Abstract
The cervicovaginal microbiota plays a key role in the health and reproductive outcomes of women. In reality epidemiological studies have demonstrated that there is an association between the structure of cervicovaginal microbiota and reproductive health, although key mechanistic questions regarding these effects remain unanswered and understanding the interplay between the immune system and the structure of the cervicovaginal microbiota. Here, we review existing literature relating to the potential mechanisms underlying the interaction between vaginal microbes and the immune system; we also describe the composition and function of the microbiome and explain the mechanisms underlying the interactions between these microbial communities and various aspects of the immune system. Finally, we also discuss the diseases that are caused by disorders of the reproductive tract and how the immune system is involved. Finally, based on the data presented in this review, the future perspectives in research directions and therapeutic opportunities are explored.
Highlights
Microbial communities are hypothesized to play an important role in promoting homeostasis
Human natural killer (NK) cells are a class of innate immune cells that play an important role against pathogenic immunity; this is due to their ability to recognize and lyse infected cells
The phage function of macrophages in the female reproductive tract is controlled by dendritic cell-specific regulators that are locally synthesized by cells and regulated by estrogen [28]
Summary
Microbial communities are hypothesized to play an important role in promoting homeostasis. The microbial community in women at childbearing age can be divided into five different categories, referred to as community-state types (CSTs). Four of these CST species are dominated by Lactobacillus, namely L. crispatus (CST-I), L. iners (CST-III), L. gasseri (CST-II) and L. jensenii (CST-V). It is hypothesized that the stability of vaginal micro-ecosystems depends on its function and not their composition. It is recognized that the stability of vaginal micro-ecosystems is based on their true function and not their composition [3]. In some women, the vaginal microbial community composition changed markedly and rapidly over time, whereas in others it was relatively stable [5]. Vaginal microbes can be used to predict the success of in vitro fertilization [9]
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