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Armstrong E, Hemmerling A, Miller S, Huibner S, Kulikova M, Liu R, Crawford E, Castañeda GR, Coburn B, Cohen CR, Kaul R. Vaginal fungi are associated with treatment-induced shifts in the vaginal microbiota and with a distinct genital immune profile. Microbiol Spectr 2024:e0350123. [PMID: 38912808 DOI: 10.1128/spectrum.03501-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/17/2024] [Indexed: 06/25/2024] Open
Abstract
Vaginal colonization by fungi may elicit genital inflammation and enhance the risk of adverse reproductive health outcomes, such as HIV acquisition. Cross-sectional studies have linked fungi with an absence of bacterial vaginosis (BV), but it is unclear whether shifts in vaginal bacteria alter the abundance of vaginal fungi. Vaginal swabs collected following topical metronidazole treatment for BV during the phase 2b, placebo-controlled trial of LACTIN-V, a Lactobacillus crispatus-based live biotherapeutic, were assayed with semi-quantitative PCR for the relative quantitation of fungi and key bacterial species and multiplex immunoassay for immune factors. Vaginal fungi increased immediately following metronidazole treatment for BV (adjusted P = 0.0006), with most of this increase attributable to Candida albicans. Vaginal fungi were independently linked to elevated levels of the proinflammatory cytokine interleukin (IL) 17A, although this association did not remain significant after correcting for multiple comparisons. Fungal relative abundance by semi-quantitative PCR returned to baseline levels within 1 month of metronidazole treatment and was not affected by LACTIN-V or placebo administration. Fungal abundance was positively associated with Lactobacillus species, negatively associated with BV-associated bacteria, and positively associated with a variety of proinflammatory cytokines and chemokines, including IL-17A, during and after study product administration. Antibiotic treatment for BV resulted in a transient expanded abundance of vaginal fungi in a subset of women which was unaffected by subsequent administration of LACTIN-V. Vaginal fungi were positively associated with Lactobacillus species and IL-17A and negatively associated with BV-associated bacteria; these associations were most pronounced in the longer-term outcomes.IMPORTANCEVaginal colonization by fungi can enhance the risk of adverse reproductive health outcomes and HIV acquisition, potentially by eliciting genital mucosal inflammation. We show that standard antibiotic treatment for bacterial vaginosis (BV) results in a transient increase in the absolute abundance of vaginal fungi, most of which was identified as Candida albicans. Vaginal fungi were positively associated with proinflammatory immune factors and negatively associated with BV-associated bacteria. These findings improve our understanding of how shifts in the bacterial composition of the vaginal microbiota may enhance proliferation by proinflammatory vaginal fungi, which may have important implications for risk of adverse reproductive health outcomes among women.
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Affiliation(s)
- Eric Armstrong
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Anke Hemmerling
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
- Delve Bio, San Francisco, California, USA
| | - Sanja Huibner
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Maria Kulikova
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Rachel Liu
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Emily Crawford
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA
| | | | - Bryan Coburn
- Department of Medicine, University of Toronto, Toronto, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
- Department of Medicine, University Health Network, Toronto, Canada
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Rupert Kaul
- Department of Medicine, University of Toronto, Toronto, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
- Department of Medicine, University Health Network, Toronto, Canada
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Armstrong E, Hemmerling A, Miller S, Huibner S, Kulikova M, Crawford E, Castañeda GR, Coburn B, Cohen CR, Kaul R. Vaginal Lactobacillus crispatus persistence following application of a live biotherapeutic product: colonization phenotypes and genital immune impact. MICROBIOME 2024; 12:110. [PMID: 38907268 PMCID: PMC11191164 DOI: 10.1186/s40168-024-01828-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 05/02/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Bacterial vaginosis (BV) increases HIV acquisition risk, potentially by eliciting genital inflammation. After BV treatment, the vaginal administration of LACTIN-V, a live biotherapeutic containing the Lactobacillus crispatus strain CTV-05, reduced BV recurrence and vaginal inflammation; however, 3 months after product cessation, CTV-05 colonization was only sustained in 48% of participants. RESULTS This nested sub-study in 32 participants receiving LACTIN-V finds that 72% (23/32) demonstrate clinically relevant colonization (CTV-05 absolute abundance > 106 CFU/mL) during at least one visit while 28% (9/32) of women demonstrate colonization resistance, even during product administration. Immediately prior to LACTIN-V administration, the colonization-resistant group exhibited elevated vaginal microbiota diversity. During LACTIN-V administration, colonization resistance was associated with elevated vaginal markers of epithelial disruption and reduced chemokines, possibly due to elevated absolute abundance of BV-associated species and reduced L. crispatus. Colonization permissive women were stratified into sustained and transient colonization groups (31% and 41% of participants, respectively) based on CTV-05 colonization after cessation of product administration. These groups also exhibited distinct genital immune profiles during LACTIN-V administration. CONCLUSIONS The genital immune impact of LACTIN-V may be contingent on the CTV-05 colonization phenotype, which is in turn partially dependent on the success of BV clearance prior to LACTIN-V administration.
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Affiliation(s)
- Eric Armstrong
- Department of Medicine, University of Toronto, Toronto, Canada.
| | - Anke Hemmerling
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, USA
| | - Sanja Huibner
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Maria Kulikova
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Emily Crawford
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, USA
| | | | - Bryan Coburn
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
- Department of Medicine, University Health Network, Toronto, Canada
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, USA
| | - Rupert Kaul
- Department of Medicine, University of Toronto, Toronto, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
- Department of Medicine, University Health Network, Toronto, Canada
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Savicheva AM. Molecular Testing for the Diagnosis of Bacterial Vaginosis. Int J Mol Sci 2023; 25:449. [PMID: 38203620 PMCID: PMC10779368 DOI: 10.3390/ijms25010449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/23/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
Previously established diagnostic approaches for the diagnosis of bacterial vaginosis (BV), such as the Amsel criteria or the Nugent scoring system, do not always correspond to modern trends in understanding the etiology and pathogenesis of polymicrobial conditions. Inter-examiner variability and interpretation of data complicate the wet mount microscopy method. Gram staining of smears does not always provide reliable information regarding bacterial taxa, biofilms, or vaginal dysbiosis. Therefore, the introduction of molecular techniques into clinical practice is extremely relevant. Molecular approaches allow not only the diagnosis of BV but also provide an assessment of microbial composition, which is especially important in the differential diagnosis of vaginal infections. The current review represents an expert opinion on BV diagnosis and is based on extensive experience in the field of vaginal infection diagnosis and treatment.
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Affiliation(s)
- Alevtina M Savicheva
- D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, St. Petersburg 199034, Russia
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Armstrong E, Hemmerling A, Joag V, Huibner S, Kulikova M, Crawford E, Castañeda GR, Anzala O, Obila O, Shahabi K, Ravel J, Coburn B, Cohen CR, Kaul R. Treatment Success Following Standard Antibiotic Treatment for Bacterial Vaginosis Is Not Associated With Pretreatment Genital Immune or Microbial Parameters. Open Forum Infect Dis 2023; 10:ofad007. [PMID: 36726539 PMCID: PMC9887266 DOI: 10.1093/ofid/ofad007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Background Bacterial vaginosis (BV) is a proinflammatory genital condition associated with adverse reproductive health outcomes, including increased HIV incidence. However, BV recurrence rates are high after standard antibiotic treatment. While the composition of the vaginal microbiota before BV treatment may be linked to BV recurrence, it is unclear whether the preceding genital immune milieu is predictive of treatment success. Methods Here we assessed whether baseline vaginal soluble immune factors or the composition of the vaginal microbiota predicted treatment success 1 month after metronidazole treatment in 2 separate cohorts of women with BV, 1 in the United States and 1 in Kenya; samples within 48 hours of BV treatment were also available for the US cohort. Results Neither soluble immune factors nor the composition of the vaginal microbiota before BV treatment was associated with treatment response in either cohort. In the US cohort, although the absolute abundances of key vaginal bacterial taxa pretreatment were not associated with treatment response, participants with sustained BV clearance had a more pronounced reduction in the absolute abundance of Gardnerella vaginalis immediately after treatment. Conclusions Pretreatment immune and microbial parameters were not predictive of BV treatment success in these clinical cohorts.
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Affiliation(s)
- Eric Armstrong
- Correspondence: Eric Armstrong, BSc, 1 King’s College Circle, Room 6356 Toronto, ON, Canada M5S 1A8 (); or Rupert Kaul, MD, PhD, 1 King’s College Circle, Room 6356, Toronto, ON, Canada M5S 1A8 ()
| | - Anke Hemmerling
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Vineet Joag
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sanja Huibner
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maria Kulikova
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Emily Crawford
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA
| | | | - Omu Anzala
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Onyango Obila
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Kamnoosh Shahabi
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bryan Coburn
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada,Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Rupert Kaul
- Correspondence: Eric Armstrong, BSc, 1 King’s College Circle, Room 6356 Toronto, ON, Canada M5S 1A8 (); or Rupert Kaul, MD, PhD, 1 King’s College Circle, Room 6356, Toronto, ON, Canada M5S 1A8 ()
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Mouafo HT, Sokamte AT, Mbawala A, Ndjouenkeu R, Devappa S. Biosurfactants from lactic acid bacteria: A critical review on production, extraction, structural characterization and food application. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101598] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Armstrong E, Hemmerling A, Miller S, Burke KE, Newmann SJ, Morris SR, Reno H, Huibner S, Kulikova M, Liu R, Crawford ED, Castañeda GR, Nagelkerke N, Coburn B, Cohen CR, Kaul R. Metronidazole treatment rapidly reduces genital inflammation through effects on bacterial vaginosis-associated bacteria rather than lactobacilli. J Clin Invest 2022; 132:152930. [PMID: 35113809 PMCID: PMC8920324 DOI: 10.1172/jci152930] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/02/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Bacterial vaginosis (BV) causes genital inflammation and increases HIV risk, while a vaginal microbiota dominated by Lactobacillus species is associated with immune quiescence and relative HIV protection. BV treatment reduces genital inflammation, but it is unclear whether this is driven by a decrease in BV-associated bacteria or an increase in Lactobacillus. METHODS To evaluate the short-term impact of standard BV treatment on genital immunology and the vaginal microbiota, vaginal swabs were collected immediately before and after metronidazole treatment for BV and analyzed with multiplex ELISA, metagenomic sequencing, and quantitative polymerase chain reaction. RESULTS Topical metronidazole treatment rapidly reduced vaginal levels of proinflammatory cytokines, chemokines, and soluble immune markers of epithelial barrier disruption. Although the vaginal microbiota shifted to dominance by L. iners or L. jensenii, this proportional shift was primarily driven by a 2-4 log10 fold reduction in BV-associated bacteria absolute abundance; BV treatment induced no change in the absolute abundance of L. crispatus or L. iners, and only minor (<1 log10 fold) increases in L. gasseri and L. jensenii that were not independently associated with reduced inflammation in multivariable models. CONCLUSION The genital immune benefits that are associated with Lactobacillus dominance following BV treatment were not directly attributable to an absolute increase in lactobacilli, but rather to the loss of BV-associated bacteria.TRAIL REGISTRATION. Participants were recruited as part of a randomized controlled trial (NCT02766023) from 2016 to 2020. FUNDING Canadian Institutes of Health Research (PJT-156123) and the National Institute of Allergy and Infectious Diseases (HHSN2722013000141 and HHSN27200007).
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Affiliation(s)
| | - Anke Hemmerling
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, United States of America
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, United States of America
| | - Kerianne E Burke
- Ruth M. Rothstein CORE Centre, Stroger Hospital of Cook County Health, Chicago, United States of America
| | - Sara J Newmann
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, United States of America
| | - Sheldon R Morris
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, United States of America
| | - Hilary Reno
- Department of Medicine, Washington University, St. Louis, United States of America
| | - Sanja Huibner
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Maria Kulikova
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Rachel Liu
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Emily D Crawford
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, United States of America
| | - Gloria R Castañeda
- Infectious Diseases, Chan Zuckerberg Biohub, San Francisco, United States of America
| | - Nico Nagelkerke
- Centre for Global Health Research, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Bryan Coburn
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Craig R Cohen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, United States of America
| | - Rupert Kaul
- Department of Medicine, University of Toronto, Toronto, Canada
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Turner E, Sobel JD, Akins RA. Prognosis of recurrent bacterial vaginosis based on longitudinal changes in abundance of Lactobacillus and specific species of Gardnerella. PLoS One 2021; 16:e0256445. [PMID: 34424942 PMCID: PMC8382169 DOI: 10.1371/journal.pone.0256445] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/07/2021] [Indexed: 02/03/2023] Open
Abstract
Refractory responses to standard-of-care oral metronidazole among recurrent bacterial vaginosis (BV) patients is not rare, and recurrence within a year is common. A better understanding of the bacterial determinants of these outcomes is essential. In this study we ask whether changes in specific species of Gardnerella are associated with poor short or long term clinical outcomes, and if and how resurgence of Lactobacillus species affects these outcomes. We quantify Lactobacillus isolates as a proportion of total vaginal bacteria using the LbRC5 qPCR assay, and 5 prevalent species of Gardnerella using primers that target species-specific polymorphisms within the cpn60 gene. The study includes 43 BV patients: 18 refractory, 16 recurrent, and 11 remission patients, sampled daily for up to two weeks post-treatment; clinical outcomes were tracked for up to 9 months. Persistently high titers of Gardnerella Gsp07 were associated with refractory responses, and persistently low abundance of Gardnerella Gsp07 and G. swidsinskii / G. leopoldii were associated with remission. Lactobacillus species abundance rose in 4–14 days after initiation of treatment in most but not all recurrent and remission patients, although increases were more sustained among remission patients. The findings suggest that Gardnerella Gsp07 and G. swidsinskii / G. leopoldii are markers of poor clinical outcome or may directly or indirectly suppress recovery of Lactobacillus species, thereby interfering with clinical recovery. Therapies that target these strains may improve patient outcome.
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Affiliation(s)
- Essence Turner
- Department of Biochemistry, Microbiology, & Immunology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Jack D. Sobel
- Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Robert A. Akins
- Department of Biochemistry, Microbiology, & Immunology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- * E-mail:
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8
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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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9
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Mohammadi A, Bagherichimeh S, Perry MC, Fazel A, Tevlin E, Huibner S, Tharao W, Coburn B, Kaul R. The impact of cervical cytobrush sampling on cervico-vaginal immune parameters and microbiota relevant to HIV susceptibility. Sci Rep 2020; 10:8514. [PMID: 32444843 PMCID: PMC7244754 DOI: 10.1038/s41598-020-65544-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/06/2020] [Indexed: 01/01/2023] Open
Abstract
The immunology and microbiota of the female genital tract (FGT) are key determinants of HIV susceptibility. Cervical cytobrush sampling is a relatively non-invasive method permitting the longitudinal assessment of endocervical immune cells, but effects on FGT immunology are unknown. Blood, cervico-vaginal secretions and cervical cytobrushes were collected from sexually transmitted infection (STI)-free women at baseline and after either 6 hours or 48 hours. Endocervical immune cell subsets were assessed by flow cytometry, and pro-inflammatory cytokines by multiplex ELISA. The density of Lactobacillus species and key bacterial vaginosis-associated bacterial taxa were determined by qPCR. Paired changes were assessed before and after cytobrush sampling. After 6 hours there were significant increases in CD4 + T cell, antigen presenting cell (APC) and neutrophil numbers; APC elevations persisted at 48 hours, while neutrophil and CD4 + T cell numbers returned to baseline. In addition, pro-inflammatory cytokine levels were increased at 6 hours and returned to baseline by 48 hours. No significant changes were observed in the absolute abundance of Lactobacillus species or BV-associated bacteria at either time point. Overall, cytobrush sampling altered genital immune parameters at 6 hours, but only APC number increases persisted at 48 hours. This should be considered in longitudinal analyses of FGT immunology.
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Affiliation(s)
- A Mohammadi
- Department of Medicine, University of Toronto, Toronto, Canada.
| | - S Bagherichimeh
- Department of Medicine, University of Toronto, Toronto, Canada
| | - M C Perry
- Department of Immunology, University of Toronto, Toronto, Canada
| | - A Fazel
- Department of Medicine, University of Toronto, Toronto, Canada
| | - E Tevlin
- Women's Health in Women's Hands Community Health Center, Toronto, Canada
| | - S Huibner
- Department of Medicine, University of Toronto, Toronto, Canada
| | - W Tharao
- Women's Health in Women's Hands Community Health Center, Toronto, Canada
| | - B Coburn
- Department of Immunology, University of Toronto, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - R Kaul
- Department of Medicine, University of Toronto, Toronto, Canada. .,Department of Immunology, University of Toronto, Toronto, Canada.
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10
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Gandhi K, Gutierrez P, Garza J, Gray Wlazlo TJ, Meiser RJ, David S, Carrillo M, Narasimhan M, Galloway M, Ventolini G. Vaginal Lactobacillus species and inflammatory biomarkers in pregnancy. ACTA ACUST UNITED AC 2020; 72:299-309. [PMID: 32403915 DOI: 10.23736/s0026-4784.20.04566-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of this study was to identify vaginal Lactobacillus spp. and quantify vaginal inflammatory cytokines in primigravida vs. multigravida women and pregnant vs. non-pregnant women. METHODS Vaginal swabs were obtained from four groups of patients. A real-time PCR was carried out to identify the Lactobacillus spp. Multiplex immunoassays were performed to quantify a total of 27 cytokines using the Bio-Plex MAGPIX multiplex reader and MesoQuick Plex SQ 120 (Meso Scale Diagnostics LLC, Rockville, MD, USA). Inferential statistics using hypothesis tests were applied to detect differences in cytokine levels. RESULTS Significant differences in cytokines and chemokines exist among the four populations of women studied. IP-10 is significantly higher in multigravida women as compared to primigravida women. IFN-γ, MCP-1, MIP-1β, IL-2 and IL-10 are significantly higher in non-pregnant women compared to pregnant women. L. iners was the most abundant species in multigravida, pregnant and non-pregnant patients, while L. crispatus was the most abundant species in primigravida patients. Significant differences in the levels of MIP-1β, TNF-α, PDGF-BB, VEGF-A, IL-12, and IL-10 exist between women identified with Lactobacillus species and women not identified with Lactobacillus species. CONCLUSIONS There were significant differences regarding cytokines, chemokines, and Lactobacillus spp. among four groups of studied patients. With these results, we increase our understanding of the role that vaginal cytokines and Lactobacillus species have during pregnancy, with the goal that this novel research will be useful for examining vaginal biomarkers in obstetrical conditions.
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Affiliation(s)
- Kushal Gandhi
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA
| | - Paula Gutierrez
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA.,University of Texas Permian Basin (UTPB), Odessa, TX, USA
| | - John Garza
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA.,University of Texas Permian Basin (UTPB), Odessa, TX, USA
| | - Taylor J Gray Wlazlo
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA
| | - Rebecca J Meiser
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA
| | | | | | - Madhusudhanan Narasimhan
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX, USA
| | - Michael Galloway
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA
| | - Gary Ventolini
- School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) of the Permian Basin, Odessa, TX, USA -
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11
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Gaspar C, Palmeira-de-Oliveira R, Martinez-de-Oliveira J, Neves JD, Pestana PG, Rolo J, Donders G, Palmeira-de-Oliveira A. Development and validation of a new one step Multiplex-PCR assay for the detection of ten Lactobacillus species. Anaerobe 2019; 59:192-200. [PMID: 31207299 DOI: 10.1016/j.anaerobe.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/27/2019] [Accepted: 06/14/2019] [Indexed: 11/29/2022]
Abstract
Lactobacillus sp. are well-known colonizers of human mucosa and frequently used as probiotics. Accurate species identification is crucial both for fundamental studies and biotechnology applications; however, it has been thus far challenging. The aim of this work was to develop a one-step multiplex-PCR assay for detection of ten Lactobacillus species (L. jensenii, L. fermentum, L. acidophilus, L. crispatus, L. reuteri, L. iners, L. casei, L. gasseri, L. plantarum, L. rhamnosus) directly in complex bacterial genomic DNA. A multiplex-PCR assay was optimized based on Box-Behnken experimental design, which showed to be efficient for optimization of all crucial reaction components. Nineteen Lactobacillus strains, including six collection strains and thirteen human isolates were used in order to verify the specificity and sensitivity of the assay. In addition, a set of PCR adjuvants was introduced to remove non-specific amplifications and enhance reaction yield. Among them, Triton™ X-100, Tween® 20, BSA, and dithiothreitol showed beneficial effects when compared with other adjuvants. The application of the developed method to samples that resulted from the mixing of DNA from the ten strains, resulted in amplicons of the expected sizes (from about 100 to 1000 bp). The detection limit was 1.25 ng/μl for all species with the exception of L. gasseri (0.31 ng/μl). In order to confirm the method applicability on human samples, ten vaginal fluids were enrolled in this study showing that the method can be successfully used on these biological materials. The proposed multiplex-PCR assay was shown to be selective, sensitive and efficient for detection of ten Lactobacillus species directly in human vaginal samples. This method provides a cost-effective and accessible methodology applicable to the detection of Lactobacillus species to different environments. At the same time, this approach represents a considerable improvement over other PCR-based approaches for identification of these species.
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Affiliation(s)
- Carlos Gaspar
- CICS-UBI, Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Labfit - HPRD: Health Products Research and Development, Covilhã, Portugal.
| | - Rita Palmeira-de-Oliveira
- CICS-UBI, Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Labfit - HPRD: Health Products Research and Development, Covilhã, Portugal; Pharmacy Department, Centro Hospitalar Cova da Beira, Covilhã, Portugal
| | - José Martinez-de-Oliveira
- CICS-UBI, Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Women and Child Health Department, Centro Hospitalar Cova da Beira, Covilhã, Portugal
| | - José das Neves
- i3S - Instituto de Investigação e Inovação em Saúde & INEB - Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
| | - Paula G Pestana
- CICS-UBI, Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Pathology Department, Centro Hospitalar Cova da Beira, Covilhã, Portugal
| | - Joana Rolo
- CICS-UBI, Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Gilbert Donders
- Femicare Clinical Health for Women, Tienen, Belgium; University Hospital Antwerp, Antwerp, Belgium
| | - Ana Palmeira-de-Oliveira
- CICS-UBI, Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; Labfit - HPRD: Health Products Research and Development, Covilhã, Portugal
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12
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Vergaro P, Tiscornia G, Barragán M, García D, Rodriguez A, Santaló J, Vassena R. Vaginal microbiota profile at the time of embryo transfer does not affect live birth rate in IVF cycles with donated oocytes. Reprod Biomed Online 2019; 38:883-891. [DOI: 10.1016/j.rbmo.2018.12.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/26/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022]
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13
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Kurbakov KA, Konorov EA, Minaev MY, Kuznetsova OA. Multiplex Real-Time PCR with HRM for Detection of Lactobacillus sakei and Lactobacillus curvatus in Food Samples. Food Technol Biotechnol 2019; 57:97-104. [PMID: 31316281 PMCID: PMC6600297 DOI: 10.17113/ftb.57.01.19.5983] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Optimization of fermentation processes requires monitoring the species composition of starter cultures and their growth during fermentation. Most starter cultures contain closely related species. Nowadays, high-resolution melting (HRM) analysis is extensively used for multiplex identification of closely related species. In the present paper, we applied real-time polymerase chain reaction (PCR) with HRM analysis for the detection and differentiation of Lactobacillus sakei and L. curvatus. A primer pair was selected for the site of the rpoA gene of Lactobacillus spp. Eleven starter cultures and fifteen fermented sausages with a known bacterial composition were successfully tested using real-time PCR with HRM analysis with the developed primer pair.
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Affiliation(s)
- Konstantin A Kurbakov
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Talalikhina 26, 109316, Moscow, Russian Federation
| | - Evgenii A Konorov
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Talalikhina 26, 109316, Moscow, Russian Federation.,Vavilov Institute of General Genetics, Gubkina 3, 119333, Moscow, Russian Federation.,Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, Sechenov University, Malaya Pirogovskaya 20-1, 119435 Moscow, Russian Federation
| | - Mikhail Y Minaev
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Talalikhina 26, 109316, Moscow, Russian Federation
| | - Oksana A Kuznetsova
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Talalikhina 26, 109316, Moscow, Russian Federation
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14
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Highly efficient treatment of aerobic vaginitis with simple acidic buffered gels: The importance of pH and buffers on the microenvironment of vaginas. Int J Pharm 2017; 525:175-182. [DOI: 10.1016/j.ijpharm.2017.04.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/31/2017] [Accepted: 04/11/2017] [Indexed: 01/09/2023]
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15
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Demkin VV, Koshechkin SI. Characterization of vaginal Lactobacillus species by rplK -based multiplex qPCR in Russian women. Anaerobe 2017; 47:1-7. [PMID: 28315382 DOI: 10.1016/j.anaerobe.2017.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/27/2017] [Accepted: 03/08/2017] [Indexed: 11/25/2022]
Abstract
We describe a multiplex qPCR assay for identification and quantitative assessment of a set of vaginal Lactobacillus species, including L. acidophilus, L. crispatus, L. gasseri, L. helveticus, L. iners, and L. jensenii. The assay extends the previously developed qPCR method for Lactobacillus detection and total quantification based on targeting the rplK gene. Both assays use only single pair of primers and a set of probes combined in three reactions, comprising a vaginal Lactobacillus diagnostic assay panel. The utility of the diagnostic panel was evaluated by analyzing of vaginal swab specimens from 145 patients with different status of vaginal health. Most frequently, only one Lactobacillus species was dominant (68,9%), mostly L. crispatus (18,6%) or L. iners (33,1%), but two or three Lactobacillus species were also being simultaneously detected (24,9%). The diagnostic panel will facilitate investigations of the role of Lactobacillus species in the health of the female reproductive system and promote studies of variability of the vaginal microbiota.
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Affiliation(s)
- Vladimir V Demkin
- Laboratory of Molecular Diagnostics, Institute of Molecular Genetics, Russian Academy of Sciences, Kurchatov Sq. 2, Moscow 123182, Russia.
| | - Stanislav I Koshechkin
- Laboratory of Molecular Diagnostics, Institute of Molecular Genetics, Russian Academy of Sciences, Kurchatov Sq. 2, Moscow 123182, Russia
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16
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Ventolini G, Khandelwal N, Hutton K, Lugo J, Gygax SE, Schlabritz-Loutsevitch N. Obesity and recurrent vulvovaginal bacterial infections in women of reproductive age. Postgrad Med J 2017; 93:297. [PMID: 28057837 PMCID: PMC5520277 DOI: 10.1136/postgradmedj-2016-134638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Gary Ventolini
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
| | - Nuvneet Khandelwal
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
| | - Kathryn Hutton
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
| | - Jonathan Lugo
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
| | - Scott E Gygax
- Genesis Biotechnology Group, Femeris Women's Health Research Center, Hamilton, New Jersey, USA
| | - Natalia Schlabritz-Loutsevitch
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
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17
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Giampaoli S, DeVittori E, Valeriani F, Berti A, Romano Spica V. Informativeness of NGS Analysis for Vaginal Fluid Identification. J Forensic Sci 2016; 62:192-196. [PMID: 27907225 DOI: 10.1111/1556-4029.13222] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/08/2016] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
Abstract
The identification of vaginal fluids in forensic examinations plays an important role in crime scene reconstruction. Molecular detection of vaginal bacterial communities can lead to the correct discrimination of body fluids. These kinds of studies can be performed through multiplex real-time PCR using primers for a specific selection of bacteria. The availability of next-generation sequencing (NGS) protocols provided for the extension of the analysis to evaluate the prokaryotes present in specimens. In this study, DNA was extracted from 18 samples (vaginal, oral, fecal, yoghurt) and analyzed by real-time PCR and NGS. The comparison between the two approaches has demonstrated that the information developed through NGS can augment the more conventional real-time PCR detection of a few key bacterial species to provide a more probative result and the correct identification of vaginal fluid from samples that are more forensically challenged.
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Affiliation(s)
- Saverio Giampaoli
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome "Foro Italico", Piazza Lauro De Bosis, 6, 00135, Rome, Italy
| | - Elisabetta DeVittori
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome "Foro Italico", Piazza Lauro De Bosis, 6, 00135, Rome, Italy
| | - Federica Valeriani
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome "Foro Italico", Piazza Lauro De Bosis, 6, 00135, Rome, Italy
| | - Andrea Berti
- Reparto Investigazioni Scientifiche di Roma, Carabinieri, Viale di Tor di Quinto, 119, 00191, Rome, Italy
| | - Vincenzo Romano Spica
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome "Foro Italico", Piazza Lauro De Bosis, 6, 00135, Rome, Italy
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18
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Demkin VV, Koshechkin SI, Slesarev A. A novel real-time PCR assay for highly specific detection and quantification of vaginal lactobacilli. Mol Cell Probes 2016; 32:33-39. [PMID: 27890610 DOI: 10.1016/j.mcp.2016.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 01/06/2023]
Abstract
PCR detection and quantification of vaginal lactobacilli remains problematic because of the high level of genetic heterogeneity and taxonomic complexity within the genus Lactobacillus. The aim of the present study was to identify conserved sequences among the genomes of major species of vaginal lactobacilli that could be used for the development of a PCR-based method for quantitative determination of vaginal microbiota-specific lactobacilli. Comparative analysis of the genomes of several species of vaginal lactobacilli allowed us to identify conserved regions in the rplK gene, which encodes ribosomal protein L11, and to design group-specific PCR primers and a probe for selected species from the L. acidophilus complex, including major vaginal lactobacilli Lactobacillus crispatus, L. gasseri, L. iners and L. jensenii as well as other species that are less common in vaginal microbiota. The applicability of the new assay in routine diagnostic testing was evaluated using a set of clinical samples. The assay was able to detect and quantify vagina-associated lactobacilli within a wide range of initial DNA template concentrations, indicating promising potential for clinical applications.
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Affiliation(s)
- Vladimir V Demkin
- Laboratory of Molecular Diagnostics, Institute of Molecular Genetics, Russian Academy of Sciences, Moscow, Russia.
| | - Stanislav I Koshechkin
- Laboratory of Molecular Diagnostics, Institute of Molecular Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Alexei Slesarev
- Zylacta Corporation, 7965 Cessna Avenue, Gaithersburg, MD 20879, USA; Winogradsky Institute of Microbiology, Russian Academy of Sciences, Moscow, Russia
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19
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Hilbert DW, Smith WL, Paulish-Miller TE, Chadwick SG, Toner G, Mordechai E, Adelson ME, Sobel JD, Gygax SE. Utilization of molecular methods to identify prognostic markers for recurrent bacterial vaginosis. Diagn Microbiol Infect Dis 2016; 86:231-42. [PMID: 27431434 DOI: 10.1016/j.diagmicrobio.2016.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/27/2016] [Accepted: 07/03/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recurrent bacterial vaginosis (BV) after antimicrobial therapy is a major problem, affecting >50% of patients within 1 year. The objective of this study was to determine if prospective identification of patients at risk for recurrence using molecular methods is feasible. METHODS Women were evaluated for BV by Amsel criteria and Nugent score. Vaginal specimens were analyzed using a panel of quantitative real-time polymerase chain reactions (qPCRs) at three times: pre-treatment, 7-10days post-treatment and 40-45days post-treatment. The PCRs quantified DNA of the following organisms: Gardnerella vaginalis; Atopobium vaginae; Bacterial Vaginosis-Associated Bacteria-1 (BVAB1), -2 (BVAB2) and -3 (BVAB3); Leptotrichia/Sneathia; Megasphaera Phylotypes 1 and 2; and Lactobacillus spp. (L. crispatus, L. gasseri, L. iners and L. jensenii). RESULTS Out of 84 women diagnosed with BV (Amsel ≥3 and Nugent ≥4), 77 (91.7%) were successfully treated after 7-10days (asymptomatic and Amsel of either 0 or 1 with elevated vaginal pH and Nugent ≤6). Of these 77 women, 46 (59.7%) remained cured after 40-45days and 31 (40.3%) developed recurrent BV. In univariate analysis, we found that women who would have recurrent BV during the study had greater concentrations of Megasphaera Phylotype 2 (P=0.001) and BVAB2 (P=0.015) at initial diagnosis and greater vaginal pH (P=0.030), higher Nugent score (P=0.043) and a greater concentration of G. vaginalis (P=0.012) post-treatment, when compared to women who were cured during the study. These differences largely remained when cure was defined as Nugent ≤3 or when only women treated with intravaginal metronidazole were evaluated. CONCLUSION Molecular analysis of BV is a useful adjunct to clinical and microscopic analysis to prospectively identify patients at high risk for recurrent BV.
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Affiliation(s)
- David W Hilbert
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA.
| | - William L Smith
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
| | - Teresa E Paulish-Miller
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
| | - Sean G Chadwick
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
| | - Geoffrey Toner
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
| | - Eli Mordechai
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
| | - Martin E Adelson
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
| | - Jack D Sobel
- Division of Infectious Diseases, Wayne State University School of Medicine, 540 E. Canfield St., Detroit, MI, USA
| | - Scott E Gygax
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Member of Genesis Biotechnology Group, 2439 Kuser Rd., Hamilton, NJ, USA
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20
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Schlabritz-Loutsevitch N, Gygax SE, Dick E, Smith WL, Snider C, Hubbard G, Ventolini G. Vaginal Dysbiosis from an Evolutionary Perspective. Sci Rep 2016; 6:26817. [PMID: 27226349 PMCID: PMC4880931 DOI: 10.1038/srep26817] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/09/2016] [Indexed: 12/11/2022] Open
Abstract
Evolutionary approaches are powerful tools for understanding human disorders. The composition of vaginal microbiome is important for reproductive success and has not yet been characterized in the contexts of social structure and vaginal pathology in non-human primates (NHPs). We investigated vaginal size, vulvovaginal pathology and the presence of the main human subtypes of Lactobacillus spp./ BV-related species in the vaginal microflora of baboons (Papio spp.). We performed morphometric measurements of external and internal genitalia (group I, n = 47), analyzed pathology records of animals from 1999–2015 (group II, n = 64 from a total of 12,776), and evaluated vaginal swabs using polymerase chain reaction (PCR) (group III, n = 14). A total of 68 lesions were identified in 64 baboons. Lactobacillus iners, Gardnerella vaginalis, Atopobium vaginae, Megasphaera I, and Megasphaera II were not detected. L. jensenii, L. crispatus, and L. gasseri were detected in 2/14 (14.2%), 1/14 (7.1%), and 1/14 (7.1%) samples, respectively. BVAB2 was detected in 5/14 (35.7%) samples. The differences in the vaginal milieu between NHP and humans might be the factor associated with human-specific pattern of placental development and should be taken in consideration in NHP models of human pharmacology and microbiology.
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Affiliation(s)
| | - Scott E Gygax
- Femeris Women's Health Research Center, Genesis Biotechnology Group - Hamilton, New Jersey, USA
| | - Edward Dick
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - William L Smith
- Femeris Women's Health Research Center, Genesis Biotechnology Group - Hamilton, New Jersey, USA
| | - Cathy Snider
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - Gene Hubbard
- University of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Gary Ventolini
- Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, USA
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21
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Hilbert DW, Smith WL, Chadwick SG, Toner G, Mordechai E, Adelson ME, Aguin TJ, Sobel JD, Gygax SE. Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis. J Clin Microbiol 2016; 54:1017-24. [PMID: 26818677 PMCID: PMC4809904 DOI: 10.1128/jcm.03104-15] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/22/2016] [Indexed: 11/20/2022] Open
Abstract
Bacterial vaginosis (BV) is the most common gynecological infection in the United States. Diagnosis based on Amsel's criteria can be challenging and can be aided by laboratory-based testing. A standard method for diagnosis in research studies is enumeration of bacterial morphotypes of a Gram-stained vaginal smear (i.e., Nugent scoring). However, this technique is subjective, requires specialized training, and is not widely available. Therefore, a highly accurate molecular assay for the diagnosis of BV would be of great utility. We analyzed 385 vaginal specimens collected prospectively from subjects who were evaluated for BV by clinical signs and Nugent scoring. We analyzed quantitative real-time PCR (qPCR) assays on DNA extracted from these specimens to quantify nine organisms associated with vaginal health or disease:Gardnerella vaginalis,Atopobium vaginae, BV-associated bacteria 2 (BVAB2, an uncultured member of the orderClostridiales),Megasphaeraphylotype 1 or 2,Lactobacillus iners,Lactobacillus crispatus,Lactobacillus gasseri, andLactobacillus jensenii We generated a logistic regression model that identifiedG. vaginalis,A. vaginae, andMegasphaeraphylotypes 1 and 2 as the organisms for which quantification provided the most accurate diagnosis of symptomatic BV, as defined by Amsel's criteria and Nugent scoring, with 92% sensitivity, 95% specificity, 94% positive predictive value, and 94% negative predictive value. The inclusion ofLactobacillusspp. did not contribute sufficiently to the quantitative model for symptomatic BV detection. This molecular assay is a highly accurate laboratory tool to assist in the diagnosis of symptomatic BV.
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Affiliation(s)
- David W Hilbert
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
| | - William L Smith
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
| | - Sean G Chadwick
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
| | - Geoffrey Toner
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
| | - Eli Mordechai
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
| | - Martin E Adelson
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
| | - Tina J Aguin
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jack D Sobel
- Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Scott E Gygax
- Femeris Women's Health Research Center, Medical Diagnostic Laboratories, a member of Genesis Biotechnology group, Hamilton, New Jersey, USA
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22
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Anderson AC, Sanunu M, Schneider C, Clad A, Karygianni L, Hellwig E, Al-Ahmad A. Rapid species-level identification of vaginal and oral lactobacilli using MALDI-TOF MS analysis and 16S rDNA sequencing. BMC Microbiol 2014; 14:312. [PMID: 25495549 PMCID: PMC4272787 DOI: 10.1186/s12866-014-0312-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 11/25/2014] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Lactobacillus represents a large genus with different implications for the human host. Specific lactobacilli are considered to maintain vaginal health and to protect from urogenital infection. The presence of Lactobacillus species in carious lesions on the other hand is associated with progressive caries. Despite their clinical significance, species-level identification of lactobacilli still poses difficulties and mostly involves a combination of different phenotypic and genotypic methods. This study evaluated rapid MALDI-TOF MS analysis of vaginal and oral Lactobacillus isolates in comparison to 16S rDNA analysis. RESULTS Both methods were used to analyze 77 vaginal and 21 oral Lactobacillus isolates. The concordance of both methods was at 96% with five samples discordantly identified. Fifteen different Lactobacillus species were found in the vaginal samples, primarily L. iners, L. crispatus, L. jensenii and L. gasseri. In the oral samples 11 different species were identified, mostly L. salivarius, L. gasseri, L. rhamnosus and L. paracasei. Overall, the species found belonged to six different phylogenetic groups. For several samples, MALDI-TOF MS analysis only yielded scores indicating genus-level identification. However, in most cases the species found agreed with the 16S rDNA analysis result. CONCLUSION MALDI-TOF MS analysis proved to be a reliable and fast tool to identify lactobacilli to the species level. Even though some results were ambiguous while 16S rDNA sequencing yielded confident species identification, accuracy can be improved by extending reference databases. Thus, mass spectra analysis provides a suitable method to facilitate monitoring clinically relevant Lactobacillus species.
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Affiliation(s)
- Annette Carola Anderson
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Hugstetter Strasse 55, Freiburg, Germany.
| | - Mohamed Sanunu
- Department of Hygiene and Microbiology, Albert-Ludwigs-University, Hermann-Herder-Str. 11, Freiburg, Germany.
| | - Christian Schneider
- Department of Hygiene and Microbiology, Albert-Ludwigs-University, Hermann-Herder-Str. 11, Freiburg, Germany.
| | - Andreas Clad
- Department for Gynaecology, Medical Center, Albert-Ludwigs-University, Hugstetter Strasse 55, Freiburg, Germany.
| | - Lamprini Karygianni
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Hugstetter Strasse 55, Freiburg, Germany.
| | - Elmar Hellwig
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Hugstetter Strasse 55, Freiburg, Germany.
| | - Ali Al-Ahmad
- Department of Operative Dentistry and Periodontology, Albert-Ludwigs-University, Hugstetter Strasse 55, Freiburg, Germany.
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23
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Cervical and vaginal flora specimens are highly concordant with respect to bacterial vaginosis-associated organisms and commensal Lactobacillus species in women of reproductive age. J Clin Microbiol 2014; 52:3078-81. [PMID: 24899020 DOI: 10.1128/jcm.00795-14] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Matched vaginal and cervical specimens from 96 subjects were analyzed by quantitative PCR for the presence and concentration of bacterial vaginosis-associated microbes and commensal Lactobacillus spp. Detection of these microbes was 92% concordant, indicating that microbial floras at these body sites are generally similar.
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Donnarumma G, Molinaro A, Cimini D, De Castro C, Valli V, De Gregorio V, De Rosa M, Schiraldi C. Lactobacillus crispatus L1: high cell density cultivation and exopolysaccharide structure characterization to highlight potentially beneficial effects against vaginal pathogens. BMC Microbiol 2014; 14:137. [PMID: 24884965 PMCID: PMC4054921 DOI: 10.1186/1471-2180-14-137] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/21/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Vaginal lactic acid bacteria defend the host against pathogens through a combination of competitive exclusion, competition for nutrients, production of antimicrobial substances and through the activation of the immune system. A new human isolate named Lactobacillus crispatus L1 was characterized in this work, and a preliminary evaluation of its probiotic potential is described together with a process to obtain a high productivity of viable biomass. RESULTS In a simulated digestion process 1.8⋅10(10) cells∙ml(-1) survived the gastric environment with 80% viability, without being affected by small intestine juices. Experiments on six different C sources were performed to analyze growth and organic acids production and, glucose, provided the best performances. A microfiltration strategy was exploited to improve the cellular yield in 2 L-fermentation processes, reaching 27 g · l(-1) of dry biomass. Moreover, L. crispatus L1 demonstrated a greater stability to high concentrations of lactic acid, compared to other lactobacilli. The specific L. crispatus L1 exopolysaccharide was purified from the fermentation broth and characterized by NMR showing structural features and similarity to exopolysaccharides produced by pathogenic strains. Live L. crispatus L1 cells strongly reduced adhesion of a yeast pathogenic strain, Candida albicans in particular, in adherence assays. Interestingly a higher expression of the human defensin HBD-2 was also observed in vaginal cells treated with the purified exopolysaccharide, indicating a possible correlation with C. albicans growth inhibition. CONCLUSIONS The paper describes the evaluation of L. crispatus L1 as potential vaginal probiotic and the fermentation processes to obtain high concentrations of viable cells.
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Affiliation(s)
| | | | | | | | | | | | | | - Chiara Schiraldi
- Department of Experimental Medicine, Section of Biotechnology and Molecular Biology, Second University of Naples, via De Crecchio n°7, Naples 80138, Italy.
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