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Swidsinski A, Amann R, Guschin A, Swidsinski S, Loening-Baucke V, Mendling W, Sobel JD, Lamont RF, Vaneechoutte M, Baptista PV, Bradshaw CS, Kogan IY, Savicheva АM, Mitrokhin OV, Swidsinski NW, Sukhikh GT, Priputnevich TV, Apolikhina IA, Dörffel Y. Polymicrobial consortia in the pathogenesis of biofilm vaginosis visualized by FISH. Historic review outlining the basic principles of the polymicrobial infection theory. Microbes Infect 2024:105403. [PMID: 39127090 DOI: 10.1016/j.micinf.2024.105403] [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: 03/28/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Abstract
The manuscript disputes the exclusive mono-infectious way of thinking, which presumes that for every infection only one pathogen is responsible and sufficient, when infectious vectors, close contact and reduced immunity meet. In situations involving heavily colonized anatomical sites such an approach often ends in insoluble contradictions. Upon critical reflection and evaluation of 20 years research on spatial organization of vaginal microbiota it is apparent, that in some situations, pathogens may act and operate in permanent, structurally organized consortia, whereas its individual components may be innocuous and innocent, failing to express any pathogenic effect. In these cases, consortia are the true pathogens responsible for many infectious conditions, which usually remain unrecognized as long as improperly diagnosed. The structure of such consortia can be unraveled using ribosomal fluorescence in situ hybridization (FISH). FISH methodology, that not only offers an ex vivo opportunity to recognize bacterial species, but provides unique physical insight into their specific role in the pathogenesis of polymicrobial infections. Ribosomal FISH technique applied to both, women with bacterial vaginosis (BV) and their male partners, has added significantly to our understanding of the pathogenesis of this condition and contributed to appreciating the mechanisms of polymicrobial, community-based infection, potentially leading to therapeutic advances.
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Affiliation(s)
- Alexander Swidsinski
- Moleculargenetic Laboratory for Polymicrobial Infections and Biofilms, Universitätsmedizin Berlin CCM Charité, 10098 Germany; I.M. Sechenov First Moscow State Medical University, Institute of Public Health, Department of General Hygiene, 119991 Moscow, Russia.
| | - Rudolf Amann
- Max Planck Institute for Marine Microbiology, Department of Molecular Ecology, Celsiusstr. 1 D-28359 Bremen, Germany.
| | - Alexander Guschin
- Molecular-genetic Laboratory, Division Polymicrobial Infections. Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, 119071 Moscow, Russia.
| | - Sonja Swidsinski
- Moleculargenetic Laboratory for Polymicrobial Infections and Biofilms, Universitätsmedizin Berlin CCM Charité, 10098, Germany.
| | - Vera Loening-Baucke
- Moleculargenetic Laboratory for Polymicrobial Infections and Biofilms, Universitätsmedizin Berlin CCM Charité, 10098, Germany.
| | - Werner Mendling
- Das Deutsche Zentrum für Infektionen in Gynäkologie und Geburtshilfe, Landesfrauenklinik Helios Universitätsklinikum Wuppertal - Universität Witten/Herdecke, Heusnerstraße 40, 42283 Wuppertal, Germany.
| | - Jack D Sobel
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Mk. 48322, USA.
| | - Ronald F Lamont
- BSc MB ChB DM FRCOG University of Southern Denmark, Odense, Denmark; Northwick Park Institute for Medical Research Campus, University College London, UK.
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research Department Diagnostic Sciences GE32, Faculty of Medicine & Health Sciences Ghent University, Flanders, Belgium; Medical Research Building II, 1st Floor Ghent University Hospital, Entrance 38 C. Heymanslaan 10, 9000 GENT, Belgium.
| | - Pedro Vieira Baptista
- Hospital Lusíadas Porto, Porto, Portugal; Department of Gynecology-Obstetrics and Pediatrics, Faculdade de Medicina da Universidade Do Porto, Porto, Portugal.
| | - Catriona S Bradshaw
- School of Translational Medicine, Monash University, Melbourne, Victoria, UK; Australia Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Victoria, Australia; Melbourne School of Population and 99 Global Health, University of Melbourne, Parkville, Victoria, Australia.
| | - Igor Yu Kogan
- D.O. Ott Res.Inst Ob/Gyn/ Rep, 199034, St. Petersburg, Russia.
| | - Аlevtina M Savicheva
- Department of Medical Microbiology, D.O. Ott Res.Inst Ob/Gyn/ Rep, 199034, St. Petersburg, Russia; St. Petersburg State Pediatric Med. University, 194100, St. Petersburg, Russia; Center for Resistance of Polymicrobial Communities and Biofilms, Russia.
| | - Oleg V Mitrokhin
- I.M. Sechenov First Moscow State Medical University, Institute of Public Health, Department of General Hygiene, 119991 Moscow, Russia.
| | - Nadezhda W Swidsinski
- Laboratory for Ecology and Clinical Implications of Polymicrobial Infections I.M. Sechenov First Moscow State Medical University, Institute of Public Health, Department of General Hygiene, 119991 Moscow, Russia.
| | - Gennadiy T Sukhikh
- Microbiological Laboratory for Polymicrobial Infections and Biofilms. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health, 117997 Moscow, Russia.
| | - Tatjana V Priputnevich
- Microbiological Laboratory for Polymicrobial Infections and Biofilms. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health, 117997 Moscow, Russia.
| | - Inna A Apolikhina
- Clinic Division for Polymicrobial Infections in Gynaecology, Department of Aesthetic Gynecology and Rehabilitation, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Russia.
| | - Yvonne Dörffel
- Outpatient Clinic, Charité Universitätsmedizin Berlin, CCM, 10117 Berlin, Germany.
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Vivekanandan V, Khan ZH, Venugopal G, Musunuru B, Mishra P, Srivastava S, Ramadass B, Subhadra B. VagiBIOM Lactobacillus suppository improves vaginal health index in perimenopausal women with bacterial vaginosis: a randomized control trial. Sci Rep 2024; 14:3317. [PMID: 38336815 PMCID: PMC10858244 DOI: 10.1038/s41598-024-53770-1] [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] [Received: 04/29/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
Bacterial vaginosis (BV) can cause vaginal dysbiosis that may influence general vaginal health and pregnancy complications. Balancing vaginal microbiome using Lactobacillus spp. may be a new way to prevent and treat mild BV. We conducted a randomized, double-blind, placebo-controlled pilot study aimed at evaluating the effect of the product VagiBIOM, a multi-Lactobacillus vaginal suppository, on peri- and premenopausal women with BV in restoring vaginal pH and overall vaginal health by resetting the vaginal microbiome composition. Sixty-six peri- and premenopausal women with BV symptoms were randomized with a 2:1 ratio to be treated with VagiBIOM or placebo suppositories. Vaginal pH, VAS itching score, total Nugent score, and vaginal health index (VHI) were measured. Vaginal microbiome changes before and after the treatment were analyzed by 16S rRNA sequencing and bioinformatics analysis. After 4 weeks of intervention with VagiBIOM or a placebo, the mean score for vaginal pH, VAS itching, and total Nugent score was significantly decreased from the baseline. Compared to the baseline scores, the VHI scores improved significantly following 28-day intervention (p < 0.001). Our results revealed two Lactobacillus species, L. hamsteri, and L. helveticus, as indicator species occurring differentially in the VagiBIOM-treated group. Furthermore, the regression and species network analyses revealed significant bacterial associations after VagiBIOM treatment. Lactobacillus hamsteri was positively associated with the Nugent score and negatively associated with vaginal pH. L. iners and L. salivarius were positively and inversely associated with VHI. As is typical, Bacteroides fragilis was positively associated with vaginal pH and negatively associated with the Nugent score. Interestingly, the Lactobacillus spp. diversity improved after VagiBIOM treatment. The VagiBIOM suppository treatment for peri- and premenopausal women with BV significantly relieved vaginal itching by decreasing vaginal pH and Nugent scores and improving the overall VHI after 4 weeks' intervention. This effect was primarily the result of VagiBIOM improving vaginal Lactobacillus diversity.Trial Registration ClinicalTrials.gov registration: NCT05060029, first registration 09/28/2021: Title: A Pilot Study to Evaluate the Efficacy and Safety of Lactobacillus Species Suppositories on Vaginal Health and pH.
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Affiliation(s)
| | - Zaiba Hasan Khan
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Giriprasad Venugopal
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bhavana Musunuru
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Priyanka Mishra
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Shalini Srivastava
- Vedic LifeSciences, Clinical Research, Andheri (West), Mumbai, Maharashtra, India
| | - Balamurugan Ramadass
- Center of Excellence for Clinical Microbiome Research (CCMR), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - Bobban Subhadra
- Biom Pharmaceutical Corporation, 2203 Industrial Blvd, Sarasota, FL, USA.
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