1
|
Li H, Han M, Xu J, Li N, Cui H. The vaginal microbial signatures of preterm birth woman. BMC Pregnancy Childbirth 2024; 24:428. [PMID: 38877389 PMCID: PMC11177453 DOI: 10.1186/s12884-024-06573-1] [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: 09/01/2023] [Accepted: 05/10/2024] [Indexed: 06/16/2024] Open
Abstract
To explore the differences of vaginal microbes in women with preterm birth (PTB), and to construct prediction model. We searched for articles related to vaginal microbiology in preterm women and obtained four 16S rRNA-sequence datasets. We analyzed that for species diversity and differences, and constructed a random forest model with 20 differential genera. We introduce an independent whole genome-sequencing (WGS) data for validation. In addition, we collected vaginal and cervical swabs from 33 pregnant women who delivered spontaneously full-term and preterm infants, performed WGS in our lab to further validate the model. Compared to term birth (TB) samples, PTB women vagina were characterized by a decrease in Firmicutes, Lactobacillus, and an increase in diversity accompanied by the colonization of pathogenic bacteria such as Gardnerella, Atopobium and Prevotella. Twenty genus markers, including Lactobacillus, Prevotella, Streptococcus, and Gardnerella performed well in predicting PTB, with study-to-study transfer validation and LODO validation, different gestation validation showing good results, and in two independent cohorts (external WGS cohorts and woman samples WGS cohorts) in which the accuracy was maintained. PTB women have unique vaginal microbiota characteristics. A predictive model of PTB was constructed and its value validated from multiple perspectives.
Collapse
Affiliation(s)
- Huan Li
- Department of Obstetrics and Gynecology, Research Center, Shengjing Hospital of China Medical University, China Medical University Birth Cohort, Shenyang, 110004, China
| | - Mengzhen Han
- Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, China
| | - Junnan Xu
- Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, China
| | - Na Li
- Department of Obstetrics and Gynecology, Research Center, Shengjing Hospital of China Medical University, China Medical University Birth Cohort, Shenyang, 110004, China.
| | - Hong Cui
- Department of Obstetrics and Gynecology, Research Center, Shengjing Hospital of China Medical University, China Medical University Birth Cohort, Shenyang, 110004, China.
| |
Collapse
|
2
|
Zhou Q, Yu Y, Zhou J, Liu J, Gao J. Relationship of Lactobacillus Vaginal Microbiota Changes and the Risk of Preterm Birth: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2024; 33:228-238. [PMID: 38064523 DOI: 10.1089/jwh.2023.0393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
Objective: With a global incidence of more than 10%, preterm birth (PTB) remains a significant concern. The vaginal microbiome strongly influences the well-being of the female reproductive tract. This study examines the correlation between changes in Lactobacillus vaginal microbiota and the PTB risk. Materials and Methods: A thorough search of PubMed, Web of Science, Cochrane Library, and EMBASE was conducted to locate studies that examined the association between changes in Lactobacillus vaginal microbiota and the risk of PTB from January 1, 2010, to January 30, 2023. The risk of PTB was determined by calculating odds ratios (ORs) with 95% confidence intervals (CIs). Results: In our analysis, there were 11 studies with 1577 pregnant women. The findings revealed a significant negative correlation between higher Lactobacillus abundance and the PTB risk (OR = 0.49, 95% CI: 0.29-0.84, p = 0.009 < 0.05). Similarly, the four individual dominant species, Lactobacillus crispatus (OR = 0.3, 95% CI: 0.14-0.67, p = 0.003 < 0.05), Lactobacillus gasseri (OR = 0.34, 95% CI: 0.17-0.69, p = 0.003 < 0.05), Lactobacillus iners (OR = 0.68, 95% CI: 0.49-0.93, p = 0.016 < 0.05), and Lactobacillus jensenii (OR = 0.43, 95% CI: 0.21-0.89, p = 0.024 < 0.05), were also negatively associated with the PTB risk. The risk of Lactobacillus for PTB was significant in both America (OR = 0.67; 95% CI: 0.50-0.92) and Asia (OR = 0.20; 95% CI: 0.09-0.47), whereas no significant risk was found in Europe (OR = 0.49; 95% CI: 0.11-2.15). Conclusions: Our study demonstrated that the abundance of Lactobacillus and the four dominant individual species (L. crispatus, L. jensenii, L. iners, and L. gasseri) were significantly and negatively associated with the PTB risk.
Collapse
Affiliation(s)
- Qian Zhou
- Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Yi Yu
- Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Jingwen Zhou
- Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Juntao Liu
- Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| | - Jinsong Gao
- Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
| |
Collapse
|
3
|
Ansari A, You YA, Lee G, Kim SM, Park SW, Hur YM, Kim YJ. Dysbiotic Vaginal Microbiota Induces Preterm Birth Cascade via Pathogenic Molecules in the Vagina. Metabolites 2024; 14:45. [PMID: 38248848 PMCID: PMC10821287 DOI: 10.3390/metabo14010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Dysbiotic vaginal microbiota (DVM) disturb the vaginal environment, including pH, metabolite, protein, and cytokine profiles. This study investigated the impact of DVM on the vaginal environment in 40 Korean pregnant women and identified predictable biomarkers of birth outcomes. Cervicovaginal fluid (CVF) samples were collected in the third trimester using vaginal swabs, examined for pH, and stored at -80 °C for further analysis. The samples were grouped as full-term (FTB, n = 20) and preterm (PTB, n = 20) births. The microbiota was profiled in the V1-V9 regions. The levels of targeted metabolites, TLR-4, and cytokines were determined. The pH of CVF from PTB (>4.5) was significantly higher than that of the CVF from FTB (>3.5) (p < 0.05). Neonatal gestational age at delivery, birth weight, and Apgar score differed significantly between groups. The relative abundances of beneficial Lactobacillus spp., such as Lactobacillus gasseri, Lactobacillus jensenii, and Bifidobacterium, were higher in FTB, whereas those of pathogenic Enterococcus faecalis, Staphylococcus, Prevotella, Ureaplasma parvum, and Corynebacterium spp. were higher in PTB. Acetate, methanol, TLR-4, and TNF-α levels were negatively correlated with gestational age at delivery and birth weight. Moreover, ethanol, methanol, TLR-4, IL-6, IL-1β, and TNF-α levels were positively correlated with succinate, acetate, acetoacetate, formate, and ammonia. Overall, DVM induces preterm birth via pathogenic molecules in the vagina.
Collapse
Affiliation(s)
- AbuZar Ansari
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07984, Republic of Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
| | - Gain Lee
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07984, Republic of Korea
| | - Soo Min Kim
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07984, Republic of Korea
| | - Sun Wha Park
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
| | - Young Min Hur
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
| | - Young Ju Kim
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, Ewha Womans University, Seoul 07985, Republic of Korea; (Y.-A.Y.); (G.L.); (S.M.K.); (S.W.P.); (Y.M.H.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07984, Republic of Korea
| |
Collapse
|
4
|
Fusco V, Chieffi D, Fanelli F, Montemurro M, Rizzello CG, Franz CMAP. The Weissella and Periweissella genera: up-to-date taxonomy, ecology, safety, biotechnological, and probiotic potential. Front Microbiol 2023; 14:1289937. [PMID: 38169702 PMCID: PMC10758620 DOI: 10.3389/fmicb.2023.1289937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/14/2023] [Indexed: 01/05/2024] Open
Abstract
Bacteria belonging to the genera Weissella and Periweissella are lactic acid bacteria, which emerged in the last decades for their probiotic and biotechnological potential. In 2015, an article reviewing the scientific literature till that date on the taxonomy, ecology, and biotechnological potential of the Weissella genus was published. Since then, the number of studies on this genus has increased enormously, several novel species have been discovered, the taxonomy of the genus underwent changes and new insights into the safety, and biotechnological and probiotic potential of weissellas and periweissellas could be gained. Here, we provide an updated overview (from 2015 until today) of the taxonomy, ecology, safety, biotechnological, and probiotic potential of these lactic acid bacteria.
Collapse
Affiliation(s)
- Vincenzina Fusco
- National Research Council, Institute of Sciences of Food Production (CNR-ISPA), Bari, Italy
| | - Daniele Chieffi
- National Research Council, Institute of Sciences of Food Production (CNR-ISPA), Bari, Italy
| | - Francesca Fanelli
- National Research Council, Institute of Sciences of Food Production (CNR-ISPA), Bari, Italy
| | - Marco Montemurro
- National Research Council, Institute of Sciences of Food Production (CNR-ISPA), Bari, Italy
| | | | | |
Collapse
|
5
|
Jabri H, Krings S, Fall PA, Baurain D, Daube G, Taminiau B. Microbiota Profiling on Veterinary Faculty Restroom Surfaces and Source Tracking. Microorganisms 2023; 11:2053. [PMID: 37630613 PMCID: PMC10459056 DOI: 10.3390/microorganisms11082053] [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: 07/10/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
In this study, we aimed to develop a comprehensive microbial source amplicon database tailored for source tracking in veterinary settings. We rigorously tested our locally curated source tracking database by selecting a frequently accessed environment by veterinary students and veterinarians. By exploring the composition of resident microbiota and identifying potential sources of contamination, including animals, the environment, and human beings, we aimed to provide valuable insights into the dynamics of microbial transmission within veterinary facilities. The 16S rDNA amplicon sequencing was used to determine the bacterial taxonomic profiles of restroom surfaces. Bacterial sources were identified by linking our metadata-enriched local database to the microbiota profiling analysis using high-quality sequences. Microbiota profiling shows the dominance of four phyla: Actinobacteria, Bacteroidetes, Proteobacteria, and Firmicutes. If the restroom cleaning process did not appear to impact microbiota composition, significant differences regarding bacterial distribution were observed between male and female users in different sampling campaigns. Combining 16S rDNA profiling to our specific sources labeling pipeline, we found aquatic and human sources were the primary environment keywords in our campaigns. The probable presence of known animal sources (bovids, insects, equids, suids…) associated with bacterial genera such as Chryseobacterium, Bergeyella, Fibrobacter, and Syntrophococcus was also involved in restroom surfaces, emphasizing the proximity between these restrooms and the exchange of bacteria between people involved in animals handling. To summarize, we have demonstrated that DNA sequence-based source tracking may be integrated with high-throughput bacterial community analysis to enrich microbial investigation of potential bacterial contamination sources, especially for little known or poorly identified taxa. However, more research is needed to determine the tool's utility in other applications.
Collapse
Affiliation(s)
- Hiba Jabri
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health Center (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, B42, Avenue de Cureghem 10, 4000 Liège, Belgium; (H.J.); (G.D.)
| | - Simone Krings
- Department of Microbial Sciences, School of Biosciences, Faculty of Health and Medical Sciences, Univesity of Surrey, Guildford GU2 7XH, UK;
| | - Papa Abdoulaye Fall
- FoodChainID GENOMICS, Laboratory Manager NGS, Rue Hayeneux, 62, 4040 Herstal, Belgium;
| | - Denis Baurain
- Eukaryotic Phylogenomics, InBioS-PhytoSYSTEMS, University of Liège, 4000 Liège, Belgium;
| | - Georges Daube
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health Center (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, B42, Avenue de Cureghem 10, 4000 Liège, Belgium; (H.J.); (G.D.)
| | - Bernard Taminiau
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health Center (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2, B42, Avenue de Cureghem 10, 4000 Liège, Belgium; (H.J.); (G.D.)
| |
Collapse
|
6
|
Liu X, Si S, Huang L, Zhang M, Chen W, Wang L, Yu Y. Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes: a nested case-control study from China. BMC Pregnancy Childbirth 2023; 23:244. [PMID: 37046188 PMCID: PMC10091657 DOI: 10.1186/s12884-023-05564-y] [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: 12/13/2021] [Accepted: 03/31/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The findings of the association of vaginal flora with preterm birth (PTB) or prelabor rupture of membranes (PROM) were conflicts. Moreover, vaginal flora was different by ethnicity and the evidence from China was limited. METHODS This study was a nested case control study, based on Yiwu birth cohort. We assessed vaginal microbiota in the second or third trimester, using 16S rDNA Amplicon Sequencing and explored the association between the diversity and composition of vaginal flora and PTB or PROM. RESULTS We finally included 144 pregnant women. In present study, the alpha diversity of TPROM (Term prelabor rupture of membranes) samples was lower than that of full term samples (Chao1 index: P < 0.05). When we further categorized PTB (Preterm birth) into SPB (PTB without PROM) and PPROM (Preterm prelabor rupture of membranes), there was no difference between SPB and full term. In addition, we found that the proportion of PCoA2 in TPROM group was different from that in full term group and preterm group. The difference between groups was significant according to anosim analysis (R = 0.059, P < 0.001). With LEfSe (Linear discriminant analysis Effect Size) analysis, we found that the abundance of Lactobacillus in the vaginal flora of pregnant women with preterm birth was the highest (P = 0.003). CONCLUSION In Chinese pregnant women, the alpha diversity in TPROM group was significantly lower than that in both PTB and full term group. However, there was no difference between PTB and full term. Lactobacillus was the most abundant in preterm birth group. More studies should be conducted to confirm our findings.
Collapse
Affiliation(s)
- Xiaomei Liu
- Department of Gynecology and Obstetrics, Yiwu Maternal and Children Hospital, Yiwu, China
- Department of Science and Education, Yiwu Maternal and Children Hospital, Yiwu, China
| | - Shuting Si
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Li Huang
- Department of Gynecology and Obstetrics, Yiwu Maternal and Children Hospital, Yiwu, China
| | - Meiliang Zhang
- Department of Gynecology and Obstetrics, Yiwu Maternal and Children Hospital, Yiwu, China
| | - Wenya Chen
- Department of Science and Education, Yiwu Maternal and Children Hospital, Yiwu, China
| | - Liquan Wang
- Department of Obstetrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.
- Department of Public Health, and Department of Anesthesiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| |
Collapse
|
7
|
Park SH, Lee ES, Park ST, Jeong SY, Yun Y, Kim Y, Jeong Y, Kang CH, Choi HJ. Efficacy and Safety of MED-01 Probiotics on Vaginal Health: A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Nutrients 2023; 15:nu15020331. [PMID: 36678202 PMCID: PMC9863863 DOI: 10.3390/nu15020331] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
Bacterial vaginosis (BV) is the most common disease in women of childbearing age and is caused by the growth of abnormal microbiota in the vagina. Probiotic consumption can be an effective alternative treatment to preserve or improve vaginal health. In the present study, MED-01, a complex of five strains of probiotic candidates isolated from the vagina of Korean women, was used. This study was designed as a 12-week, randomized, multicenter, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of MED-01 on vaginal health. A total of 101 reproductive-aged women with a Nugent score of 4-6 took MED-01 (5.0 × 109 CFU) or a placebo once a day, and 76 participants completed the procedure. MED-01 significantly reduced the Nugent score compared with the placebo. Quantitative PCR analysis confirmed that Lactobacillus plantarum was significantly increased in the vagina, whereas harmful bacteria such as Mobiluncus spp., Gardnerella vaginalis, and Atopobium vaginae were suppressed after 12 weeks of MED-01 ingestion. No adverse events to the test food supplements were observed in the participants. These results confirmed that MED-01 can be used as a probiotic for treating BV, as it improves the vaginal microbiota.
Collapse
Affiliation(s)
- Sung-Ho Park
- Hallym University Kangnam Sacred Heart Hospital, 665 Siheung-daero, Yeongdeungpo-gu, Seoul 07442, Republic of Korea
| | - Eun Sil Lee
- Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Sung Taek Park
- Hallym University Kangnam Sacred Heart Hospital, 665 Siheung-daero, Yeongdeungpo-gu, Seoul 07442, Republic of Korea
| | - Soo Young Jeong
- Hallym University Kangnam Sacred Heart Hospital, 665 Siheung-daero, Yeongdeungpo-gu, Seoul 07442, Republic of Korea
| | - Yeoul Yun
- Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - YongGyeong Kim
- Mediogen, Co., Ltd., Biovalley 1-ro, Jecheon-si 27159, Chungcheongbuk-do, Republic of Korea
| | - Yulah Jeong
- Mediogen, Co., Ltd., Biovalley 1-ro, Jecheon-si 27159, Chungcheongbuk-do, Republic of Korea
| | - Chang-Ho Kang
- Mediogen, Co., Ltd., Biovalley 1-ro, Jecheon-si 27159, Chungcheongbuk-do, Republic of Korea
| | - Hyun Jin Choi
- Department of Obstetrics and Gynecology, College of Medicine Chung-Ang University, Chung-Ang University Gwangmyeong Hospital, 501 Iljik-dong, Gwangmyeong-si 14353, Gyeonggi-do, Republic of Korea
- Correspondence:
| |
Collapse
|
8
|
Odogwu NM. Role of short interpregnancy interval, birth mode, birth practices, and the postpartum vaginal microbiome in preterm birth. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 4:1082199. [PMID: 36685092 PMCID: PMC9845938 DOI: 10.3389/frph.2022.1082199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023] Open
Abstract
There have been widely documented beneficial role of vaginal Lactobacillus species as an important biomarker for vaginal health and healthy pregnancy progression. When translating this to clinical settings, pregnant women with low proportions of Lactobacillus and commensurately high proportion of rich and highly diverse abnormal microbiota are most likely to encounter negative pregnancy outcome such as preterm birth and postpartum complications. However, multiple literatures have also addressed this notion that the absence of a Lactobacillus-dominated microbiota does not appear to directly imply to a diseased condition and may not be a major determinant of negative obstetric outcome. Caesarian delivery is notably a risk factor for preterm birth and postpartum endometritis, yet recent data shows a trend in the overuse of CS across several populations. Growing evidence suggest the potential role of vaginal/uterine cleaning practice during CS procedures in influencing postpartum infections, however there is a controversy that this practice is associated with increased rates of postpartum endometritis. The preponderance of bacterial vaginosis associated bacteria vagitype at postpartum which persist for a long period of time even after lochia regression in some women may suggest why short interpregnancy interval may pose a potential risk for preterm birth, especially multigravidas. While specifically linking a community of microbes in the female reproductive tract or an exact causative infectious agent to preterm birth and postpartum pathologies remains elusive, clinical attention should also be drawn to the potential contribution of other factors such as short interpregnancy interval, birth mode, birth practices and the postpartum vaginal microbiome in preterm birth which is explicitly described in this narrative review.
Collapse
Affiliation(s)
- Nkechi Martina Odogwu
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States,School of Public Health, University of Minnesota, Minneapolis, MN, United States,Correspondence: Nkechi Martina Odogwu ,
| |
Collapse
|
9
|
You YA, Park S, Kim K, Kwon EJ, Hur YM, Kim SM, Lee G, Ansari A, Park J, Kim YJ. Transition in vaginal Lactobacillus species during pregnancy and prediction of preterm birth in Korean women. Sci Rep 2022; 12:22303. [PMID: 36566290 PMCID: PMC9789976 DOI: 10.1038/s41598-022-26058-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/08/2022] [Indexed: 12/25/2022] Open
Abstract
The predominance of vaginal Lactobacillus species, specifically L. crispatus, is important for pregnancy maintenance, but varies by race. The composition of the vaginal microbiome can affect susceptibility to adverse pregnancy outcomes. We performed 16S rRNA gene amplicon sequencing on vaginal swabs taken from Korean pregnant women. Here, we report the transition of Lactobacillus spp. in samples of full-term birth (FTB) collected longitudinally in the second and third trimesters of pregnancy in a cohort study (n = 23) and their association with Lactobacillus abundance and preterm birth (PTB) in a case-control study (n = 200). Lactobacillus species, which was dominant in FTB samples including those that received interventions in the second trimester, did not change until 37 weeks of gestation. However, L. crispatus was replaced by other Lactobacillus species after 37 weeks. The PTB risk showed a closer association with the Lactobacillus abundance than with community state type determined by Lactobacillus species. PTB was associated with less than 90% of Lactobacillus abundance and an increase in Ureplasma parvum in the second trimester. Thus, the vaginal microbiome may change in preparation for childbirth in response to multiple intrinsic factors after 37 weeks of gestation. Monitoring the Lactobacillus abundance may help improve the reliability of microbial PTB biomarkers.
Collapse
Affiliation(s)
- Young-Ah You
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea
| | - Sunwha Park
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea ,grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Womans University Mok Dong Hospital, Seoul, 158-051 South Korea
| | | | - Eun Jin Kwon
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea
| | - Young Min Hur
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea ,grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Womans University Mok Dong Hospital, Seoul, 158-051 South Korea
| | - Soo Min Kim
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea ,grid.255649.90000 0001 2171 7754Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Gain Lee
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea ,grid.255649.90000 0001 2171 7754Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - AbuZar Ansari
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea ,grid.255649.90000 0001 2171 7754Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | | | - Young Ju Kim
- grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, Seoul, 07985 Republic of Korea ,grid.255649.90000 0001 2171 7754Department of Obstetrics and Gynecology, Ewha Womans University Mok Dong Hospital, Seoul, 158-051 South Korea ,grid.255649.90000 0001 2171 7754Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
10
|
Park S, Moon J, Kang N, Kim YH, You YA, Kwon E, Ansari A, Hur YM, Park T, Kim YJ. Predicting preterm birth through vaginal microbiota, cervical length, and WBC using a machine learning model. Front Microbiol 2022; 13:912853. [PMID: 35983325 PMCID: PMC9378785 DOI: 10.3389/fmicb.2022.912853] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
An association between the vaginal microbiome and preterm birth has been reported. However, in practice, it is difficult to predict premature birth using the microbiome because the vaginal microbial community varies highly among samples depending on the individual, and the prediction rate is very low. The purpose of this study was to select markers that improve predictive power through machine learning among various vaginal microbiota and develop a prediction algorithm with better predictive power that combines clinical information. As a multicenter case–control study with 150 Korean pregnant women with 54 preterm delivery group and 96 full-term delivery group, cervicovaginal fluid was collected from pregnant women during mid-pregnancy. Their demographic profiles (age, BMI, education level, and PTB history), white blood cell count, and cervical length were recorded, and the microbiome profiles of the cervicovaginal fluid were analyzed. The subjects were randomly divided into a training (n = 101) and a test set (n = 49) in a two-to-one ratio. When training ML models using selected markers, five-fold cross-validation was performed on the training set. A univariate analysis was performed to select markers using seven statistical tests, including the Wilcoxon rank-sum test. Using the selected markers, including Lactobacillus spp., Gardnerella vaginalis, Ureaplasma parvum, Atopobium vaginae, Prevotella timonensis, and Peptoniphilus grossensis, machine learning models (logistic regression, random forest, extreme gradient boosting, support vector machine, and GUIDE) were used to build prediction models. The test area under the curve of the logistic regression model was 0.72 when it was trained with the 17 selected markers. When analyzed by combining white blood cell count and cervical length with the seven vaginal microbiome markers, the random forest model showed the highest test area under the curve of 0.84. The GUIDE, the single tree model, provided a more reasonable biological interpretation, using the 10 selected markers (A. vaginae, G. vaginalis, Lactobacillus crispatus, Lactobacillus fornicalis, Lactobacillus gasseri, Lactobacillus iners, Lactobacillus jensenii, Peptoniphilus grossensis, P. timonensis, and U. parvum), and the covariates produced a tree with a test area under the curve of 0.77. It was confirmed that the association with preterm birth increased when P. timonensis and U. parvum increased (AUC = 0.77), which could also be explained by the fact that as the number of Peptoniphilus lacrimalis increased, the association with preterm birth was high (AUC = 0.77). Our study demonstrates that several candidate bacteria could be used as potential predictors for preterm birth, and that the predictive rate can be increased through a machine learning model employing a combination of cervical length and white blood cell count information.
Collapse
Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea
| | - Jeongsup Moon
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea
| | - Nayeon Kang
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul, South Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea
| | - Eunjin Kwon
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea
| | - AbuZar Ansari
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea
| | - Taesung Park
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea
- Department of Statistics, Seoul National University, Seoul, South Korea
- *Correspondence: Taesung Park,
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea
- Young Ju Kim,
| |
Collapse
|
11
|
Park S, You YA, Kim YH, Kwon E, Ansari A, Kim SM, Lee G, Hur YM, Jung YJ, Kim K, Kim YJ. Ureaplasma and Prevotella colonization with Lactobacillus abundance during pregnancy facilitates term birth. Sci Rep 2022; 12:10148. [PMID: 35710793 PMCID: PMC9203766 DOI: 10.1038/s41598-022-13871-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Ureaplasma and Prevotella infections are well-known bacteria associated with preterm birth. However, with the development of metagenome sequencing techniques, it has been found that not all Ureaplasma and Prevotella colonizations cause preterm birth. The purpose of this study was to determine the association between Ureaplasma and Prevotella colonization with the induction of preterm birth even in the presence of Lactobacillus. In this matched case–control study, a total of 203 pregnant Korean women were selected and their cervicovaginal fluid samples were collected during mid-pregnancy. The microbiome profiles of the cervicovaginal fluid were analyzed using 16S rRNA gene amplification. Sequencing data were processed using QIIME1.9.1. Statistical analyses were performed using R software, and microbiome analysis was performed using the MicrobiomeAnalyst and Calypso software. A positive correlation between Ureaplasma and other genera was highly related to preterm birth, but interestingly, there was a negative correlation with Lactobacillus and term birth, with the same pattern observed with Prevotella. Ureaplasma and Prevotella colonization with Lactobacillus abundance during pregnancy facilitates term birth, although Ureaplasma and Prevotella are associated with preterm birth. Balanced colonization between Lactobacillus and Ureaplasma and Prevotella is important to prevent preterm birth.
Collapse
Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul, Korea
| | - Eunjin Kwon
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - AbuZar Ansari
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - Soo Min Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - Gain Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea
| | - Yun Ji Jung
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul, Korea
| | | | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea.
| |
Collapse
|
12
|
Gudnadottir U, Debelius JW, Du J, Hugerth LW, Danielsson H, Schuppe-Koistinen I, Fransson E, Brusselaers N. The vaginal microbiome and the risk of preterm birth: a systematic review and network meta-analysis. Sci Rep 2022; 12:7926. [PMID: 35562576 PMCID: PMC9106729 DOI: 10.1038/s41598-022-12007-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/04/2022] [Indexed: 02/02/2023] Open
Abstract
Preterm birth is a major cause of neonatal morbidity and mortality worldwide. Increasing evidence links the vaginal microbiome to the risk of spontaneous preterm labour that leads to preterm birth. The aim of this systematic review and network meta-analysis was to investigate the association between the vaginal microbiome, defined as community state types (CSTs, i.e. dominance of specific lactobacilli spp, or not (low-lactobacilli)), and the risk of preterm birth. Systematic review using PubMed, Web of Science, Embase and Cochrane library was performed. Longitudinal studies using culture-independent methods categorizing the vaginal microbiome in at least three different CSTs to assess the risk of preterm birth were included. A (network) meta-analysis was conducted, presenting pooled odds ratios (OR) and 95% confidence intervals (CI); and weighted proportions and 95% CI. All 17 studies were published between 2014 and 2021 and included 38-539 pregnancies and 8-107 preterm births. Women presenting with "low-lactobacilli" vaginal microbiome were at increased risk (OR 1.69, 95% CI 1.15-2.49) for delivering preterm compared to Lactobacillus crispatus dominant women. Our network meta-analysis supports the microbiome being predictive of preterm birth, where low abundance of lactobacilli is associated with the highest risk, and L. crispatus dominance the lowest.
Collapse
Affiliation(s)
- Unnur Gudnadottir
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden.
| | - Justine W Debelius
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden
| | - Juan Du
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden
| | - Luisa W Hugerth
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden.,Science for Life Laboratory, 171 65, Solna, Sweden
| | - Hanna Danielsson
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden.,Sach's Children's and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Ina Schuppe-Koistinen
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden.,Science for Life Laboratory, 171 65, Solna, Sweden
| | - Emma Fransson
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Nele Brusselaers
- Department of Microbiology, Tumor and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, 171 65, SolnaStockholm, Sweden.,Global Health Institute, University of Antwerp, 2610, Antwerp, Belgium.,Department of Head and Skin, Ghent University, 9000, Ghent, Belgium
| |
Collapse
|
13
|
An Insight into Vaginal Microbiome Techniques. Life (Basel) 2021; 11:life11111229. [PMID: 34833105 PMCID: PMC8623751 DOI: 10.3390/life11111229] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/16/2022] Open
Abstract
There is a unique microbial community in the female lower genital tract known as the vaginal microbiota, which varies in composition and density and provides significant benefits during pregnancy, reproductive cyclicity, healthy newborn delivery, protection from preterm birth, infections such as UTIs, bacterial vaginosis, and so on, and improves the efficacy of treatments for vaginal cancers. Methods: It is necessary to know how the vaginal microbiome is composed in order to make an accurate diagnosis of the diseases listed above. A microbiome’s members are difficult to classify, and the way microbial communities function and influence host–pathogen interactions are difficult to understand. More and more metagenomic studies are able to unravel such complexities due to advances in high-throughput sequencing and bioinformatics. When it comes to vaginal microbiota research, we’ll be looking at the use of modern techniques and strategies that can be used to investigate variations in vaginal microbiota in order to detect diseases earlier, better treat vaginal disorders, and boost women’s health. Discussion: The discussed techniques and strategies may improve the treatment of vaginal disorders and may be beneficial for women’s overall health.
Collapse
|
14
|
Nguyen MH, Shin KC, Lee JK. Fungal Community Analyses of Endophytic Fungi from Two Oak Species, Quercus mongolica and Quercus serrata, in Korea. MYCOBIOLOGY 2021; 49:385-395. [PMID: 34512082 PMCID: PMC8409933 DOI: 10.1080/12298093.2021.1948175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/19/2021] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
Fungal endophytes have been recorded in various plant species with a richness of diversity, and their presence plays an essential role in host plant protection against biotic and abiotic stresses. This study applied the Illumina MiSeq sequencing platform based on the amplification of fungal ribosomal ITS2 region to analyze fungal endophytic communities of two oak species (Quercus mongolica and Q. serrata) with different oak wilt disease susceptibilities in Korea. The results showed a total of 230,768 sequencing reads were obtained and clustered at a 97% similarity threshold into 709 operational taxonomic units (OTUs). The OTUs of Q. serrata were higher than that of Q. mongolica with the number of 617 OTUs and 512 OTUs, respectively. Shannon index also showed that Q. serrata had a significantly higher level of fungal diversity than Q. mongolica. Total of OTUs were assigned into 5 fungal phyla, 17 classes, 60 orders, 133 families, 195 genera, and 280 species. Ascomycota was the dominant phylum with 75.11% relative abundance, followed by Basidiomycota with 5.28%. Leptosillia, Aureobasidium and Acanthostigma were the most abundant genera detected in Q. serrata with the average relative abundance of 2.85, 2.76, and 2.19%, respectively. On the other hand, Peltaster, Cladosporium and Monochaetia were the most common genera detected in Q. mongolica with the average relative abundance of 4.83, 3.03, and 2.87%, respectively. Our results indicated that fungal endophytic communities were significantly different between two oak species and these differences could influence responses of host trees to oak wilt disease caused by Raffaelea quercus-mongolicae.
Collapse
Affiliation(s)
- Manh Ha Nguyen
- Tree Pathology and Mycology Laboratory, College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
- Forest Protection Research Center, Vietnamese Academy of Forest Sciences, Hanoi, Vietnam
| | - Keum Chul Shin
- Department of Forest Environmental Resources, College of Agriculture and Life Sciences, Gyeongsang National University (Institute of Agriculture and Life Science), Jinju, Korea
| | - Jong Kyu Lee
- Tree Pathology and Mycology Laboratory, College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
| |
Collapse
|
15
|
Ansari A, Bose S, You Y, Park S, Kim Y. Molecular Mechanism of Microbiota Metabolites in Preterm Birth: Pathological and Therapeutic Insights. Int J Mol Sci 2021; 22:8145. [PMID: 34360908 PMCID: PMC8347546 DOI: 10.3390/ijms22158145] [Citation(s) in RCA: 16] [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: 05/31/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/11/2022] Open
Abstract
Preterm birth (PTB) refers to the birth of infants before 37 weeks of gestation and is a challenging issue worldwide. Evidence reveals that PTB is a multifactorial dysregulation mediated by a complex molecular mechanism. Thus, a better understanding of the complex molecular mechanisms underlying PTB is a prerequisite to explore effective therapeutic approaches. During early pregnancy, various physiological and metabolic changes occur as a result of endocrine and immune metabolism. The microbiota controls the physiological and metabolic mechanism of the host homeostasis, and dysbiosis of maternal microbial homeostasis dysregulates the mechanistic of fetal developmental processes and directly affects the birth outcome. Accumulating evidence indicates that metabolic dysregulation in the maternal or fetal membranes stimulates the inflammatory cytokines, which may positively progress the PTB. Although labour is regarded as an inflammatory process, it is still unclear how microbial dysbiosis could regulate the molecular mechanism of PTB. In this review based on recent research, we focused on both the pathological and therapeutic contribution of microbiota-generated metabolites to PTB and the possible molecular mechanisms.
Collapse
Affiliation(s)
- AbuZar Ansari
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (A.A.); (Y.Y.); (S.P.)
| | - Shambhunath Bose
- Department of Bioscience, Sri Sathya Sai University for Human Excellence, Navanihal, Okali Post, Kamalapur, Kalaburagi, Karnataka 585313, India;
| | - Youngah You
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (A.A.); (Y.Y.); (S.P.)
| | - Sunwha Park
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (A.A.); (Y.Y.); (S.P.)
| | - Youngju Kim
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (A.A.); (Y.Y.); (S.P.)
| |
Collapse
|
16
|
You YA, Kwon EJ, Hwang HS, Choi SJ, Choi SK, Kim YJ. Elevated methylation of the vault RNA2-1 promoter in maternal blood is associated with preterm birth. BMC Genomics 2021; 22:528. [PMID: 34246240 PMCID: PMC8272312 DOI: 10.1186/s12864-021-07865-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background Preterm birth, defined as parturition before 37 completed weeks of gestation, is associated with an increased risk of neonatal complications and death, as well as poor health and disease later in life. Epigenetics could contribute to the mechanism underlying preterm birth. Results Genome-wide DNA methylation analysis of whole blood cells from 10 women (5 term and 5 preterm deliveries) was performed using an Illumina Infinium HumanMethylation450 BeadChips array. We identified 1,581 differentially methylated CpG sites in promoter regions between term and preterm birth. Although the differences were not significant after correcting for multiple tests, seven CpGs on the genomically imprinted vault RNA2-1 (VTRNA2-1; also known as non-coding RNA, nc886 or miR-886) showed the largest differences (range: 26–39 %). Pyrosequencing verification was performed with blood samples from pregnant women recruited additionally (39 term and 43 preterm deliveries). In total, 28 (34.1 %) samples showed hypomethylation of the VTRNA2-1 promoter (< 13 % methylation), while 54 (65.9 %) samples showed elevated methylation levels between 30 and 60 %. Elevated methylation of VTRNA2-1 promoter was associated with an increased risk of preterm birth after adjusting for maternal age, season of delivery, parity and white blood cell count. The mRNA expression of VTRNA2-1 was 0.51-fold lower in women with preterm deliveries (n = 20) compared with women with term deliveries (n = 20). Conclusions VTRNA2-1 is a noncoding transcript to environmentally responsive epialleles. Our results suggest that elevated methylation of the VTRNA2-1 promoter may result in increased risk of PTB caused by the pro-inflammatory cytokines. Further studies are needed to confirm the association of VTRNA2-1 methylation with preterm birth in a large population, and to elucidate the underlying mechanism. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-021-07865-y.
Collapse
Affiliation(s)
- Young-Ah You
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, 07985, Seoul, Korea
| | - Eun Jin Kwon
- Graduate Program in System Health Science and Engineering, Ewha Womans University, 03760, Seoul, Korea
| | - Han-Sung Hwang
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, 143-729, Seoul, Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 135-710, Seoul, Korea
| | - Sae Kyung Choi
- College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, 137-040, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, 07985, Seoul, Korea. .,Graduate Program in System Health Science and Engineering, Ewha Womans University, 03760, Seoul, Korea. .,Department of Obstetrics and Gynecology, Ewha Womans University Mok Dong Hospital, 158-051, Seoul, South Korea.
| |
Collapse
|
17
|
Identification of Indicators for Preterm Birth Using Retinoid Metabolites. Metabolites 2021; 11:metabo11070443. [PMID: 34357337 PMCID: PMC8304766 DOI: 10.3390/metabo11070443] [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: 05/31/2021] [Revised: 06/15/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022] Open
Abstract
Metabolites reflect the biochemical dynamics for the maintenance of pregnancy and parturition. UPLC-Q/TOF-MS and LC-MS/MS metabolomics were performed to identify and validate the plasma metabolomic signatures of preterm birth (PTB). We recruited pregnant women between 16 and 40 weeks 5 days gestational age at Ewha Womans Mokdong Hospital for a nested case-control study. In untargeted UPLC-Q/TOF-MS, score plots of partial least-squares discriminant analysis clearly separated the PTB group from the term birth (TB, n = 10; PTB, n = 11). Fifteen metabolites were significantly different between the two groups, as indicated by a variable importance in projection >1 and p < 0.05. Metabolic pathways involving retinol, linoleic acid, d-arginine, and d-ornithine were associated with PTB. Verification by LC-MS/MS focused on retinol metabolism (TB, n = 39; PTB, n = 20). Retinol levels were significantly reduced in PTB compared to TB, while retinal palmitate, all-trans-retinal, and 13-cis-retinoic acid (13cis-RA) significantly increased (p < 0.05). Retinol-binding protein levels were also elevated in PTB. Additionally, all-trans-retinal (AUC 0.808, 95% CI: 0.683–0.933) and 13cis-RA (AUC 0.826, 95% CI: 0.723–0.930) showed improved predictions for PTB-related retinol metabolites. This study suggests that retinoid metabolism improves the accuracy of PTB predictions and plays an important role in maintaining pregnancy and inducing early parturition.
Collapse
|
18
|
Park S, Oh D, Heo H, Lee G, Kim SM, Ansari A, You YA, Jung YJ, Kim YH, Lee M, Kim YJ. Prediction of preterm birth based on machine learning using bacterial risk score in cervicovaginal fluid. Am J Reprod Immunol 2021; 86:e13435. [PMID: 33905152 DOI: 10.1111/aji.13435] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/04/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
PROBLEM Preterm birth (PTB) is a major cause of increased morbidity and mortality in newborns. The main cause of spontaneous PTB (sPTB) is the activation of an inflammatory response as a result of ascending genital tract infection. Despite various studies on the effects of the vaginal microbiome on PTB, a practical method for its clinical application has yet to be developed. METHOD OF STUDY In this case-control study, 94 Korean pregnant women with PTB (n = 38) and term birth (TB; n = 56) were enrolled. Their cervicovaginal fluid (CVF) was sampled, and a total of 10 bacteria were analyzed using multiplex quantitative real-time PCR (qPCR). The PTB and TB groups were compared, and a PTB prediction model was created using bacterial risk scores using machine learning techniques (decision tree and support vector machine). The predictive performance of the model was validated using random subsampling. RESULTS Bacterial risk scoring model showed significant differences (P < 0.001). The PTB risk was low when the Lactobacillus iners ratio was 0.812 or more. In groups with a ratio under 0.812, moderate and high risk was classified as a U. parvum ratio of 4.6 × 10-3 . The sensitivity and specificity of the PTB prediction model using bacteria risk score were 71% and 59%, respectively, and 77% and 67%, respectively, when white blood cell (WBC) data were included. CONCLUSION Using machine learning, the bacterial risk score in CVF can be used to predict PTB.
Collapse
Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | | | - Hanna Heo
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Gain Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea.,System Health & Engineering Major in Graduate School (BK21 Plus Program, Seoul, Korea
| | - Soo Min Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea.,System Health & Engineering Major in Graduate School (BK21 Plus Program, Seoul, Korea
| | - AbuZar Ansari
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Yun Ji Jung
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul, Korea
| | | | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea.,System Health & Engineering Major in Graduate School (BK21 Plus Program, Seoul, Korea
| |
Collapse
|
19
|
Longitudinal Profiling of the Macaque Vaginal Microbiome Reveals Similarities to Diverse Human Vaginal Communities. mSystems 2021; 6:6/2/e01322-20. [PMID: 33906914 PMCID: PMC8092128 DOI: 10.1128/msystems.01322-20] [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] [Indexed: 12/11/2022] Open
Abstract
The vaginal microbiota plays an important role in women's reproductive and urogenital health. It is now well accepted that a "healthy" vaginal microbiome is dominated by Lactobacillus species. Disturbances in this microbial community can lead to several adverse outcomes, including pelvic inflammatory disease and bacterial vaginosis (BV), as well as increased susceptibility to sexually transmitted infections, miscarriage, and preterm births. However, vaginal communities, especially those of women in the developing world, can be comprised of a diverse set of microorganisms in the absence of overt clinical symptoms. The implications of these diverse vaginal microbiomes for women's health remain poorly understood. Rhesus macaques are an excellent translational animal model to address these questions due to significant physiological and genetic homology with humans. In this study, we performed a longitudinal analysis of clinical and microbiome data from 16 reproductive-age female rhesus macaques. At both the taxonomic and functional levels, the rhesus macaque vaginal microbiome was most similar to that of women who harbor a diverse vaginal community associated with asymptomatic/symptomatic bacterial vaginosis. Specifically, rhesus macaque vaginal microbiomes harbored a diverse set of anaerobic Gram-negative bacteria, including Sneathia, Prevotella, Porphyromonas, and Mobiluncus Interestingly, some animals were transiently colonized by Lactobacillus and some with Gardnerella Our in-depth and comprehensive analysis highlights the importance of the model to understand the health implications of a diverse vaginal microbiome and test interventions for manipulating this community.IMPORTANCE It is widely accepted that the "healthy" vaginal microbiome of women in the developed world is dominated by Lactobacillus species. However, in the developing world, many asymptomatic women harbor diverse vaginal microbial communities that are typically associated with bacterial vaginosis. Many questions remain about the drivers and health implications of a diverse vaginal microbial community. Rhesus macaques provide an excellent translational model to address these questions due to significant physiological and genetic homology with humans. In this study, we performed a longitudinal analysis of clinical and microbiome data from a large cohort of reproductive-age rhesus macaques. At the taxonomic, genomic, and functional levels, the rhesus macaque vaginal microbiome was most similar to that of humans, who harbor a diverse vaginal community associated with asymptomatic/symptomatic bacterial vaginosis. Our in-depth and comprehensive analysis highlights the utility of macaques as a model to study diverse vaginal community state types and test interventions for manipulating the vaginal microbiome.
Collapse
|
20
|
Predominance of Atopobium vaginae at Midtrimester: a Potential Indicator of Preterm Birth Risk in a Nigerian Cohort. mSphere 2021; 6:6/1/e01261-20. [PMID: 33504666 PMCID: PMC7885325 DOI: 10.1128/msphere.01261-20] [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] [Indexed: 01/04/2023] Open
Abstract
Giving birth too soon accounts for half of all newborn deaths worldwide. Clinical symptoms alone are not sufficient to identify women at risk of giving birth too early, as such a pragmatic approach to reducing the incidence of preterm birth entails developing early strategies for intervention before it materializes. Preterm birth (PTB) is the largest contributor to infant death in sub-Saharan Africa and globally. With a global estimate of 773,600, Nigeria has the third highest rate of PTB worldwide. There have been a number of microbiome profiling studies to identify vaginal microbiomes suggestive of preterm and healthy birth outcome. However, studies on the pregnancy vaginal microbiome in Africa are sparse with none performed in Nigeria. Moreover, few studies have considered the concurrent impact of steroid hormones and the vaginal microbiome on pregnancy outcome. We assessed two key determinants of pregnancy progression to gain a deeper understanding of the interactions between vaginal microbiome composition, steroid hormone concentrations, and pregnancy outcome. Vaginal swabs and blood samples were prospectively collected from healthy midtrimester pregnant women. Vaginal microbiome compositions were assessed by analysis of the V3-V5 region of 16S rRNA genes, and potential functional metabolic traits of identified vaginal microbiomes were imputed by PICRUSt (phylogenetic investigation of communities by reconstruction of unobserved states) analysis, while plasma estradiol (E2) and progesterone (P1) levels were quantified by the competitive enzyme-linked immunosorbent assay (ELISA). PTB vaginal samples were characterized by increased microbial richness, high diversity, and depletion of lactobacilli compared to term delivery samples. Women who delivered preterm were characterized by an Atopobium vaginae-dominated vagitype. High relative abundance of Atopobium vaginae at the midtrimester was highly predictive of PTB (area under the receiving operator characteristics [AUROC] of 0.983). There was a marked overlap in the range of plasma E2 and P1 values between term and PTB groups. IMPORTANCE Giving birth too soon accounts for half of all newborn deaths worldwide. Clinical symptoms alone are not sufficient to identify women at risk of giving birth too early, as such a pragmatic approach to reducing the incidence of preterm birth entails developing early strategies for intervention before it materializes. In view of the role played by the vaginal microbiome and maternal steroid hormones in determining obstetric outcome, we assessed the vaginal microbiome composition and steroid hormone during pregnancy and examined their relationship in predicting preterm birth risk in Nigerian women. This study highlights a potential early-driver microbial marker for prediction of preterm birth risk and supports the notion that vaginal microbiome composition varies across populations. A knowledge of relevant preterm birth microbial markers specific to populations would enhance the development of personalized therapeutic interventions toward restoring a microbiome that optimizes reproductive health fitness, therefore reducing the incidence of preterm birth.
Collapse
|
21
|
Detection of Vaginal Metabolite Changes in Premature Rupture of Membrane Patients in Third Trimester Pregnancy: a Prospective Cohort Study. Reprod Sci 2020; 28:585-594. [PMID: 33025530 PMCID: PMC7537967 DOI: 10.1007/s43032-020-00338-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/28/2020] [Indexed: 10/25/2022]
Abstract
Premature rupture of membranes (PROM) is usually associated with pregnant and neonatal complications. Most of the PROM cases are caused by ascending asymptomatic genital infection. In China, PROM (15.3%) is more common than spontaneous preterm labor (7.3%) and leads to more adverse pregnancy outcomes. Here, we designed a prospective cohort study to measure the metabolomics changes in vaginal swab samples and explored their potential contribution to PROM. A total of 260 differentially expressed metabolites were identified and further analyzed. In the PROM group, N-acetyl-D-galactosamine and sucrose were downregulated (P = 0.0025, P = 0.0195, respectively), both of which are the upstream metabolites of the glycolysis pathway. Furthermore, estriol 3-sulfate 16-glucuronide (P = 0.0154) and 2-methoxy-17beta-estradiol 3-glucosiduronic acid (P = 0.004), two final metabolites in steroid hormone biosynthesis, were both downregulated in the PROM group. Finally, we found two catechin metabolites (epigallocatechin-7-glucuronide, P = 0.0009; 4'-methyl-epigallocatechin-7-glucuronide, P = 0.01) as well as DL-citrulline (P = 0.0393) were also significantly downregulated in the PROM group compared with the healthy control (HC) group, which are related to important antioxidant and anti-inflammatory activities in the human body. Altogether, metabolite changes in glycolysis, steroid hormone biosynthesis, and antioxidant/anti-inflammatory pathways may contribute to (or be a consequence of) vaginal dysbiosis and PROM. Metabolite pathway analysis is a new and promising approach to further investigate the mechanism of PROM and help prevent its unfavorable pregnant outcomes at a functional level. Trial registration number: ChiCTR2000034721.
Collapse
|
22
|
Identification of Potential Biomarkers in the Cervicovaginal Fluid by Metabolic Profiling for Preterm Birth. Metabolites 2020; 10:metabo10090349. [PMID: 32867268 PMCID: PMC7570126 DOI: 10.3390/metabo10090349] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
During pregnancy, dysbiosis in the vaginal microbiota directly affects the metabolic profiles, which might impact preterm birth (PTB). In this study, we performed cervicovaginal fluid (CVF) metabolic profiling using nuclear magnetic resonance (NMR) spectroscopy and identified the metabolic markers for predicting PTB. In this nested case-control study, 43 South Korean pregnant women with PTB (n = 22), and term birth (TB; n = 21) were enrolled with their demographic profiles, and CVF samples were collected by vaginal swabs. The PTB group had two subgroups based on post-CVF sampling birth: PTB less than (PTB < 7 d) and more than 7 days (PTB ≥ 7 d). We observed significant differences in the gestational age at birth (GAB), cervical length (CL), and neonatal birth weight among the groups. The principal component analysis (PCA), and partial least square discriminant analysis (PLS-DA) scatter plot showed the separation between the PTB < 7 d group, and the TB group. Out of 28 identified metabolites, acetone, ethanol, ethylene glycol, formate, glycolate, isopropanol, methanol, and trimethylamine N-oxide (TMAO) were significantly increased in the PTB group compared with the TB group. The ROC curve analysis revealed that the acetone, ethylene glycol, formate, glycolate, isopropanol, methanol, and TMAO had the best predictive values for PTB. Additionally, the correlation analysis of these metabolites showed a strong negative correlation with GAB and CL. These metabolites could be beneficial markers for the clinical application of PTB prediction.
Collapse
|
23
|
Stout MJ, Wylie TN, Gula H, Miller A, Wylie KM. The microbiome of the human female reproductive tract. CURRENT OPINION IN PHYSIOLOGY 2020. [DOI: 10.1016/j.cophys.2019.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
24
|
Tsonis O, Gkrozou F, Harrison E, Stefanidis K, Vrachnis N, Paschopoulos M. Female genital tract microbiota affecting the risk of preterm birth: What do we know so far? A review. Eur J Obstet Gynecol Reprod Biol 2019; 245:168-173. [PMID: 31923737 DOI: 10.1016/j.ejogrb.2019.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022]
Abstract
Spontaneous Preterm birth (SPTB) is a common obstetric complication affecting 12.9 million births worldwide and is the leading cause of neonatal morbidity and mortality. Disruption in the vaginal microbiota has an impact on the maternal immunological profile leading to SPTBs. Scientists have struggled to link maternal infectious agents with the dysregulation of the maternal immune response in cases of SPTBs. Throughout the last decade, important findings regarding the role of microbiota and its genome, the so-called microbiome, have linked alterations within the population of the microorganisms in our bodies with changes in nutrition, immunity, behaviour and diseases. In this review, evidence regarding the female genital tract microbiota and microbiome has been examined to help further our understanding of its role in disrupting the maternal immune system resulting in spontaneous preterm birth.
Collapse
Affiliation(s)
- O Tsonis
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Greece.
| | - F Gkrozou
- Department of Obstetrics and Gynaecology, University Hospitals of Birmingham, UK
| | - E Harrison
- Department of Obstetrics and Gynaecology, University Hospitals of Birmingham, UK
| | - K Stefanidis
- Department of Obstetrics and Gynaecology, University Hospital of Athens, "Alexandra", Greece
| | - N Vrachnis
- 3rd Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - M Paschopoulos
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Greece
| |
Collapse
|
25
|
Lin WX, Du X, Yang LL, Chen SY, Qiu WY, Wu HW, Zhao G, Feng YH, Yu QY, Tian H, Luo SP, Gao J. Differences in the Composition of Vaginal Microbiota between Women Exhibiting Spleen-Deficiency Syndrome and Women with Damp-Heat Syndrome, Two of the Most Common Syndromes of Vaginitis in Traditional Chinese Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:5456379. [PMID: 31772596 PMCID: PMC6855005 DOI: 10.1155/2019/5456379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/29/2019] [Accepted: 09/23/2019] [Indexed: 11/17/2022]
Abstract
Spleen-deficiency syndrome and damp-heat syndrome are the two most common syndromes of vaginitis in traditional Chinese medicine (TCM). Although it is known that the vaginal microbiota is closely associated with vaginitis, present studies have not fully elucidated the relationship between the composition of the vaginal microbiome and type of TCM syndrome because of the limitations in the present reductionist approaches. Samples of vaginal secretions were collected from patients with bacterial vaginitis and healthy subjects with spleen-deficiency syndrome and damp-heat syndrome, in order to analyze the constitution of the vaginal microflora using 16S rRNA sequencing methods that encompass taxonomic units, alpha diversity rarefaction curves, and principal component analyses. This prospective study indicated that there was a statistically significant difference in the composition of the vaginal microbiome between patients with spleen-deficiency syndrome and patients with damp-heat syndrome. Streptococcus was the dominant microbiota in patients with spleen-deficiency syndrome. This can serve as a biomarker for differentiating spleen-deficiency syndrome and damp-heat syndrome. In addition, as indicated by the findings on the samples, patients with bacterial vaginitis of dominant abundance in Pseudomonadaceae might be prone to manifest spleen-deficiency syndrome, while patients with bacterial vaginitis of dominant abundance in Prevotella might be prone to manifest damp-heat syndrome. These present findings can provide a new approach to acquire a scientific understanding of the syndromes of TCM, which in turn would benefit the development of personalized medicine, in terms of ancient medicine and complex biological systems.
Collapse
Affiliation(s)
- Wei Xian Lin
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Du
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Lin Yang
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Si Yun Chen
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Yu Qiu
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hai Wang Wu
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guang Zhao
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Hui Feng
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qing Ying Yu
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - He Tian
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Song ping Luo
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie Gao
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
26
|
Hočevar K, Maver A, Vidmar Šimic M, Hodžić A, Haslberger A, Premru Seršen T, Peterlin B. Vaginal Microbiome Signature Is Associated With Spontaneous Preterm Delivery. Front Med (Lausanne) 2019; 6:201. [PMID: 31552254 PMCID: PMC6746969 DOI: 10.3389/fmed.2019.00201] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/27/2019] [Indexed: 01/12/2023] Open
Abstract
Background: Preterm delivery (PTD) represents an important public health and therapeutic challenge. Despite the reported link between the composition of vaginal microbiome and PTD, previous studies were inconsistent in their conclusions and utilized non-uniform designs. We performed an independent case-control study carried out on the Slovenian population, where we re-evaluated the role of the vaginal microbiome in PTD. Methods: Vaginal microbiomes of pregnant women who delivered preterm were compared to those delivered at term to examine differences in the microbial richness, diversity, and differential abundance of specific taxa. We obtained vaginal swab samples from 155 Caucasian women who were classified as either term (≥380/7 weeks, n = 107) or preterm (≤366/7 weeks, n = 48) in exclusion of any other medical or obstetric conditions. The vaginal microbiomes of these women were characterized by 16S ribosomal RNA (rRNA) gene sequencing of the V3-V4 region on the MiSeq platform. Results: Women who experienced PTD had a higher microbial richness (Chao1, P = 0.011) and alpha diversity (Shannon, P = 0.00059) than women with term deliveries. We report that overall vaginal microbial community composition (beta-diversity) was significantly different by delivery gestational age category (PWeightedUnifrac < 0.001). Women who delivered preterm had decreased Lactobacilli spp. abundance as well as increased abundance of Gardnerella and other bacterial vaginosis (BV) and aerobic vaginitis (AV) associated genera including Atopobium, Sneathia, Gemella, Megasphaera, Dorea, Streptococcus, and Escherichia/Shigella. Conclusions: In the present study, we provide further evidence that vaginal microbiome composition is associated with PTD.
Collapse
Affiliation(s)
- Keli Hočevar
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Aleš Maver
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marijana Vidmar Šimic
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Alenka Hodžić
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Tanja Premru Seršen
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| |
Collapse
|