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育龄女性阴道乳杆菌与阴道微生态的相关性研究
Study on the correlation between vaginal Lactobacillus and vaginal microecology in Chinese women of childbearing age
目的 了解育龄女性阴道乳杆菌种类和分布情况，分析阴道乳杆菌与阴道微生态的相关性，为阴道感染性疾病的微生态疗法提供理论依据。 方法 对2021年9月至12月首都医科大学附属北京妇产医院妇科门诊就诊，年龄在19~54岁的114例育龄女性，进行阴道微生态检测及乳杆菌鉴定。 结果 （1）阴道乳杆菌鉴定结果表明，共检出8种菌株，其中以卷曲乳杆菌（占18.4%）和詹氏乳杆菌（占14.9%）为优势菌株。（2）阴道微生态正常组中有67.1%分离出乳杆菌，微生态异常组仅有24.4%乳杆菌检出（P<0.001）。微生态正常组主要以卷曲乳杆菌（28.8%）和詹氏乳杆菌（19.2%）为优势菌株；微生态异常组主要以詹氏乳杆菌、格氏乳杆菌及发酵乳杆菌（均为7.3%）为优势菌株。（3）阴道微生态指标中，pH值、菌群密集度、乳杆菌等级及过氧化氢显示与乳杆菌检出存在相关性（P<0.05）。 结论 育龄女性正常阴道微生态主要以卷曲乳杆菌和詹氏乳杆菌为优势菌株。阴道微生态异常与阴道乳杆菌相关。
Objective To investigate the species and distribution of vaginal Lactobacillus in women of childbearing age， analyze the correlation between vaginal Lactobacillus and vaginal microecology， and provide a theoretical basis for the microecological therapy of vaginal infectious diseases. Methods From September to December 2021， a total of 114 women aged 19-54 years who attended the Gynecology Clinic of Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University were enrolled. All participants underwent vaginal microecological testing and Lactobacillus identification. Results （1）Vaginal Lactobacillus identification showed that a total of 8 strains were detected， among which Lactobacillus crispatus （18.4%） and Lactobacillus jensenii （14.9%） were the dominant strains. （2）Lactobacillus was isolated from 67.1% of the subjects in the normal vaginal microecology group， while the detection rate of Lactobacillus in the abnormal microecology group was only 24.4% （P<0.001）. The dominant strains in the normal microecology group were mainly Lactobacillus crispatus （28.8%） and Lactobacillus jensenii （19.2%）； in the abnormal microecology group， the dominant strains were Lactobacillus jensenii， Lactobacillus gasseri and Lactobacillus fermentum， each accounting for 7.3%. （3）Among the vaginal microecological indicators， pH value， bacterial density， Lactobacillus grade and hydrogen peroxide were found to be correlated with the detection of Lactobacillus （P<0.05）. Conclusions The normal vaginal microecology of women of childbearing age is mainly dominated by Lactobacillus crispatus and Lactobacillus jensenii. Abnormal vaginal microecology is associated with vaginal Lactobacillus status.
women of childbearing age / vaginal Lactobacillus / vaginal microecology / correlation
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Vaginal bacterial communities dominated by Lactobacillus species are associated with a reduced risk of various adverse health outcomes. However, somewhat unexpectedly, many healthy women have microbiota that are not dominated by lactobacilli. To determine the factors that drive vaginal community composition we characterized the genetic composition and transcriptional activities of vaginal microbiota in healthy women.We demonstrate that the abundance of a species is not always indicative of its transcriptional activity and that impending changes in community composition can be predicted from metatranscriptomic data. Functional comparisons highlight differences in the metabolic activities of these communities, notably in their degradation of host produced mucin but not glycogen. Degradation of mucin by communities not dominated by Lactobacillus may play a role in their association with adverse health outcomes. Finally, we show that the transcriptional activities of L. crispatus, L. iners, and Gardnerella vaginalis vary with the taxonomic composition of the communities in which they reside. Notably, L. iners and G. vaginalis both demonstrate lower expression of their cholesterol-dependent cytolysins when co-resident with Lactobacillus spp. and higher expression when co-resident with other facultative and obligate anaerobes. The pathogenic potential of these species may depend on the communities in which they reside and thus could be modulated by interventional strategies.Our results provide insight to the functional ecology of the vaginal microbiota, demonstrate the diagnostic potential of metatranscriptomic data, and reveal strategies for the management of these ecosystems.© 2022. The Author(s).
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\n The microbiome of the female reproductive tract defies the convention that high biodiversity is a hallmark of an optimal ecosystem. Although not universally true, a homogeneous vaginal microbiome composed of species of\n Lactobacillus\n is generally associated with health, whereas vaginal microbiomes consisting of other taxa are generally associated with dysbiosis and a higher risk of disease.\n
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The human vaginal microbiota is a critical determinant of vaginal health. These communities live in close association with the vaginal epithelium and rely on host tissues for resources. Although often dominated by lactobacilli, the vaginal microbiota is also frequently composed of a collection of facultative and obligate anaerobes. The prevalence of these communities with a paucity of Lactobacillus species varies among women, and epidemiological studies have associated them with an increased risk of adverse health outcomes. The mechanisms that drive these associations have yet to be described in detail, with few studies establishing causative relationships. Here, we review our current understanding of the vaginal microbiota and its connection with host health. We centre our discussion around the biology of the vaginal microbiota when Lactobacillus species are dominant versus when they are not, including host factors that are implicated in shaping these microbial communities and the resulting adverse health outcomes. We discuss current approaches to modulate the vaginal microbiota, including probiotics and vaginal microbiome transplants, and argue that new model systems of the cervicovaginal environment that incorporate the vaginal microbiota are needed to progress from association to mechanism and this will prove invaluable for future research.© 2022. Springer Nature Limited.
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