Abstract

Regarding bacterial vaginosis (BV), the relevance of the vaginal microbiota to the women’s health fulfills a key role, but knowledge gaps regarding aerobic vaginitis (AV) exist. This study aims to characterize vaginal microbiome and its relationship with the local immune mediators, providing an opportunity to define the link between vaginal commensal microorganisms and opportunistic pathogens in the relation of a given vaginal community state type (CST). A total of 90 vaginal samples from Caucasian asymptomatic women of reproductive age (18–40 years) attending the yearly examination and not reporting any vaginal complaints were retrospectively evaluated for microbiome assessment and immune factor dosage. The samples were tested by the Ion Torrent PGM and the Luminex Bio-Plex technologies for the analysis of microbiome and immune factors, respectively. In our study, the CST classification together with the local immune response profiling represented a good predictive indicator of the vaginal health, suggesting that the predominance of a specific Lactobacillus and its relative abundance are pivotal elements to maintain a physiologic status. A vaginal colonization from Bifidobacterium may absolve a protective role similar to that of Lactobacillus, corresponding to a newly identified CST, although studies are needed to better clarify its clinical significance. Moreover, within each CST, a different pattern of inflammation is activated and orchestrated both by the dominant Lactobacillus spp. and by specific non-Lactobacillus bacteria and can give insights into the pathogenic mechanisms. In conclusion, this study contributes to the characterization of vaginal dysbiosis, reshaping this concept by taking into consideration the CST profiling, local immune marker, and immune–microbial network.

Highlights

  • Vaginal dysbiosis consists of a prolonged deviation from a low-diversity, Lactobacilli-dominated microbiome (Van de Wijgert and Jespers, 2017)

  • Considering the relevance of the vaginal microbiota to women’s health and the existing knowledge gap regarding aerobic vaginitis (AV), the study of vaginal microbiome and its relationship with the local immune mediators will provide an opportunity to define the link between vaginal commensal microorganisms and opportunistic pathogens in relation to a given vaginal community state type (CST; Kaambo et al, 2018)

  • From the sequencing of the V3 region of the 16S rRNA gene, we obtained a total of 5,683,700 reads and a total number of observed operational taxonomic unit (OTU) of 11,168

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Summary

Introduction

Vaginal dysbiosis consists of a prolonged deviation from a low-diversity, Lactobacilli-dominated microbiome (Van de Wijgert and Jespers, 2017). The microbial composition of vagina differs from that of other human surfaces and mucosal sites, characterized by a lower microbial diversity dominated by Lactobacillus species These bacteria, acidifying the vaginal environment, play an important role in local defense (Borges et al, 2014; Aldunate et al, 2015). Considering the relevance of the vaginal microbiota to women’s health and the existing knowledge gap regarding AV, the study of vaginal microbiome and its relationship with the local immune mediators will provide an opportunity to define the link between vaginal commensal microorganisms and opportunistic pathogens in relation to a given vaginal community state type (CST; Kaambo et al, 2018) Such studies will contribute to the characterization of AV and BV dysbiosis and may well inform about the importance of the immune–microbial specific network in identifying dysbiosis

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