran parte de la población y que generalmente se resuelve con manejo antibiótico. Se compone de una amplia variedad de entidades clínicas que pueden variar desde una cistitis no complicada hasta un shock séptico de origen urinario. Los patógenos etiológicos de la IVU no complicada están ampliamente establecidos y se han mantenido de forma consistente a lo largo del tiempo, siendo la Escherichia coli el microorganismo más predominante. En la actualidad, la resistencia bacteriana a los antibióticos es de gran preocupación y por esa razón, se busca optimizar la terapia antimicrobiana con el fin de disminuir la estancia hospitalaria, la severidad clínica de la infección y los costos a los sistemas de salud. La presente revisión, tiene como objetivo servir como guía para la correcta definición, clasificación, diagnóstico, tratamiento y prevención de la IVU no complicada.
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Affiliation(s)
- Ana María Becerra
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel Parra
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
| | - Carlos Gustavo Trujillo
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
| | - Julián Azuero
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
| | - Sandra García
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
| | - Fabián Daza
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
| | - Mauricio Plata
- Departamento de Urología, Hospital Universitario Fundación Santa Fe de Bogotá, Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
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117
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Tung CK, Suarez SS. Co-Adaptation of Physical Attributes of the Mammalian Female Reproductive Tract and Sperm to Facilitate Fertilization. Cells 2021; 10:cells10061297. [PMID: 34073739 PMCID: PMC8225031 DOI: 10.3390/cells10061297] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 12/20/2022] Open
Abstract
The functions of the female reproductive tract not only encompass sperm migration, storage, and fertilization, but also support the transport and development of the fertilized egg through to the birth of offspring. Further, because the tract is open to the external environment, it must also provide protection against invasive pathogens. In biophysics, sperm are considered “pusher microswimmers”, because they are propelled by pushing fluid behind them. This type of swimming by motile microorganisms promotes the tendency to swim along walls and upstream in gentle fluid flows. Thus, the architecture of the walls of the female tract, and the gentle flows created by cilia, can guide sperm migration. The viscoelasticity of the fluids in the tract, such as mucus secretions, also promotes the cooperative swimming of sperm that can improve fertilization success; at the same time, the mucus can also impede the invasion of pathogens. This review is focused on how the mammalian female reproductive tract and sperm interact physically to facilitate the movement of sperm to the site of fertilization. Knowledge of female/sperm interactions can not only explain how the female tract can physically guide sperm to the fertilization site, but can also be applied for the improvement of in vitro fertilization devices.
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Affiliation(s)
- Chih-Kuan Tung
- Department of Physics, North Carolina A&T State University, Greensboro, NC 27411, USA
- Correspondence:
| | - Susan S. Suarez
- Department of Biomedical Sciences, Cornell University, Ithaca, NY 14853, USA;
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118
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Lactate Like Fluconazole Reduces Ergosterol Content in the Plasma Membrane and Synergistically Kills Candida albicans. Int J Mol Sci 2021; 22:ijms22105219. [PMID: 34069257 PMCID: PMC8156871 DOI: 10.3390/ijms22105219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 01/04/2023] Open
Abstract
Candida albicans is an opportunistic pathogen that induces vulvovaginal candidiasis (VVC), among other diseases. In the vaginal environment, the source of carbon for C. albicans can be either lactic acid or its dissociated form, lactate. It has been shown that lactate, similar to the popular antifungal drug fluconazole (FLC), reduces the expression of the ERG11 gene and hence the amount of ergosterol in the plasma membrane. The Cdr1 transporter that effluxes xenobiotics from C. albicans cells, including FLC, is delocalized from the plasma membrane to a vacuole under the influence of lactate. Despite the overexpression of the CDR1 gene and the increased activity of Cdr1p, C. albicans is fourfold more sensitive to FLC in the presence of lactate than when glucose is the source of carbon. We propose synergistic effects of lactate and FLC in that they block Cdr1 activity by delocalization due to changes in the ergosterol content of the plasma membrane.
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119
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Chandrashekhar P, Minooei F, Arreguin W, Masigol M, Steinbach-Rankins JM. Perspectives on Existing and Novel Alternative Intravaginal Probiotic Delivery Methods in the Context of Bacterial Vaginosis Infection. AAPS J 2021; 23:66. [PMID: 33973067 PMCID: PMC8356663 DOI: 10.1208/s12248-021-00602-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/27/2021] [Indexed: 12/17/2022] Open
Abstract
Bacterial vaginosis (BV) is one of the most common vaginal infections that affects hundreds of millions of women of reproductive age, worldwide. Traditional treatment strategies, such as oral and topical antibiotics, have shown efficacy against BV, but frequent recurrence of infection and the development of antibiotic-resistant bacteria remain as significant challenges. Alternatively, recent progress in understanding immune, microbiological, and metabolic interactions in the vaginal microbiota has prompted the consideration of administering probiotic organisms to restore and maintain vaginal health within the context of BV prevention and treatment. Given this, the objective of this review is to discuss existing and potential alternative approaches to deliver, and to potentially sustain the delivery of probiotics, to prevent and/or treat BV infections. First, a brief overview is provided regarding the probiotic species and combinatorial probiotic strategies that have shown promise in the treatment of BV and in restoring female reproductive health. Additionally, the advantages and challenges associated with current oral and intravaginal probiotic delivery platforms are discussed. Lastly, we present emerging and promising alternative dosage forms, such as electrospun fibers and 3D bioprinted scaffolds, that may be adapted as new strategies to intravaginally deliver probiotic organisms. Graphical abstract.
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Affiliation(s)
| | - Farnaz Minooei
- Department of Chemical Engineering, University of Louisville Speed School of Engineering, Louisville, Kentucky, USA
- Center for Predictive Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Wenndy Arreguin
- Department of Bioengineering, University of Louisville Speed School of Engineering, 505 S. Hancock St., Room 623, Louisville, Kentucky, 40202, USA
| | - Mohammadali Masigol
- Center for Predictive Medicine, University of Louisville, Louisville, Kentucky, USA
- Department of Bioengineering, University of Louisville Speed School of Engineering, 505 S. Hancock St., Room 623, Louisville, Kentucky, 40202, USA
| | - Jill M Steinbach-Rankins
- Center for Predictive Medicine, University of Louisville, Louisville, Kentucky, USA.
- Department of Bioengineering, University of Louisville Speed School of Engineering, 505 S. Hancock St., Room 623, Louisville, Kentucky, 40202, USA.
- Department of Microbiology and Immunology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
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120
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O’Hanlon DE, Brown SE, He X, Stennett CA, Robbins SJ, Johnston ED, Wnorowski AM, Mark K, Ravel J, Cone RA, Brotman RM. Observational cohort study of the effect of a single lubricant exposure during transvaginal ultrasound on cell-shedding from the vaginal epithelium. PLoS One 2021; 16:e0250153. [PMID: 33939727 PMCID: PMC8092793 DOI: 10.1371/journal.pone.0250153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
The outer layers of the vaginal epithelium (VE) are important because they accumulate glycogen which, under optimal conditions, Lactobacillus spp. consume to grow and acidify the vaginal microenvironment with lactic acid. We hypothesized that exposure to lubricant, for example in the conduct of a transvaginal ultrasound (TVUS), may contribute to the shedding of mature epithelial cells, exposing immature cells. Cervicovaginal fluid (CVF) was sampled at four time points by menstrual cup (Softdisc™) from 50 women referred for TVUS, during which a controlled volume of lubricant was applied to the TVUS wand. Samples were collected (1) immediately before TVUS and (2) 6-12 hours, (3) within one week, and (4) two weeks after TVUS. Clinical vaginal lubricants are similar to commercial lubricants, and often have a high osmolality or pH, and contain bactericides such as methylparaben and propylparaben. The number and maturity of epithelial cells in each CVF sample were measured by quantitative and differential fluorimetry (maturity index, MI). Comparisons of cell-counts and maturity were made by paired Wilcoxon signed-rank tests. Among women with a high pre-TVUS MI (> 3), there was a decrease in median cell-count and mean MI in the sample collected 6-12 hours after TVUS (p<0.001, n = 26 and p < 0.001, n = 26, respectively). For these women, cell-count and MI remained lower in the sample collected within the subsequent week (p<0.001, n = 29 and p<0.01, n = 29, respectively), and MI remained lower in the sample collected within two weeks of TVUS (p<0.01, n = 25), compared to the pre-TVUS sample. Among participants with a low pre-TVUS MI (< 3), cell-count was higher in the sample collected within two weeks of TVUS compared to the pre-TVUS sample (p = 0.03, n = 15), but no significant changes in MI were observed. Results were similar when restricted to reproductive-age women. This preliminary data indicates hypertonic vaginal lubricants may increase vaginal epithelial cell shedding.
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Affiliation(s)
- D. Elizabeth O’Hanlon
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Sarah E. Brown
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, United States of America
| | - Christina A. Stennett
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Sarah J. Robbins
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Elizabeth D. Johnston
- Faculty Physicians Inc., University of Maryland, Baltimore, MD, United States of America
| | - Amelia M. Wnorowski
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Katrina Mark
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Richard A. Cone
- Department of Biophysics, Johns Hopkins University, Baltimore, MD, United States of America
| | - Rebecca M. Brotman
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
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121
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Dabee S, Passmore JAS, Heffron R, Jaspan HB. The Complex Link between the Female Genital Microbiota, Genital Infections, and Inflammation. Infect Immun 2021; 89:e00487-20. [PMID: 33558324 PMCID: PMC8091093 DOI: 10.1128/iai.00487-20] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The female genital tract microbiota is part of a complex ecosystem influenced by several physiological, genetic, and behavioral factors. It is uniquely linked to a woman's mucosal immunity and plays a critical role in the regulation of genital inflammation. A vaginal microbiota characterized by a high abundance of lactobacilli and low overall bacterial diversity is associated with lower inflammation. On the other hand, a more diverse microbiota is linked to high mucosal inflammation levels, a compromised genital epithelial barrier, and an increased risk of sexually transmitted infections and other conditions. Several bacterial taxa such as Gardnerella spp., Prevotella spp., Sneathia spp., and Atopobium spp. are well known to have adverse effects; however, the definitive cause of this microbial dysbiosis is yet to be fully elucidated. The aim of this review is to discuss the multiple ways in which the microbiota influences the overall genital inflammatory milieu and to explore the causes and consequences of this inflammatory response. While there is abundant evidence linking a diverse genital microbiota to elevated inflammation, understanding the risk factors and mechanisms through which it affects genital health is essential. A robust appreciation of these factors is important for identifying effective prevention and treatment strategies.
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Affiliation(s)
- Smritee Dabee
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - Jo-Ann S Passmore
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- CAPRISA Centre of Excellence in HIV Prevention, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Cape Town, South Africa
| | | | - Heather B Jaspan
- Seattle Children's Research Institute, Seattle, Washington, USA
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- University of Washington, Seattle, Washington, USA
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Agarwal K, Lewis AL. Vaginal sialoglycan foraging by Gardnerella vaginalis: mucus barriers as a meal for unwelcome guests? Glycobiology 2021; 31:667-680. [PMID: 33825850 DOI: 10.1093/glycob/cwab024] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 03/07/2021] [Accepted: 03/15/2021] [Indexed: 12/17/2022] Open
Abstract
Bacterial vaginosis (BV) is a condition of the vaginal microbiome in which there are few lactobacilli and abundant anaerobic bacteria. Members of the genus Gardnerella are often one of the most abundant bacteria in BV. BV is associated with a wide variety of poor health outcomes for women. It has been recognized since the 1980s that women with BV have detectable and sometimes markedly elevated levels of sialidase activity in vaginal fluids and that bacteria associated with this condition produce this activity in culture. Mounting evidence collected using diverse methodologies points to the conclusion that BV is associated with a reduction in intact sialoglycans in cervicovaginal secretions. Here we review evidence for the contributions of vaginal bacteria, especially Gardnerella, in the processes of mucosal sialoglycan degradation, uptake, metabolism and depletion. Our understanding of the impacts of vaginal sialoglycan degradation is still limited. However, the potential implications of sialic acid depletion are discussed in light of our current understanding of the roles played by sialoglycans in vaginal physiology.
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Affiliation(s)
- Kavita Agarwal
- Department of Obstetrics, Gynecology and Reproductive Sciences, Glycobiology Research and Training Center, University of California San Diego, 9500 Gilman Drive, La Jolla CA 92093, USA
| | - Amanda L Lewis
- Department of Obstetrics, Gynecology and Reproductive Sciences, Glycobiology Research and Training Center, University of California San Diego, 9500 Gilman Drive, La Jolla CA 92093, USA
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123
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Chumduri C, Turco MY. Organoids of the female reproductive tract. J Mol Med (Berl) 2021; 99:531-553. [PMID: 33580825 PMCID: PMC8026429 DOI: 10.1007/s00109-020-02028-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 02/08/2023]
Abstract
Healthy functioning of the female reproductive tract (FRT) depends on balanced and dynamic regulation by hormones during the menstrual cycle, pregnancy and childbirth. The mucosal epithelial lining of different regions of the FRT-ovaries, fallopian tubes, uterus, cervix and vagina-facilitates the selective transport of gametes and successful transfer of the zygote to the uterus where it implants and pregnancy takes place. It also prevents pathogen entry. Recent developments in three-dimensional (3D) organoid systems from the FRT now provide crucial experimental models that recapitulate the cellular heterogeneity and physiological, anatomical and functional properties of the organ in vitro. In this review, we summarise the state of the art on organoids generated from different regions of the FRT. We discuss the potential applications of these powerful in vitro models to study normal physiology, fertility, infections, diseases, drug discovery and personalised medicine.
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Affiliation(s)
- Cindrilla Chumduri
- Department of Microbiology, University of Würzburg, Biocenter, Würzburg, Germany.
- Max Planck Institute for Infection Biology, Berlin, Germany.
| | - Margherita Y Turco
- Department of Pathology, University of Cambridge, Cambridge, UK.
- Centre for Trophoblast Research, Cambridge, UK.
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Effect of 17β-estradiol on a human vaginal Lactobacillus crispatus strain. Sci Rep 2021; 11:7133. [PMID: 33785829 PMCID: PMC8010061 DOI: 10.1038/s41598-021-86628-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/18/2021] [Indexed: 02/01/2023] Open
Abstract
Lactobacilli and estrogens play essential roles in vaginal homeostasis. We investigated the potential direct effect of 17β-estradiol on a vaginal strain of Lactobacillus crispatus, the major bacterial species of the vaginal microbiota. 17β-estradiol (10-6 to 10-10 M) had no effect on L. crispatus growth, but markedly affected the membrane dynamics of this bacterium. This effect appeared consistent with a signal transduction process. The surface polarity and aggregation potential of the bacterium were unaffected by exposure to 17β-estradiol, but its mean size was significantly reduced. 17β-estradiol also promoted biosurfactant production by L. crispatus and adhesion to vaginal VK2/E6E7 cells, but had little effect on bacterial biofilm formation activity. Bioinformatic analysis of L. crispatus identified a membrane lipid raft-associated stomatin/prohibitin/flotillin/HflK domain containing protein as a potential 17β-estradiol binding site. Overall, our results reveal direct effects of 17β-estradiol on L. crispatus. These effects are of potential importance in the physiology of the vaginal environment, through the promotion of lactobacillus adhesion to the mucosa and protection against pathogens.
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125
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Purification and Characterization of (2R,3R)-2,3-Butanediol Dehydrogenase of the Human Pathogen Neisseria gonorrhoeae FA1090 Produced in Escherichia coli. Mol Biotechnol 2021; 63:491-501. [PMID: 33763825 DOI: 10.1007/s12033-021-00308-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 02/12/2021] [Indexed: 12/22/2022]
Abstract
2,3-Butanediol dehydrogenase (BDH), also known as acetoin/diacetyl reductase, is a pivotal enzyme for the formation of 2,3-butanediol (2,3-BD), a chiral compound with potential roles in the virulence of certain pathogens. Here, a NAD(H)-dependent (2R,3R)-BDH from Neisseria gonorrhoeae FA1090 (NgBDH), the causative agent of gonorrhoea, was functionally characterized. Sequence analysis indicated that it belongs to zinc-containing medium-chain dehydrogenase/reductase family. The recombinant NgBDH migrated as a single band with a size of around 45 kDa on SDS-PAGE and could be confirmed by Western blotting and mass spectrometry. For the oxidation of either (2R,3R)-2,3-BD or meso-2,3-BD, the enzyme exhibited a broad pH optimum between pH 9.5 to 11.5. For the reduction of (3R/3S)-acetoin, the pH optimum was around 6.5. The enzyme could catalyze the stereospecific oxidation of (2R,3R)-2,3-BD (Km = 0.16 mM, kcat/Km = 673 s-1 · mM-1) and meso-BD (Km = 0.72 mM, kcat/Km = 165 s-1 · mM-1). Moreover, it could also reduce (3R/3S)-acetoin with a Km of 0.14 mM and a kcat/Km of 885 s-1 · mM-1. The results presented here contribute to understand the 2,3-BD metabolism in N. gonorrhoeae and pave the way for studying the influence of 2,3-BD metabolism on the virulence of this pathogen in the future.
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126
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Lactic acid-containing products for bacterial vaginosis and their impact on the vaginal microbiota: A systematic review. PLoS One 2021; 16:e0246953. [PMID: 33571286 PMCID: PMC7877752 DOI: 10.1371/journal.pone.0246953] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/28/2021] [Indexed: 01/14/2023] Open
Abstract
Objective The vaginal microbiota in bacterial vaginosis (BV) typically has low abundance of lactic acid producing lactobacilli. Lactic acid has properties that may make it effective for treating BV and/or restoring an optimal lactobacillus-dominated vaginal microbiota. We conducted a systematic review to describe the effect of intravaginal lactic acid-containing products on BV cure, and their impact on vaginal microbiota composition (PROSPERO registration: CRD42018115982). Methods PubMed, Embase and OVID were searched from inception to November 2019 to identify eligible studies. Included studies evaluated an intravaginal lactic acid-containing product and reported BV cure using established diagnostic methods, and/or vaginal microbiota composition using molecular methods. Studies were independently screened and assessed, and the proportion of women cured post-treatment was calculated. Study results were described in a qualitative manner. Results We identified 1,883 articles and assessed 57 full-texts for eligibility. Seven different lactic acid-containing products were evaluated and differed with respect to excipients, lactic acid concentration and pH. Most studies had medium or high risk of bias. Three trials compared the efficacy of a lactic acid-containing product to metronidazole for BV cure. One study found lactic acid to be equivalent to metronidazole and two studies found lactic acid to be significantly inferior to metronidazole. Two studies included a control group receiving a placebo or no treatment. One reported lactic acid to be superior than no treatment and the other reported lactic acid to be equivalent to placebo. Lactic acid-containing products did not significantly impact the vaginal microbiota composition. Conclusion There is a lack of high-quality evidence to support the use of lactic acid-containing products for BV cure or vaginal microbiota modulation. However, adequately powered and rigorous randomised trials with accompanying vaginal microbiota data are needed to evaluate the efficacy of lactic acid as a BV treatment strategy.
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127
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das Neves J, Sverdlov Arzi R, Sosnik A. Molecular and cellular cues governing nanomaterial-mucosae interactions: from nanomedicine to nanotoxicology. Chem Soc Rev 2021; 49:5058-5100. [PMID: 32538405 DOI: 10.1039/c8cs00948a] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mucosal tissues constitute the largest interface between the body and the surrounding environment and they regulate the access of molecules, supramolecular structures, particulate matter, and pathogens into it. All mucosae are characterized by an outer mucus layer that protects the underlying cells from physicochemical, biological and mechanical insults, a mono-layered or stratified epithelium that forms tight junctions and controls the selective transport of solutes across it and associated lymphoid tissues that play a sentinel role. Mucus is a gel-like material comprised mainly of the glycoprotein mucin and water and it displays both hydrophilic and hydrophobic domains, a net negative charge, and high porosity and pore interconnectivity, providing an efficient barrier for the absorption of therapeutic agents. To prolong the residence time, absorption and bioavailability of a broad spectrum of active compounds upon mucosal administration, mucus-penetrating and mucoadhesive particles have been designed by tuning the chemical composition, the size, the density, and the surface properties. The benefits of utilizing nanomaterials that interact intimately with mucosae by different mechanisms in the nanomedicine field have been extensively reported. To ensure the safety of these nanosystems, their compatibility is evaluated in vitro and in vivo in preclinical and clinical trials. Conversely, there is a growing concern about the toxicity of nanomaterials dispersed in air and water effluents that unintentionally come into contact with the airways and the gastrointestinal tract. Thus, deep understanding of the key nanomaterial properties that govern the interplay with mucus and tissues is crucial for the rational design of more efficient drug delivery nanosystems (nanomedicine) and to anticipate the fate and side-effects of nanoparticulate matter upon acute or chronic exposure (nanotoxicology). This review initially overviews the complex structural features of mucosal tissues, including the structure of mucus, the epithelial barrier, the mucosal-associated lymphatic tissues and microbiota. Then, the most relevant investigations attempting to identify and validate the key particle features that govern nanomaterial-mucosa interactions and that are relevant in both nanomedicine and nanotoxicology are discussed in a holistic manner. Finally, the most popular experimental techniques and the incipient use of mathematical and computational models to characterize these interactions are described.
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Affiliation(s)
- José das Neves
- i3S - Instituto de Investigação e Inovação em Saúde & INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Roni Sverdlov Arzi
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion-Israel Institute of Technology, De-Jur Building, Office 607, Haifa, 3200003, Israel.
| | - Alejandro Sosnik
- Laboratory of Pharmaceutical Nanomaterials Science, Department of Materials Science and Engineering, Technion-Israel Institute of Technology, De-Jur Building, Office 607, Haifa, 3200003, Israel.
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128
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Payne MS, Newnham JP, Doherty DA, Furfaro LL, Pendal NL, Loh DE, Keelan JA. A specific bacterial DNA signature in the vagina of Australian women in midpregnancy predicts high risk of spontaneous preterm birth (the Predict1000 study). Am J Obstet Gynecol 2021; 224:206.e1-206.e23. [PMID: 32861687 DOI: 10.1016/j.ajog.2020.08.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/23/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Intrauterine infection accounts for a quarter of the cases of spontaneous preterm birth; however, at present, it is not possible to efficiently identify pregnant women at risk to deliver preventative treatments. OBJECTIVE This study aimed to establish a vaginal microbial DNA test for Australian women in midpregnancy that will identify those at increased risk of spontaneous preterm birth. STUDY DESIGN A total of 1000 women with singleton pregnancies were recruited in Perth, Australia. Midvaginal swabs were collected between 12 and 23 weeks' gestation. DNA was extracted for the detection of 23 risk-related microbial DNA targets by quantitative polymerase chain reaction. Obstetrical history, pregnancy outcome, and demographics were recorded. RESULTS After excluding 64 women owing to losses to follow-up and insufficient sample for microbial analyses, the final cohort consisted of 936 women of predominantly white race (74.3%). The overall preterm birth rate was 12.6% (118 births); the spontaneous preterm birth rate at <37 weeks' gestation was 6.2% (2.9% at ≤34 weeks' gestation), whereas the preterm premature rupture of the membranes rate was 4.2%. No single individual microbial target predicted increased spontaneous preterm birth risk. Conversely, women who subsequently delivered at term had higher amounts of Lactobacillus crispatus, Lactobacillus gasseri, or Lactobacillus jensenii DNA in their vaginal swabs (13.8% spontaneous preterm birth vs 31.2% term; P=.005). In the remaining women, a specific microbial DNA signature was identified that was strongly predictive of spontaneous preterm birth risk, consisting of DNA from Gardnerella vaginalis (clade 4), Lactobacillus iners, and Ureaplasma parvum (serovars 3 and 6). Risk prediction was improved if Fusobacterium nucleatum detection was included in the test algorithm. The final algorithm, which we called the Gardnerella Lactobacillus Ureaplasma (GLU) test, was able to detect women at risk of spontaneous preterm birth at <37 and ≤34 weeks' gestation, with sensitivities of 37.9% and 44.4%, respectively, and likelihood ratios (plus or minus) of 2.22 per 0.75 and 2.52 per 0.67, respectively. Preterm premature rupture of the membranes was more than twice as common in GLU-positive women. Adjusting for maternal demographics, ethnicity, and clinical history did not improve prediction. Only a history of spontaneous preterm birth was more effective at predicting spontaneous preterm birth than a GLU-positive result (odds ratio, 3.6). CONCLUSION We have identified a vaginal bacterial DNA signature that identifies women with a singleton pregnancy who are at increased risk of spontaneous preterm birth and may benefit from targeted antimicrobial therapy.
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Affiliation(s)
- Matthew S Payne
- Division of Obstetrics and Gynaecology, The University of Western Australia, Subiaco, Australia; Women and Infants Research Foundation, Subiaco, Australia.
| | - John P Newnham
- Division of Obstetrics and Gynaecology, The University of Western Australia, Subiaco, Australia; Women and Infants Research Foundation, Subiaco, Australia
| | - Dorota A Doherty
- Division of Obstetrics and Gynaecology, The University of Western Australia, Subiaco, Australia; Women and Infants Research Foundation, Subiaco, Australia
| | - Lucy L Furfaro
- Division of Obstetrics and Gynaecology, The University of Western Australia, Subiaco, Australia
| | - Narisha L Pendal
- Division of Obstetrics and Gynaecology, The University of Western Australia, Subiaco, Australia
| | - Diane E Loh
- Women and Infants Research Foundation, Subiaco, Australia
| | - Jeffrey A Keelan
- Division of Obstetrics and Gynaecology, The University of Western Australia, Subiaco, Australia; Women and Infants Research Foundation, Subiaco, Australia
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129
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The Association between Early-Life Gut Microbiota and Long-Term Health and Diseases. J Clin Med 2021; 10:jcm10030459. [PMID: 33504109 PMCID: PMC7865818 DOI: 10.3390/jcm10030459] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/12/2021] [Accepted: 01/21/2021] [Indexed: 12/14/2022] Open
Abstract
Early life gut microbiota have been increasingly recognized as major contributors to short and/or long-term human health and diseases. Numerous studies have demonstrated that human gut microbial colonization begins at birth, but continues to develop a succession of taxonomic abundances for two to three years until the gut microbiota reaches adult-like diversity and proportions. Several factors, including gestational age (GA), delivery mode, birth weight, feeding types, antibiotic exposure, maternal microbiome, and diet, influence the diversity, abundance, and function of early life gut microbiota. Gut microbial life is essential for assisting with the digestion of food substances to release nutrients, exerting control over pathogens, stimulating or modulating the immune system, and influencing many systems such as the liver, brain, and endocrine system. Microbial metabolites play multiple roles in these interactions. Furthermore, studies provide evidence supporting that imbalances of the gut microbiota in early life, referred to as dysbiosis, are associated with specific childhood or adult disease outcomes, such as asthma, atopic dermatitis, diabetes, allergic diseases, obesity, cardiovascular diseases (CVD), and neurological disorders. These findings support that the human gut microbiota may play a fundamental role in the risk of acquiring diseases that may be programmed during early life. In fact, it is critical to explore the role of the human gut microbiota in early life.
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130
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Lykke MR, Becher N, Haahr T, Boedtkjer E, Jensen JS, Uldbjerg N. Vaginal, Cervical and Uterine pH in Women with Normal and Abnormal Vaginal Microbiota. Pathogens 2021; 10:pathogens10020090. [PMID: 33498288 PMCID: PMC7909242 DOI: 10.3390/pathogens10020090] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction: Healthy women of reproductive age have a vaginal pH around 4.5, whereas little is known about pH in the upper genital tract. A shift in the vaginal microbiota may result in an elevated pH in the upper genital tract. This might contribute to decreased fertility and increased risk of preterm birth. Therefore, we aimed to measure pH in different compartments of the female genital tract in both nonpregnant and pregnant women, stratifying into a normal and abnormal vaginal microbiota. Material and methods: In this descriptive study, we included 6 nonpregnant, 12 early-pregnant, and 8 term-pregnant women. A pH gradient was recorded with a flexible pH probe. An abnormal vaginal microbiota was diagnosed by a quantitative polymerase chain reaction technique for Atopobium vaginae; Sneathia sanguinegens; Leptotrichia amnionii; bacterial vaginosis-associated bacterium 1, 2, 3, and TM7; and Prevotella spp. among others. Results: In all participants we found the pH gradient in the lower reproductive canal to be most acidic in the lower vagina and most alkaline in the upper uterine cavity. Women with an abnormal vaginal microbiota had an increased pH in the lower vagina compared to the other groups. Conclusions: There is a pronounced pH gradient within the female genital tract. This gradient is not disrupted in women with an abnormal vaginal microbiota.
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Affiliation(s)
- Malene Risager Lykke
- Department of Obstetrics and Gynecology, Aarhus University Hospital, DK-8200 Aarhus, Denmark; (T.H.); (N.U.)
- Correspondence:
| | - Naja Becher
- Department of Molecular Biology and Genetics, Aarhus University Hospital, DK-8200 Aarhus, Denmark;
| | - Thor Haahr
- Department of Obstetrics and Gynecology, Aarhus University Hospital, DK-8200 Aarhus, Denmark; (T.H.); (N.U.)
- The Fertility Clinic, Skive Regional Hospital Denmark, DK-7800 Skive, Denmark
| | - Ebbe Boedtkjer
- Department of Biomedicine, Aarhus University, DK-8000 Aarhus, Denmark;
| | - Jørgen Skov Jensen
- Research Unit for Reproductive Microbiology, Statens Serum Institut, DK-2300 Copenhagen, Denmark;
| | - Niels Uldbjerg
- Department of Obstetrics and Gynecology, Aarhus University Hospital, DK-8200 Aarhus, Denmark; (T.H.); (N.U.)
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131
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Nunn KL, Witkin SS, Schneider GM, Boester A, Nasioudis D, Minis E, Gliniewicz K, Forney LJ. Changes in the Vaginal Microbiome during the Pregnancy to Postpartum Transition. Reprod Sci 2021; 28:1996-2005. [PMID: 33432532 PMCID: PMC8189965 DOI: 10.1007/s43032-020-00438-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/13/2020] [Indexed: 01/04/2023]
Abstract
Substantial changes in the composition of the vaginal microbiome occur following the end of pregnancy. To identify potential drivers of microbiome changes in individual women during the pregnancy to postpartum transition, we evaluated vaginal samples from 48 pregnant women during their first and third trimesters and postpartum. We determined the species composition of vaginal communities and the vaginal fluid levels of compounds involved in mediating changes in host physiology and the immune system at each time point. We used linear mixed-effects models to characterize associations. Consistent with previous reports, but with a larger sample size, a US population, and variations in the dominant bacteria, the vaginal microbiome was found to be more diverse during the postpartum period. There was a lower abundance of Lactobacillus and significantly higher proportions of Streptococcus anginosus and Prevotella bivia. Moreover, we uniquely demonstrated that postpartum vaginal secretions were also altered postpartum. There were elevated levels of hyaluronan and Hsp70 and decreased levels of the D- and L-lactic acid isomers. We posit that these variations are consequences of alterations in the vagina after delivery that profoundly alter the host environment and, thus, lead to changes in the capability of different bacterial species to survive and proliferate.
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Affiliation(s)
- Kenetta L Nunn
- Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow, ID, USA.,Bioinformatics and Computational Biology Graduate Program, University of Idaho, Moscow, ID, USA
| | - Steven S Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.,Virology Laboratory, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - G Maria Schneider
- Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow, ID, USA.,Department of Biological Sciences, University of Idaho, 875 Perimeter MS 3051, Moscow, ID, 83844-3051, USA
| | - Allison Boester
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA
| | - Dimitrios Nasioudis
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA
| | - Evelyn Minis
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA
| | - Karol Gliniewicz
- Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow, ID, USA.,Department of Biological Sciences, University of Idaho, 875 Perimeter MS 3051, Moscow, ID, 83844-3051, USA
| | - Larry J Forney
- Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow, ID, USA. .,Department of Biological Sciences, University of Idaho, 875 Perimeter MS 3051, Moscow, ID, 83844-3051, USA.
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Application of Ligilactobacillus salivarius CECT5713 to Achieve Term Pregnancies in Women with Repetitive Abortion or Infertility of Unknown Origin by Microbiological and Immunological Modulation of the Vaginal Ecosystem. Nutrients 2021; 13:nu13010162. [PMID: 33419054 PMCID: PMC7825435 DOI: 10.3390/nu13010162] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 01/01/2023] Open
Abstract
In this study, the cervicovaginal environment of women with reproductive failure (repetitive abortion, infertility of unknown origin) was assessed and compared to that of healthy fertile women. Subsequently, the ability of Ligilactobacillus salivarius CECT5713 to increase pregnancy rates in women with reproductive failure was evaluated. Vaginal pH and Nugent score were higher in women with reproductive failure than in fertile women. The opposite was observed regarding the immune factors TGF-β 1, TFG-β 2, and VEFG. Lactobacilli were detected at a higher frequency and concentration in fertile women than in women with repetitive abortion or infertility. The metataxonomic study revealed that vaginal samples from fertile women were characterized by the high abundance of Lactobacillus sequences, while DNA from this genus was practically absent in one third of samples from women with reproductive failure. Daily oral administration of L. salivarius CECT5713 (~9 log10 CFU/day) to women with reproductive failure for a maximum of 6 months resulted in an overall successful pregnancy rate of 56%. The probiotic intervention modified key microbiological, biochemical, and immunological parameters in women who got pregnant. In conclusion, L. salivarius CECT5713 has proved to be a good candidate to improve reproductive success in women with reproductive failure.
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Pramanick R, Aranha C. Distinct Functional Traits of Lactobacilli from Women with Asymptomatic Bacterial Vaginosis and Normal Microbiota. Microorganisms 2020; 8:E1949. [PMID: 33316918 PMCID: PMC7763271 DOI: 10.3390/microorganisms8121949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022] Open
Abstract
Asymptomatic bacterial vaginosis (BV) in reproductive-age women has serious obstetric and gynecological consequences. Despite its high incidence, the behavior of vaginal lactobacilli in asymptomatic BV is unknown. We analyzed the functional properties of previously isolated vaginal lactobacilli from asymptomatic women with normal, intermediate, and BV microbiota. Lactic acid and antimicrobial activity against seven urogenital pathogens were evaluated from lactobacilli cell-free culture supernatants (CFCs) (n = 207) after 48 h incubation in MRS. Lactobacilli isolates were used to evaluate H2O2, autoaggregation and coaggregation with C. albicans. Lactobacilli from normal microbiota produced more d-lactate than lactobacilli from intermediate and asymptomatic BV (p = 0.007). L. plantarum, L. fermentum and L. reuteri produced greater d-lactate whereas L. rhamnosus, L. crispatus, L. johnsonii were greater producers of l-lactate. Interspecies positive correlation was observed in the lactic acid contents of CFCs. Distribution of H2O2-producing lactobacilli did not vary significantly among the groups. When lactic acid isomers were considered, species from intermediate and BV microbiota clustered together with each other and distinctly from species of normal microbiota. Broad-spectrum antagonism (≥90% inhibition) against E. coli, C. albicans, S. aureus, P. aeruginosa, G. vaginalis, N. gonorrhoeae, S. agalactiae were displayed by 46.86% (97) of isolates. Our study highlights the differential functional properties of vaginal lactobacilli from women with normal microbiota and asymptomatic BV.
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Affiliation(s)
| | - Clara Aranha
- Department of Molecular Immunology and Microbiology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai 400102, India;
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Abstract
In this study, we show that multiple bacteria in the vaginal community produce amylases that hydrolyze glycogen into simpler sugars (i.e., maltose and maltotriose). These sugars serve as “common goods” that sustain bacterial populations in vaginal communities. Dominance of Lactobacillus species in vaginal communities is a hallmark of healthy conditions in the female genital tract. Key nutrients for lactobacilli include sugars produced when glycogen is degraded by α-amylase in the vagina. While α-amylase activity has been demonstrated in vaginal fluids, it is unclear whether α-amylases are produced solely by the host, bacteria in the vagina, or both. We screened cervicovaginal mucus from 23 reproductive-age women, characterized the species composition of vaginal communities, measured vaginal pH, and determined levels of amylase activity, glycogen, and lactic acid. Based on differences in these measured variables, one sample from each of four individual donors was selected for metagenomic and proteomic analyses. Of eight putative bacterial amylases identified in the assembled bacterial metagenomes, we detected four in vaginal fluids. These amylases were produced by various bacteria in different vaginal communities. Moreover, no two communities were the same in terms of which bacteria were producing amylases. Although we detected bacterial amylases in vaginal fluids, there was no clear association between the bacterial species that was dominant in a community and the level of amylase activity. This association was likely masked by the presence of human α-amylase, which was also detected in vaginal fluids. Finally, the levels of amylase activity and glycogen were only weakly associated. Our findings show, for the first time, that multiple amylases from both bacterial and human origins can be present simultaneously in the vagina. This work also suggests that the link between glycogen, amylase, and Lactobacillus in the vagina is complex. IMPORTANCE In this study, we show that multiple bacteria in the vaginal community produce amylases that hydrolyze glycogen into simpler sugars (i.e., maltose and maltotriose). These sugars serve as “common goods” that sustain bacterial populations in vaginal communities. Given the temporal changes that are observed in the human vaginal microbiome, we expect the kinds of bacterial amylases produced will also vary over time. These differences influence the pool of resources that are broadly shared and shape the species composition of the vaginal bacterial community.
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135
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Zangl I, Beyer R, Pap IJ, Strauss J, Aspöck C, Willinger B, Schüller C. Human Pathogenic Candida Species Respond Distinctively to Lactic Acid Stress. J Fungi (Basel) 2020; 6:jof6040348. [PMID: 33302409 PMCID: PMC7762603 DOI: 10.3390/jof6040348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/01/2020] [Accepted: 12/05/2020] [Indexed: 01/08/2023] Open
Abstract
Several Candida species are opportunistic human fungal pathogens and thrive in various environmental niches in and on the human body. In this study we focus on the conditions of the vaginal tract, which is acidic, hypoxic, glucose-deprived, and contains lactic acid. We quantitatively analyze the lactic acid tolerance in glucose-rich and glucose-deprived environment of five Candida species: Candidaalbicans, Candida glabrata, Candida parapsilosis, Candida krusei and Candida tropicalis. To characterize the phenotypic space, we analyzed 40–100 clinical isolates of each species. Each Candida species had a very distinct response pattern to lactic acid stress and characteristic phenotypic variability. C. glabrata and C. parapsilosis were best to withstand high concentrations of lactic acid with glucose as carbon source. A glucose-deprived environment induced lactic acid stress tolerance in all species. With lactate as carbon source the growth rate of C. krusei is even higher compared to glucose, whereas the other species grow slower. C. krusei may use lactic acid as carbon source in the vaginal tract. Stress resistance variability was highest among C. parapsilosis strains. In conclusion, each Candida spp. is adapted differently to cope with lactic acid stress and resistant to physiological concentrations.
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Affiliation(s)
- Isabella Zangl
- Department of Applied Genetics and Cell Biology (DAGZ), Institute of Microbial Genetics, University of Natural Resources and Life Sciences, Vienna (BOKU), 3430 Tulln an der Donau, Austria; (I.Z.); (R.B.); (J.S.)
| | - Reinhard Beyer
- Department of Applied Genetics and Cell Biology (DAGZ), Institute of Microbial Genetics, University of Natural Resources and Life Sciences, Vienna (BOKU), 3430 Tulln an der Donau, Austria; (I.Z.); (R.B.); (J.S.)
| | - Ildiko-Julia Pap
- Institute for Hygiene and Microbiology, University Hospital of St. Pölten, Dunant-Platz 1, 3100 St Pölten, Austria; (I.-J.P.); (C.A.)
| | - Joseph Strauss
- Department of Applied Genetics and Cell Biology (DAGZ), Institute of Microbial Genetics, University of Natural Resources and Life Sciences, Vienna (BOKU), 3430 Tulln an der Donau, Austria; (I.Z.); (R.B.); (J.S.)
| | - Christoph Aspöck
- Institute for Hygiene and Microbiology, University Hospital of St. Pölten, Dunant-Platz 1, 3100 St Pölten, Austria; (I.-J.P.); (C.A.)
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Christoph Schüller
- Department of Applied Genetics and Cell Biology (DAGZ), Institute of Microbial Genetics, University of Natural Resources and Life Sciences, Vienna (BOKU), 3430 Tulln an der Donau, Austria; (I.Z.); (R.B.); (J.S.)
- Bioactive Microbial Metabolites (BiMM), Department of Applied Genetics and Cell Biology (DAGZ), Institute of Microbial Genetics, University of Natural Resources and Life Sciences, 3430 Vienna, Austria
- Correspondence: ; Tel.: +43-1-47654-94484
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136
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Lee CY, Cheu RK, Lemke MM, Gustin AT, France MT, Hampel B, Thurman AR, Doncel GF, Ravel J, Klatt NR, Arnold KB. Quantitative modeling predicts mechanistic links between pre-treatment microbiome composition and metronidazole efficacy in bacterial vaginosis. Nat Commun 2020; 11:6147. [PMID: 33262350 PMCID: PMC7708644 DOI: 10.1038/s41467-020-19880-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Bacterial vaginosis is a condition associated with adverse reproductive outcomes and characterized by a shift from a Lactobacillus-dominant vaginal microbiota to a polymicrobial microbiota, consistently colonized by strains of Gardnerella vaginalis. Metronidazole is the first-line treatment; however, treatment failure and recurrence rates remain high. To understand complex interactions between Gardnerella vaginalis and Lactobacillus involved in efficacy, here we develop an ordinary differential equation model that predicts bacterial growth as a function of metronidazole uptake, sensitivity, and metabolism. The model shows that a critical factor in efficacy is Lactobacillus sequestration of metronidazole, and efficacy decreases when the relative abundance of Lactobacillus is higher pre-treatment. We validate results in Gardnerella and Lactobacillus co-cultures, and in two clinical cohorts, finding women with recurrence have significantly higher pre-treatment levels of Lactobacillus relative to bacterial vaginosis-associated bacteria. Overall results provide mechanistic insight into how personalized differences in microbial communities influence vaginal antibiotic efficacy.
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Affiliation(s)
- Christina Y Lee
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Ryan K Cheu
- University of Miami Department of Pediatrics, University of Miami, Miami, FL, USA
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA
| | - Melissa M Lemke
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Andrew T Gustin
- University of Miami Department of Pediatrics, University of Miami, Miami, FL, USA
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA
| | - Michael T France
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Benjamin Hampel
- Division of Infectious Diseases and Hospital Epidemiology, University of Zurich, Zürich, Switzerland
| | | | | | - Jacques Ravel
- Institute for Genome Sciences and Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nichole R Klatt
- University of Miami Department of Pediatrics, University of Miami, Miami, FL, USA.
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA.
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
| | - Kelly B Arnold
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
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137
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France MT, Ma B, Gajer P, Brown S, Humphrys MS, Holm JB, Waetjen LE, Brotman RM, Ravel J. VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition. MICROBIOME 2020; 8:166. [PMID: 33228810 PMCID: PMC7684964 DOI: 10.1186/s40168-020-00934-6] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/06/2020] [Indexed: 05/12/2023]
Abstract
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. Video abstract.
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Affiliation(s)
- Michael T France
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Bing Ma
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Pawel Gajer
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Sarah Brown
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Michael S Humphrys
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - Johanna B Holm
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
| | - L Elaine Waetjen
- Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Sacramento, USA
| | - Rebecca M Brotman
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA.
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138
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Castanheira CP, Sallas ML, Nunes RAL, Lorenzi NPC, Termini L. Microbiome and Cervical Cancer. Pathobiology 2020; 88:187-197. [PMID: 33227782 DOI: 10.1159/000511477] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/07/2020] [Indexed: 11/19/2022] Open
Abstract
Persistent infection with some types of mucosal human papillomavirus (HPV) is the etiological factor for the development of cervical cancer and its precursor lesions. Besides, several cofactors are known to play a role in cervical disease onset and progression either by favoring or by preventing HPV infection and persistence. The microbiome of a healthy female genital tract is characterized by the presence of 1 or few varieties of lactobacilli. However, high-throughput studies addressing the bacterial diversity and abundance in the female genital tract have shown that several factors, including hormonal levels, hygiene habits, and sexually transmitted diseases may disrupt the natural balance, favoring the outgrowth of some groups of bacteria, which in turn may favor some pathological states. Recently, the vaginal microbiome has emerged as a new variable that could greatly influence the natural history of HPV infections and their clinical impact. In this context, changes in the vaginal microbiome have been detected in women infected with HPV and women with HPV-associated lesions and cancer. However, the role of specific bacteria groups in the development/progression or prevention/regression of HPV-associated pathologies is not well understood. In this review we summarize the current knowledge concerning changes in vaginal microbiome and cervical disease. We discuss the potential functional interplay between specific bacterial groups and HPV infection outcomes.
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Affiliation(s)
| | - Mayara Luciana Sallas
- Innovation in Cancer Laboratory, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rafaella Almeida Lima Nunes
- Innovation in Cancer Laboratory, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Lara Termini
- Innovation in Cancer Laboratory, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil,
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139
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Vaginal Microbiota Diversity of Patients with Embryonic Miscarriage by Using 16S rDNA High-Throughput Sequencing. Int J Genomics 2020; 2020:1764959. [PMID: 33299847 PMCID: PMC7704210 DOI: 10.1155/2020/1764959] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 08/31/2020] [Accepted: 10/09/2020] [Indexed: 12/30/2022] Open
Abstract
Embryonic miscarriage severely affects the life quality and physical and mental state of pregnant women. However, the detailed mechanism underlying embryonic miscarriage is not fully understood. This study is aimed at analyzing embryonic miscarriage. We collected samples from 25 normal pregnant women and 25 embryonic miscarriage patients of similar age to analyze microbiota isolated from the vagina. Crude examination of the vagina isolates showed that compared with the control group, 80% of the embryonic miscarriage group contained a significantly lower number of Lactobacillus, the major healthy microbe in the vagina. Furthermore, the levels of Th1 and Th2 secreted cytokine interleukin 2 (IL-2) and interleukin10 (IL-10), respectively, were examined. Results showed that the IL2 level was higher, and IL10 level was lower in the embryonic miscarriage group than in the control group, whereas the IL2/IL10 level was higher in the embryonic miscarriage group than in the control group. This finding suggested that the immune response was suppressed in the embryonic miscarriage group. To further dissect the microbiota of the vagina in the two groups, 16S rDNA sequencing was performed. Bioinformatics analysis showed that 1096 and 998 overlapped operational taxonomic units were identified from the embryonic miscarriage and control groups, respectively. At the genus level, the relative abundance of Fam_Finegoldia, Lac_Coprococcus_3, and Lac_Roseburia significantly differed in the embryonic miscarriage group. Overall, our analyses provided potential biomarkers for embryonic miscarriage and elucidated the causative relationship between microbiota and immune responses and may enable the possible diagnosis and therapeutics of early pregnancy loss.
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140
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Morais J, Marques C, Teixeira D, Durão C, Faria A, Brito S, Cardoso M, Macedo I, Pereira E, Tomé T, Calhau C. Extremely preterm neonates have more Lactobacillus in meconium than very preterm neonates - the in utero microbial colonization hypothesis. Gut Microbes 2020; 12:1785804. [PMID: 32658601 PMCID: PMC7524394 DOI: 10.1080/19490976.2020.1785804] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Growing evidence suggests that maternal microbiota can influence the neonates' gut colonization. However, the mechanisms of vertical bacterial transmission remain poorly defined. We believed that the first colonizers of the newborn come from the mother's gut and vagina during pregnancy and that this is independent of the mode of delivery. We conducted an observational longitudinal study to evaluate the link between the maternal gut microbiota and the meconium's microbiota in extremely and very preterm neonates. Bacterial DNA was extracted from samples and specific bacterial groups were quantified by RT-PCR. In this cohort of 117 preterm neonates, we detected bacterial DNA in 88% of meconium samples. Meconium microbiota of neonates born after 28 gestational weeks (very preterm neonates) showed stronger correlations with their mothers' fecal microbiota. However, neonates born before 28 gestational weeks (extremely preterm neonates) had more Lactobacillus - genus that dominated the vaginal microbiota - than very preterm neonates, regardless of the mode of delivery. Collectively, these data support the hypothesis that maternal bacteria from the gut and vagina can play a role in shaping neonates' gut microbiota and that mother-to-infant bacterial transmission is a controlled and time-specific process. ClinicalTrials.gov Identifier: NCT03663556.
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Affiliation(s)
- Juliana Morais
- Nutrition and Metabolism, Faculdade de Ciências Médicas
- NOVA Medical Schoo
- , Universidade NOVA de Lisboa, Lisboa, Portugal,CINTESIS, Center for Health Technology Services Research, Porto, Portugal
| | - Cláudia Marques
- Nutrition and Metabolism, Faculdade de Ciências Médicas
- NOVA Medical Schoo
- , Universidade NOVA de Lisboa, Lisboa, Portugal,CINTESIS, Center for Health Technology Services Research, Porto, Portugal
| | - Diana Teixeira
- Nutrition and Metabolism, Faculdade de Ciências Médicas
- NOVA Medical Schoo
- , Universidade NOVA de Lisboa, Lisboa, Portugal,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal,Unidade Universitária Lifestyle Medicine José de Mello Saúde by NOVA Medical School, Lisboa, Portugal
| | - Catarina Durão
- Nutrition and Metabolism, Faculdade de Ciências Médicas
- NOVA Medical Schoo
- , Universidade NOVA de Lisboa, Lisboa, Portugal,EPIUnit - Institute of Public Health, Universidade do Porto, Porto, Portugal
| | - Ana Faria
- Nutrition and Metabolism, Faculdade de Ciências Médicas
- NOVA Medical Schoo
- , Universidade NOVA de Lisboa, Lisboa, Portugal,CINTESIS, Center for Health Technology Services Research, Porto, Portugal,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Sara Brito
- Neonatal Intensive Care Unit, Liutrition and Dietetics Unit, Centro Hospitalar Universitário de Lisboa Central, Maternidade Dr. Alfredo da Costa, Cesboa, Portugal
| | - Manuela Cardoso
- Nutrition and Dietetics Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Israel Macedo
- Neonatal Intensive Care Unit, Liutrition and Dietetics Unit, Centro Hospitalar Universitário de Lisboa Central, Maternidade Dr. Alfredo da Costa, Cesboa, Portugal
| | - Esmeralda Pereira
- Neonatology Department, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Teresa Tomé
- Neonatal Intensive Care Unit, Liutrition and Dietetics Unit, Centro Hospitalar Universitário de Lisboa Central, Maternidade Dr. Alfredo da Costa, Cesboa, Portugal
| | - Conceição Calhau
- Nutrition and Metabolism, Faculdade de Ciências Médicas
- NOVA Medical Schoo
- , Universidade NOVA de Lisboa, Lisboa, Portugal,CINTESIS, Center for Health Technology Services Research, Porto, Portugal,Unidade Universitária Lifestyle Medicine José de Mello Saúde by NOVA Medical School, Lisboa, Portugal,CONTACT Conceição Calhau, Faculdade de Ciências Médicas
- NOVA Medical School, Universidade NOVA de Lisboa, Lisboa1169-056, Portugal
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141
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Lacroix G, Gouyer V, Gottrand F, Desseyn JL. The Cervicovaginal Mucus Barrier. Int J Mol Sci 2020; 21:ijms21218266. [PMID: 33158227 PMCID: PMC7663572 DOI: 10.3390/ijms21218266] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 12/19/2022] Open
Abstract
Preterm births are a global health priority that affects 15 million babies every year worldwide. There are no effective prognostic and therapeutic strategies relating to preterm delivery, but uterine infections appear to be a major cause. The vaginal epithelium is covered by the cervicovaginal mucus, which is essential to health because of its direct involvement in reproduction and functions as a selective barrier by sheltering the beneficial lactobacilli while helping to clear pathogens. During pregnancy, the cervical canal is sealed with a cervical mucus plug that prevents the vaginal flora from ascending toward the uterine compartment, which protects the fetus from pathogens. Abnormalities of the cervical mucus plug and bacterial vaginosis are associated with a higher risk of preterm delivery. This review addresses the current understanding of the cervicovaginal mucus and the cervical mucus plug and their interactions with the microbial communities in both the physiological state and bacterial vaginosis, with a focus on gel-forming mucins. We also review the current state of knowledge of gel-forming mucins contained in mouse cervicovaginal mucus and the mouse models used to study bacterial vaginosis.
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142
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Salinas AM, Osorio VG, Pacha-Herrera D, Vivanco JS, Trueba AF, Machado A. Vaginal microbiota evaluation and prevalence of key pathogens in ecuadorian women: an epidemiologic analysis. Sci Rep 2020; 10:18358. [PMID: 33110095 PMCID: PMC7591572 DOI: 10.1038/s41598-020-74655-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022] Open
Abstract
Vaginal infection is a gynecological problem in women of reproductive age with multiple health outcomes. The most common forms of infection include bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and aerobic vaginitis (AV). Our main goals were to evaluate different types of vaginal infections in Ecuadorian women in a large urban area (Quito) and to characterize the vaginal microbiota colonization by opportunistic species. We collected vaginal swabs and epidemiological surveys from 414 women from June 2016 to July of 2017. We analyzed vaginal samples for the presence of any vaginal infection. The microbiological examination was done through Gram-stain, wet mount smears, and polymerase chain reaction (PCR) assays using primers for target genes, such as 16S rRNA (Atopobium vaginae, Mobiluncus mulieris, and Gardnerella species), ddl (Enterococcus faecalis), adk (Escherichia coli) and KER1 (Candida albicans) genes. Most women showed a healthy vaginal microbiota (66.7%). Nearly one-tenth (10.4%) of the participants had intermediate microbiota, and the remaining women (22.9%) had a single vaginal infection (BV, AV, or VC) or coinfections. From the 95 participants that had an infection, AV was the main diagnosed vaginal infection (51.6%), followed by BV (24.2%) and finally VC (7.4%). The remaining women (16.8%) showed coinfections, being BV and AV the most common coinfection. Using univariable logistic regression analyses we found an increased odds of healthy microbiota in women with a sexual partner (P = 0.02, OR = 1.64). Also, women in a free union relationship (P = 0.000, OR = 16.65) had an increased odds of having coinfections. On the other hand, the use of birth control (condom OR = 0.388 or other contraceptive method OR = 0.363) was associated with significantly lower odds of intermediate microbiota (P ≤ 0.05). We found no statistically significant differences between women with infection and a particular group age. Using multivariate logistic regression analyses we initially found an increased odds of having BV in women with M. mulieris (P = 0.020, OR = 4.98) and Gardnerella species (P = 0.010, OR = 4.16). Women with E. coli showed an increased odds of having AV (P = 0.009, OR = 2.81). The presence of C. albicans in women showed an increased odds of having VC (P = 0.007, OR = 17.94). Finally, women with M. mulieris showed a reverse odds of having healthy microbiota (P = 0.008, OR = 0.06). We found no statistically significant differences between women with symptomatic and asymptomatic infections or the presence of Enterococcus faecalis. We found using logistic regression analyses that M. mulieris was the most prevalent opportunistic pathogen among women with vaginal infection. Further studies should evaluate the possibility to use M. mulieris as a potential key predictor for vaginal infections.
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Affiliation(s)
- Ana María Salinas
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - Verónica Gabriela Osorio
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - David Pacha-Herrera
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - Juan S Vivanco
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - Ana Francisca Trueba
- Brain and Behavior Laboratory, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador
| | - António Machado
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales (COCIBA), Universidad San Francisco de Quito (USFQ), Diego de Robles y Vía Interoceánica, Campus Cumbayá, Casilla Postal 17-1200-841, Quito, 170901, Ecuador.
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143
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Santoro A, Zhao J, Wu L, Carru C, Biagi E, Franceschi C. Microbiomes other than the gut: inflammaging and age-related diseases. Semin Immunopathol 2020; 42:589-605. [PMID: 32997224 PMCID: PMC7666274 DOI: 10.1007/s00281-020-00814-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022]
Abstract
During the course of evolution, bacteria have developed an intimate relationship with humans colonizing specific body sites at the interface with the body exterior and invaginations such as nose, mouth, lung, gut, vagina, genito-urinary tract, and skin and thus constituting an integrated meta-organism. The final result has been a mutual adaptation and functional integration which confers significant advantages to humans and bacteria. The immune system of the host co-evolved with the microbiota to develop complex mechanisms to recognize and destroy invading microbes, while preserving its own bacteria. Composition and diversity of the microbiota change according to development and aging and contribute to humans' health and fitness by modulating the immune system response and inflammaging and vice versa. In the last decades, we experienced an explosion of studies on the role of gut microbiota in aging, age-related diseases, and longevity; however, less reports are present on the role of the microbiota at different body sites. In this review, we describe the key steps of the co-evolution between Homo sapiens and microbiome and how this adaptation can impact on immunosenescence and inflammaging. We briefly summarized the role of gut microbiota in aging and longevity while bringing out the involvement of the other microbiota.
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Affiliation(s)
- Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
| | - Jiangchao Zhao
- Department of Animal Science, Division of Agriculture, University of Arkansas, Fayetteville, AR, 72703, USA
| | - Lu Wu
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Ciriaco Carru
- Department of Biomedical Sciences, University Hospital (AOU) - University of Sassari, Sassari, Italy
| | - Elena Biagi
- Department of Pharmacy and Biotechnology (FABIT), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Laboratory of Systems Medicine of Healthy Aging and Department of Applied Mathematics, Lobachevsky University, Nizhny Novgorod, Russia
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144
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Rosca AS, Castro J, Sousa LGV, Cerca N. Gardnerella and vaginal health: the truth is out there. FEMS Microbiol Rev 2020; 44:73-105. [PMID: 31697363 DOI: 10.1093/femsre/fuz027] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/06/2019] [Indexed: 12/16/2022] Open
Abstract
The human vagina is a dynamic ecosystem in which homeostasis depends on mutually beneficial interactions between the host and their microorganisms. However, the vaginal ecosystem can be thrown off balance by a wide variety of factors. Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age but its etiology is not yet fully understood, with different controversial theories being raised over the years. What is generally accepted is that BV is often characterized by a shift in the composition of the normal vaginal microbiota, from a Lactobacillus species dominated microbiota to a mixture of anaerobic and facultative anaerobic bacteria. During BV, a polymicrobial biofilm develops in the vaginal microenvironment, being mainly composed of Gardnerella species. The interactions between vaginal microorganisms are thought to play a pivotal role in the shift from health to disease and might also increase the risk of sexually transmitted infections acquisition. Here, we review the current knowledge regarding the specific interactions that occur in the vaginal niche and discuss mechanisms by which these interactions might be mediated. Furthermore, we discuss the importance of novel strategies to fight chronic vaginal infections.
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Affiliation(s)
- Aliona S Rosca
- Centre of Biological Engineering (CEB), Laboratory of Research in Biofilms Rosário Oliveira (LIBRO), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Joana Castro
- Centre of Biological Engineering (CEB), Laboratory of Research in Biofilms Rosário Oliveira (LIBRO), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Lúcia G V Sousa
- Centre of Biological Engineering (CEB), Laboratory of Research in Biofilms Rosário Oliveira (LIBRO), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Nuno Cerca
- Centre of Biological Engineering (CEB), Laboratory of Research in Biofilms Rosário Oliveira (LIBRO), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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145
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Ratten LK, Plummer EL, Murray GL, Danielewski J, Fairley CK, Garland SM, Hocking JS, Tachedjian G, Chow E, Bradshaw CS, Vodstrcil LA. Sex is associated with the persistence of non-optimal vaginal microbiota following treatment for bacterial vaginosis: a prospective cohort study. BJOG 2020; 128:756-767. [PMID: 33480468 DOI: 10.1111/1471-0528.16430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Determine the associations between factors and sexual practices and the composition of the vaginal microbiome (VM) of women treated for bacterial vaginosis (BV). DESIGN Prospective cohort study. SETTING The Melbourne Sexual Health Centre, Melbourne, Australia. POPULATION Seventy-five reproductive-age women diagnosed with clinical BV, treated with first-line antibiotics and followed for up to 6 months. METHODS Women self-collected vaginal swabs and completed questionnaires at enrolment, the day following antibiotics and monthly for up to 6months until BV recurrence or no BV recurrence (n = 430 specimens). Bacterial composition was determined using 16S rRNA gene amplicon sequencing. The effects of ongoing factors on VM composition (utilising 291 monthly specimens) were assessed using generalised estimating equations population-averaged models, which accounted for repeated measures within individuals. MAIN OUTCOME MEASURES The relative abundance of vaginal bacterial taxa. RESULTS Women who reported ongoing sex with a regular sexual partner (RSP) had a VM comprised of increased relative abundance of non-optimal BV-associated bacteria (Adjusted co-efficient [Adjusted co-eff] = 11.91, 95% CI 3.39to20.43, P = 0.006) and a decreased relative abundance of optimal, Lactobacillus species (Adjusted co-eff = -12.76, 95% CI -23.03 to -2.49, P = 0.015). A history of BV was also associated with a decreased relative abundance of Lactobacillus spp. (Adjusted co-eff = -12.35, 95% CI -22.68, P = 0.019). The relative abundance of Gardnerella, Atopobium and Sneathia spp. increased following sex with an RSP. CONCLUSIONS Sex with an untreated RSP after BV treatment was associated with a VM comprised of non-optimal BV-associated bacteria. BV treatment approaches may need to include partner treatment if they are to achieve a sustained optimal VM associated with improved health outcomes. TWEETABLE ABSTRACT Sex drives a return to a 'non-optimal' vaginal microbiota after antibiotics for bacterial vaginosis.
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Affiliation(s)
- L K Ratten
- Central Clinical School, Monash University, Melbourne, Vic., Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia
| | - E L Plummer
- Central Clinical School, Monash University, Melbourne, Vic., Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia
| | - G L Murray
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Vic., Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Vic., Australia
| | - J Danielewski
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Vic., Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - C K Fairley
- Central Clinical School, Monash University, Melbourne, Vic., Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia
| | - S M Garland
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Vic., Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Vic., Australia
| | - J S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Vic., Australia
| | - G Tachedjian
- Burnet Institute, Melbourne, Vic., Australia.,Department of Microbiology, Monash University, Clayton, Vic., Australia.,Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute of Infection and Immunity, Melbourne, Vic., Australia
| | - Epf Chow
- Central Clinical School, Monash University, Melbourne, Vic., Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Vic., Australia
| | - C S Bradshaw
- Central Clinical School, Monash University, Melbourne, Vic., Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia
| | - L A Vodstrcil
- Central Clinical School, Monash University, Melbourne, Vic., Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia
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146
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N'Guessan Gnaman KC, Bouttier S, Yeo A, Aka Any-Grah AAS, Geiger S, Huang N, Nicolas V, Villebrun S, Faye-Kette H, Ponchel G, Koffi AA, Agnely F. Characterization and in vitro evaluation of a vaginal gel containing Lactobacillus crispatus for the prevention of gonorrhea. Int J Pharm 2020; 588:119733. [PMID: 32768529 DOI: 10.1016/j.ijpharm.2020.119733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 11/26/2022]
Abstract
The increasing resistance of Neisseria gonorrhoeae to any current antibiotic treatment and the difficulties associated with the use of prevention means such as condom urge the need for alternative methods to prevent this sexually transmitted infection. In this work, a prevention strategy based on the use of a vaginal gel containing Lactobacilli was assessed in vitro. A Lactobacillus crispatus strain (ATCC 33197) was selected based on the published data on its ability to inhibit Neisseria gonorrhoeae. Its probiotic properties were first characterized. Then, a thermo-sensitive hydrogel containing 21.5% of poloxamer 407, 1% of sodium alginate and 9log10 CFU of Lactobacillus crispatus per gel sample (5 g) was developed. The gelation temperature and the rheological characteristics of this formulation appeared suitable for a vaginal administration. Lactobacillus crispatus was viable in the gel for six months although a large amount of the bacteria was not culturable. The ability of Lactobacillus crispatus to inhibit Neisseria gonorrhoeae was still observed with the gel. Such system, thus, appeared promising for the prevention of gonorrhea.
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Affiliation(s)
- K C N'Guessan Gnaman
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92290 Châtenay-Malabry, France; Laboratoire de Pharmacie Galénique, Cosmétologie et Législation Pharmaceutique, UFR des Sciences Pharmaceutiques et Biologiques d'Abidjan, Université Félix Houphouet-Boigny, 01 BP V 34 Abidjan 01, Côte d'Ivoire
| | - S Bouttier
- INRAE, AgroParisTech, MIcalis Institute, Équipe Bactéries pathogènes et santé, Université Paris-Saclay, 92290 Châtenay-Malabry, France
| | - A Yeo
- Institut Pasteur, Departement de microbiologie, Unité des agents du tractus génital, Abidjan, Côte d'Ivoire
| | - A A S Aka Any-Grah
- Laboratoire de Pharmacie Galénique, Cosmétologie et Législation Pharmaceutique, UFR des Sciences Pharmaceutiques et Biologiques d'Abidjan, Université Félix Houphouet-Boigny, 01 BP V 34 Abidjan 01, Côte d'Ivoire
| | - S Geiger
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92290 Châtenay-Malabry, France
| | - N Huang
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92290 Châtenay-Malabry, France
| | - V Nicolas
- Université Paris-Saclay, SFR-UMS-IPSIT, Plateforme d'imagerie cellulaire MIPSIT, 92290 Châtenay-Malabry, France
| | - S Villebrun
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92290 Châtenay-Malabry, France
| | - H Faye-Kette
- Institut Pasteur, Departement de microbiologie, Unité des agents du tractus génital, Abidjan, Côte d'Ivoire
| | - G Ponchel
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92290 Châtenay-Malabry, France
| | - A A Koffi
- Laboratoire de Pharmacie Galénique, Cosmétologie et Législation Pharmaceutique, UFR des Sciences Pharmaceutiques et Biologiques d'Abidjan, Université Félix Houphouet-Boigny, 01 BP V 34 Abidjan 01, Côte d'Ivoire
| | - F Agnely
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92290 Châtenay-Malabry, France.
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147
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Riganelli L, Iebba V, Piccioni M, Illuminati I, Bonfiglio G, Neroni B, Calvo L, Gagliardi A, Levrero M, Merlino L, Mariani M, Capri O, Pietrangeli D, Schippa S, Guerrieri F. Structural Variations of Vaginal and Endometrial Microbiota: Hints on Female Infertility. Front Cell Infect Microbiol 2020; 10:350. [PMID: 32760681 PMCID: PMC7372811 DOI: 10.3389/fcimb.2020.00350] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/08/2020] [Indexed: 12/18/2022] Open
Abstract
Microbiota are microorganismal communities colonizing human tissues exposed to the external environment, including the urogenital tract. The bacterial composition of the vaginal microbiota has been established and is partially related to obstetric outcome, while the uterine microbiota, considered to be a sterile environment for years, is now the focus of more extensive studies and debates. The characterization of the microbiota contained in the reproductive tract (RT) of asymptomatic and infertile women, could define a specific RT microbiota associated with implantation failure. In this pilot study, 34 women undergoing personalized hormonal stimulation were recruited and the biological samples of each patient, vaginal fluid, and endometrial biopsy, were collected immediately prior to oocyte-pick up, and sequenced. Women were subsequently divided into groups according to fertilization outcome. Analysis of the 16s rRNA V4-V5 region revealed a significant difference between vaginal and endometrial microbiota. The vaginal microbiota of pregnant women corroborated previous data, exhibiting a lactobacilli-dominant habitat compared to non-pregnant cases, while the endometrial bacterial colonization was characterized by a polymicrobial ecosystem in which lactobacilli were exclusively detected in the group that displayed unsuccessful in vitro fertilization. Overall, these preliminary results revisit our knowledge of the genitourinary microbiota, and highlight a putative relationship between vaginal/endometrial microbiota and reproductive success.
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Affiliation(s)
- Lucia Riganelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Valerio Iebba
- SSD of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.,Department of Medical, Surgical and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Mariagrazia Piccioni
- Department of Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Isabella Illuminati
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Giulia Bonfiglio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Bruna Neroni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Ludovica Calvo
- Center for Life NanoScience@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Antonella Gagliardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Massimo Levrero
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.,Epigenetics and Epigenomic of Hepatocellular Carcinoma, Cancer Research Center of Lyon (CRCL), UMR Inserm 1052 - CNRS 5286, Lyon, France
| | - Lucia Merlino
- Department of Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Marianna Mariani
- Department of Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Oriana Capri
- Department of Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Daniela Pietrangeli
- Department of Obstetrics and Gynaecology, Sapienza University of Rome, Rome, Italy
| | - Serena Schippa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesca Guerrieri
- Center for Life NanoScience@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy.,Epigenetics and Epigenomic of Hepatocellular Carcinoma, Cancer Research Center of Lyon (CRCL), UMR Inserm 1052 - CNRS 5286, Lyon, France
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148
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Serrano M, Climent E, Freire F, Martínez-Blanch JF, González C, Reyes L, Solaz-Fuster MC, Calvo JH, Jiménez MÁ, Codoñer FM. Influence of the Ovine Genital Tract Microbiota on the Species Artificial Insemination Outcome. A Pilot Study in Commercial Sheep Farms. High Throughput 2020; 9:E16. [PMID: 32640606 PMCID: PMC7576495 DOI: 10.3390/ht9030016] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 12/31/2022] Open
Abstract
To date, there is a lack of research into the vaginal and sperm microbiome and its bearing on artificial insemination (AI) success in the ovine species. Using hypervariable regions V3-V4 of the 16S rRNA, we describe, for the first time, the combined effect of the ovine microbiome of both females (50 ewes belonging to five herds) and males (five AI rams from an AI center) on AI outcome. Differences in microbiota abundance between pregnant and non-pregnant ewes and between ewes carrying progesterone-releasing intravaginal devices (PRID) with or without antibiotic were tested at different taxonomic levels. The antibiotic treatment applied with the PRID only altered Streptobacillus genus abundance, which was significantly lower in ewes carrying PRID with antibiotic. Mageebacillus, Histophilus, Actinobacilllus and Sneathia genera were significantly less abundant in pregnant ewes. In addition, these genera were more abundant in two farms with higher AI failure. Species of these genera such as Actinobacillus seminis and Histophilus somni have been associated with reproductive disorders in the ovine species. These genera were not present in the sperm samples of AI rams, but were found in the foreskin samples of rams belonging to herd 2 (with high AI failure rate) indicating that their presence in ewes' vagina could be due to prior transmission by natural mating with rams reared in the herd.
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Affiliation(s)
- Malena Serrano
- Department of Animal Genetic Improvement, National Institute of Agrarian Technology and Food—INIA, Ctra. de la Coruña, 28040 Madrid, Spain; (C.G.); (M.Á.J.)
| | - Eric Climent
- ADM Lifesequencing, University of Valencia Science Park, Carrer del Catedrático A. Escardino Benlloch 9, 46980 Paterna, Spain; (E.C.); (J.F.M.-B.); (M.C.S.-F.)
| | - Fernando Freire
- OVIGEN, Granja Florencia S/N, Ctra. Villalazán-Peleagonzalo, 49800 Zamora, Spain; (F.F.); (L.R.)
| | - Juan F. Martínez-Blanch
- ADM Lifesequencing, University of Valencia Science Park, Carrer del Catedrático A. Escardino Benlloch 9, 46980 Paterna, Spain; (E.C.); (J.F.M.-B.); (M.C.S.-F.)
| | - Carmen González
- Department of Animal Genetic Improvement, National Institute of Agrarian Technology and Food—INIA, Ctra. de la Coruña, 28040 Madrid, Spain; (C.G.); (M.Á.J.)
| | - Luis Reyes
- OVIGEN, Granja Florencia S/N, Ctra. Villalazán-Peleagonzalo, 49800 Zamora, Spain; (F.F.); (L.R.)
| | - M. Carmen Solaz-Fuster
- ADM Lifesequencing, University of Valencia Science Park, Carrer del Catedrático A. Escardino Benlloch 9, 46980 Paterna, Spain; (E.C.); (J.F.M.-B.); (M.C.S.-F.)
| | - Jorge H. Calvo
- Animal Production Technology Unit—CITA, 59059 Zaragoza, Spain; Aragonese Agency Foundation for Research and Development—ARAID, 50004 Zaragoza, Spain;
| | - M. Ángeles Jiménez
- Department of Animal Genetic Improvement, National Institute of Agrarian Technology and Food—INIA, Ctra. de la Coruña, 28040 Madrid, Spain; (C.G.); (M.Á.J.)
| | - Francisco M. Codoñer
- ADM Lifesequencing, University of Valencia Science Park, Carrer del Catedrático A. Escardino Benlloch 9, 46980 Paterna, Spain; (E.C.); (J.F.M.-B.); (M.C.S.-F.)
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149
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Bagga R, Arora P. Genital Micro-Organisms in Pregnancy. Front Public Health 2020; 8:225. [PMID: 32612969 PMCID: PMC7308476 DOI: 10.3389/fpubh.2020.00225] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/14/2020] [Indexed: 01/12/2023] Open
Abstract
The microbiome of the female genital tract may undergo changes in pregnancy due to metabolic, endocrinological, and immunological alterations. These dysbiotic states may cause infections which may ascend upwards to the feto-placental unit or may be seeded hematogenously. These low grade and often low virulent infectious states lead to chronic inflammatory states and maybe associated with adverse maternal and neonatal outcome. Organisms have been isolated from amniotic fluid and placentae from women delivering pre-term; however the possibility of contamination cannot be conclusively ruled out. Common vaginal dysbiotic states often cause symptoms that are overlooked and often untreated. Vulvovaginal Candidiasis (VVC), Bacterial Vaginosis (BV), and Trichomonas Vaginitis (TV) are the commonly occurring dysbiotic states leading to vaginal infective states in pregnancy. With the advent of novel technologies like Next Generation sequencing (NGS), it will soon be possible to comprehensively map the vaginal microbiome and assess the interplay of each microbial state with their effects in pregnancy. This may open new avenues for antibiotic recommendations, probiotics and potential alternate therapies for dysbiotic states leading to pregnancy complications.
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Affiliation(s)
- Rashmi Bagga
- Department of Obstetrics & Gynaecology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Parul Arora
- Reproductive Medicine, Nova IVF Fertility, Ahmedabad, India
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150
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Abstract
In the 1980s, menstrual toxic shock syndrome (mTSS) became a household topic, particularly among mothers and their daughters. The research performed at the time, and for the first time, exposed the American public as well as the biomedical community, in a major way, to understanding disease progression and investigation. Those studies led to the identification of the cause, Staphylococcus aureus and the pyrogenic toxin superantigen TSS toxin 1 (TSST-1), and many of the risk factors, for example, tampon use. Those studies in turn led to TSS warning labels on the outside and inside of tampon boxes and, as important, uniform standards worldwide of tampon absorbency labeling. This review addresses our understanding of the development and conclusions related to mTSS and risk factors. We leave the final message that even though mTSS is not commonly in the news today, cases continue to occur. Additionally, S. aureus strains cycle in human populations in roughly 10-year intervals, possibly dependent on immune status. TSST-1-producing S. aureus bacteria appear to be reemerging, suggesting that physician awareness of this emergence and mTSS history should be heightened.
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