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The Influence of Vitamin E and Omega-3 Fatty Acids on Reproductive Health Indices Among Male Workers Exposed to Electromagnetic Fields.
Mohammadi, H, Golbabaei, F, Dehghan, SF, Imani, H, Ramezani Tehrani, F, Khodakarim Ardakani, S
American journal of men's health. 2022;16(1):15579883221074821
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Studies have suggested that low-frequency electromagnetic fields (EMF) may have a detrimental effect on male fertility. Lower hormone levels and higher free radicals in the body damaging sperm cells have been indicated to play a role in this relationship. Supporting the development of sperm cells in individuals who have been subjected to EMF may be an effective therapy. Sperm cells contain large amounts of polyunsaturated fatty acids such as omega-3 and supplementation may be of benefit. Although high amounts of omega-3 can have side effects, which can be limited with the dual supplementation of vitamin E. This randomised control trial aimed to determine the effect of omega-3 and vitamin E supplementation on reproductive indices of individuals who work with EMF. The results showed that EMF exposure affected sperm count, morphology, and motility and that the supplementation of omega-3 and vitamin E in conjunction could limit effects on morphology and motility. It was concluded that simultaneous vitamin E and omega-3 consumption could be of benefit for fertility in men exposed to EMF, however further studies are required to confirm this finding due to study limitations and size. This study could be used by healthcare professionals to understand that EMF is of detriment to fertility in men but there may be ways to limit the effects involving the use of omega-3 and vitamin E supplementation.
Abstract
The present study aims to investigate the effects of using the supplementation of vitamin E and Omega 3 fatty acids on reproductive indices among workers in an automobile parts manufacturing plant. The effect of exposure to electromagnetic fields on certain sex hormones and sperm parameters will also be assessed. The participants were deployed into four groups as per the double-blind block randomization method. Semen parameters and sex hormones of the participants were analyzed before and after 3-month consumption of supplements. The level of workers' exposure to low-frequency magnetic and electrical fields was measured through the recommendation of National Institute for Occupational Safety and Health. Univariate analysis of variance indicated that exposure to electric fields had a statistically significant effect on sperm count, morphology, and motility. The simultaneous consumption of vitamin E + Omega 3 had a statistically significant effect on sperm morphology and motility.
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Prenatal exposure to phthalate and decreased body mass index of children: a systematic review and meta-analysis.
Lee, DW, Lim, HM, Lee, JY, Min, KB, Shin, CH, Lee, YA, Hong, YC
Scientific reports. 2022;12(1):8961
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Phthalates are widely used chemicals to improve the utility of plastics and personal care products. Phthalates can be classified as high-molecular-weight phthalates and low-molecular-weight phthalates. The aim of this study was to clarify whether prenatal and postnatal exposures to phthalates are associated with physical growth as measured by body composition indices in children. This study is a systematic literature review and meta-analysis of 39 studies about the association of phthalates with body composition indices among children. Results showed that prenatal exposure to phthalates is significantly associated with low body mass index in children, but not with body fat mass. In addition, prenatal phthalate exposure may affect the disturbance of normal growth of children rather than act as an obesogen. Authors conclude that it is necessary to administer stricter and broader regulations on phthalates in living environments.
Abstract
Phthalates are well-known endocrine-disrupting chemicals. Many detrimental health effects of phthalates were investigated, but studies on the association of phthalates with obesity in children showed inconsistent results. Thus, this systematic review and meta-analysis were performed to clarify whether prenatal and postnatal exposures to phthalates are associated with physical growth disturbances in children. We performed the systematic review and meta-analysis following the PRISMA 2020 statement guidelines, and found 39 studies that met our inclusion criteria, including 22 longitudinal and 17 cross-sectional studies. We observed a significant negative association between the prenatal exposure to DEHP and the body mass index (BMI) z-score of the offspring (β = - 0.05; 95% CI: - 0.10, - 0.001) in the meta-analysis, while no significant association between the prenatal exposure to DEHP and the body fat percentage of the offspring was observed (β = 0.01; 95% CI: - 0.41, 0.44). In the systematic review, studies on the association between phthalates exposure in childhood and obesity were inconsistent. Prenatal exposure to phthalates was found to be associated with decreased BMI z-score in children, but not associated with body fat percentage. Our findings suggest that phthalates disturb the normal muscle growth of children, rather than induce obesity, as previous studies have hypothesized.
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Cigarette Smoke Extract Disturbs Mitochondria-Regulated Airway Epithelial Cell Responses to Pneumococci.
Aghapour, M, Tulen, CBM, Abdi Sarabi, M, Weinert, S, Müsken, M, Relja, B, van Schooten, FJ, Jeron, A, Braun-Dullaeus, R, Remels, AH, et al
Cells. 2022;11(11)
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Cigarette smoking can affect airway epithelial cells, causing overproduction of mucus, damage, and inflammation, which may result in the progression of airway diseases. Airway epithelial cells (AEC) rely on mitochondria for energy, and mitochondrial dysfunction may affect innate immunity and the integrity of the airway epithelium. Cigarette smoking is found to accelerate mitochondrial damage within AEC. Maintaining a normal microbial composition within the respiratory tract is essential for maintaining immunity. There is evidence that smoking cigarettes disrupts the microbial composition and increases the spread of pathogenic bacteria such as Streptococcus pneumoniae (Sp) which causes inflammation. By exposing 16HBE cells to Sp and cigarette smoke extract (CSE), this study investigated the effect of cigarette smoking on mitochondrial dysfunction in ACE in an in vitro model. Additionally, the study examined the direct and indirect pathways involved in cigarette smoking-induced mitochondrial dysfunction and altered innate immune response to Sp infection. CSE exposure decreases mitochondrial complex protein levels and mitochondrial membrane potential, which affects energy production. It also increases mitochondrial oxidative stress and mitochondrial degradation. All these factors lead to mitochondrial dysfunction in ACE. CSE exposure to ACE was associated with altered gene expression in the tight and adherence junctions that serve as a protective barrier against pathogens and pollutants and reduced type I interferon immune responses to Sp. Using the results of this study, healthcare professionals can gain a better understanding of the impact of cigarette smoking on mitochondrial dysfunction and how it increases susceptibility to Sp-related immune responses. It is necessary to conduct further studies to evaluate the effects of cigarette smoking on mitochondrial dysfunction, microbial composition disruption, and the interaction between AECs and elevated immune responses.
Abstract
Mitochondrial functionality is crucial for the execution of physiologic functions of metabolically active cells in the respiratory tract including airway epithelial cells (AECs). Cigarette smoke is known to impair mitochondrial function in AECs. However, the potential contribution of mitochondrial dysfunction in AECs to airway infection and airway epithelial barrier dysfunction is unknown. In this study, we used an in vitro model based on AECs exposed to cigarette smoke extract (CSE) followed by an infection with Streptococcus pneumoniae (Sp). The levels of oxidative stress as an indicator of mitochondrial stress were quantified upon CSE and Sp treatment. In addition, expression of proteins associated with mitophagy, mitochondrial content, and biogenesis as well as mitochondrial fission and fusion was quantified. Transcriptional AEC profiling was performed to identify the potential changes in innate immune pathways and correlate them with indices of mitochondrial function. We observed that CSE exposure substantially altered mitochondrial function in AECs by suppressing mitochondrial complex protein levels, reducing mitochondrial membrane potential and increasing mitochondrial stress and mitophagy. Moreover, CSE-induced mitochondrial dysfunction correlated with reduced enrichment of genes involved in apical junctions and innate immune responses to Sp, particularly type I interferon responses. Together, our results demonstrated that CSE-induced mitochondrial dysfunction may contribute to impaired innate immune responses to Sp.
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The vaginal microbiome and the risk of preterm birth: a systematic review and network meta-analysis.
Gudnadottir, U, Debelius, JW, Du, J, Hugerth, LW, Danielsson, H, Schuppe-Koistinen, I, Fransson, E, Brusselaers, N
Scientific reports. 2022;12(1):7926
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Preterm birth is a major cause of neonatal mortality and morbidity. Many factors can trigger premature labour onset, including preterm premature rupture of membranes, infections and microbial invasion of the amniotic cavity. The vaginal microbiome is thought to protect from such infections. The aim of this study was to assess the association between the vaginal microbiome and the risk of preterm birth. This study is a systematic review and meta-analysis of 17 cohort studies. The number of pregnancies per study ranged between 38 and 539, with 8 and 107 preterm births. Results show that women with a “low-lactobacilli” vaginal microbiome composition were at higher risk of preterm birth (spontaneous and overall) compared to women with L. crispatus (microbiome) dominant microbiome compositions. Authors conclude that the diversity of the vaginal microbiome seems to play a part in the risk of preterm birth.
Expert Review
Conflicts of interest:
None
Take Home Message:
- The diversity of the vaginal microbiome is reported to play a part in the risk of preterm births.
- Practitioners could consider testing the virginal microbiome for low Lactobacilli or the dominance of Gardnerella and Prevotella and then recommending a probiotic supplement to pregnant patients who have low Lactobacilli vaginal microbiome.
Evidence Category:
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A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
A systematic review and network meta-analysis was conducted to investigate the association between vaginal microbiome and risk of preterm births.
Seventeen longitudinal cohort studies were included. Seven originated from North America, three from Europe, two from South America, three from Asia, and two from Africa. The number of pregnancies per study ranged between 38 and 539, with 8 and 107 preterm births. 16S Sequencing techniques were used to identify the microbial species. Preterm birth was defined as birth before 37 weeks of gestation.
Microbiome community state types (CSTs) were grouped into five categories based on dominating species: L. crispatus, L. gasseri, L. iners,“low-lactobacilli” and L. jensenii. “Low-lactobacilli” was defined as an increased diversity of anaerobic or mixture of aerobe and facultative anaerobe bacteria (such as Gardnerella and Prevotella) based on the cut-offs and categorization used in the individual studies.
Primary clinical outcomes were:
- Among women who delivered preterm, the pooled proportion with “low-lactobacilli” was 0.41 (95% CI 0.30-0.53) compared to 0.29 (95% CI 0.20-0.38) of women with full-term deliveries.
- The risk of preterm births was higher among women with “low-lactobacilli” compared to L. crispatus (OR 1.69, 95%CI 1.15 -2.49).”Low-lactobacilli” included Garnerella and Provotella, both of which are known to promote inflammatory cytokines and are commonly found in vaginal microbiome just before preterm premature rupture of membranes (PPROM).
Clinical practice applications:
- The diversity of the vaginal microbiome is reported to play an important role in the risk of preterm births.
- Women with low Lactobacilli seem to be at a greater risk of delivering preterm compared to women with L. crispatus dominant microbiome.
- Based on this study, practitioners could therefore consider testing the vaginal microbiome of their patients for low Lactobacilli and/or the dominance of Gardnerella and Prevotella.
- Practitioners may also consider recommending specific probiotic supplementation during pregnancy to increase the dominance of Lactobacilli and L. crispatus vaginal microbiome.
Considerations for future research:
- In the past, researchers have grouped the microbiome into categories based on dominating species, which is not ideal. Therefore, further studies are needed where individual microbiome sequencing data is used to make comparisons.
- Additionally, longitudinal studies are needed with higher sample sizes to investigate the natural changes of the vaginal microbiome during pregnancy and the physiological mechanisms underlying these apparent different risk profiles.
- Furthermore, randomized-controlled trials are needed to establish if pregnant women could benefit from specific probiotic supplementation during pregnancy.
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.
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Adverse pregnancy and birth outcomes associated with Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum: a systematic review and meta-analysis.
Jonduo, ME, Vallely, LM, Wand, H, Sweeney, EL, Egli-Gany, D, Kaldor, J, Vallely, AJ, Low, N
BMJ open. 2022;12(8):e062990
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Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum, referred to together as genital mycoplasmas, commonly colonise the urogenital tract in women, and are often found together. These species do not appear to cause symptoms or harmful effects in non-pregnant women. However, studies have reported that colonisation with a genital mycoplasma has been associated with several adverse pregnancy outcomes. The main objective of this study was to investigate the associations between M. hominis, U. urealyticum and/or U. parvum and the risk of pre-term birth, alone and in combination with bacterial vaginosis (BV). This study is a systematic review and meta-analysis of fifty-seven studies. Results show that genital mycoplasmas are associated with several different adverse pregnancy outcomes in univariable analysis only. Authors conclude that since only six of the fifty-seven studies reported multivariable analysis, the current available literature does not allow conclusions about the role of mycoplasmas in adverse pregnancy and birth outcomes, alone or with coexisting BV.
Abstract
OBJECTIVES Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum (genital mycoplasmas) commonly colonise the urogenital tract in pregnant women. This systematic review aims to investigate their role in adverse pregnancy and birth outcomes, alone or in combination with bacterial vaginosis (BV). METHODS We searched Embase, Medline and CINAHL databases from January 1971 to February 2021. Eligible studies tested for any of the three genital mycoplasmas during pregnancy and reported on the primary outcome, preterm birth (PTB) and/or secondary outcomes low birth weight (LBW), premature rupture of membranes (PROM), spontaneous abortion (SA) and/or perinatal or neonatal death (PND).Two reviewers independently screened titles and abstracts, read potentially eligible full texts and extracted data. Two reviewers independently assessed risks of bias using published checklists. Random effects meta-analysis was used to estimate summary ORs (with 95% CIs and prediction intervals). Multivariable and stratified analyses were synthesised descriptively. RESULTS Of 57/1194 included studies, 39 were from high-income countries. In meta-analysis of unadjusted ORs, M. hominis was associated with PTB (OR 1.87, 95% CI 1.49 to 2.34), PROM, LBW and PND but not SA. U. urealyticum was associated with PTB (OR 1.84, 95% CI 1.34 to 2.55), PROM, LBW, SA and PND. U. parvum was associated with PTB (1.60, 95% CI 1.12 to 2.30), PROM and SA. Nine of 57 studies reported any multivariable analysis. In two studies, analyses stratified by BV status showed that M. hominis and U. parvum were more strongly associated with PTB in the presence than in the absence of BV. The most frequent source of bias was a failure to control for confounding. CONCLUSIONS The currently available literature does not allow conclusions about the role of mycoplasmas in adverse pregnancy and birth outcomes, alone or with coexisting BV. Future studies that consider genital mycoplasmas in the context of the vaginal microbiome are needed. PROSPERO REGISTRATION NUMBER CRD42016050962.
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Menstruation-Related Disorders-Dysmenorrhea and Heavy Bleeding-as Significant Epiphenomena in Women With Rheumatic Diseases.
Orlandi, M, Vannuccini, S, El Aoufy, K, Melis, MR, Lepri, G, Sambataro, G, Bellando-Randone, S, Guiducci, S, Cerinic, MM, Petraglia, F
Frontiers in pharmacology. 2022;13:807880
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Rheumatic diseases (RDs) affect significantly more women than men, and for this reason, gynaecological disorders may have an additional negative impact on women’s health. The aim of this study was to describe gynaecological symptoms among fertile age women with RDs and their impact on quality of life. This study is a monocentric, cross-sectional observational study. Results show that a large number of women with RDs report menstrual disorders. In fact, more than half of the population reported of having dysmenorrhea since adolescence. Similarly, during fertile age, menstrual pain was frequently reported, and in 72% of the cases, the intensity resulted to be moderate/severe. Additionally, heavy menstrual bleeding was found in 38% of the patients during adulthood and in 52% of patients during adolescence. Authors conclude that the management of female patients with RDs is a challenge for clinicians and should include an accurate evaluation of gynaecological aspects (menstruation, fertility, maternity, and sexuality) as well as manage an interdisciplinary teamwork approach (rheumatologist and gynaecologists).
Abstract
Background: In women with rheumatic diseases (RDs) menstruation-related disorders have never been investigated. The aim of this study was to evaluate gynecological symptoms/disorders in fertile age women with RDs. Materials and methods: All patients (n = 200) filled up a self-administered questionnaire on their gynecological history, menstrual cycle pattern, menstrual-related symptoms, and quality of life (QoL). The RD group was then compared to a control group of 305 age-matched fertile age women. Results: Among patients with RDs, 58% had arthritis, 40% connective tissue diseases (CTDs), and 1.5% systemic vasculitis. No differences were observed between CTDs and arthritis, except for a family history of HMB which was more common among women with CTDs (p < .01). When compared to controls, women with RDs reported more frequent heavy menstrual bleeding (HMB) during adolescence (51.7 and 25.4%, respectively; p = .0001) and adult life (37.7 and 25.9%, respectively; p = .0065). Also, dysmenorrhea in adolescence was significantly more common among cases (55.6 and 45.4%, respectively; p = .0338). Gynecological pain (dysmenorrhea, non-menstrual pelvic pain, dyspareunia, dysuria, and dyschezia) in patients with RDs was more frequent than in controls (p = .0001, .0001, .0001, .0001, .0002, respectively). Considering women who reported moderate and severe symptoms in RDs, dysmenorrhea and dyspareunia remain significantly more frequent in women with RDs than in controls (p = .0001; p = .0022; respectively). QoL scores were significantly reduced in women with RDs, either in physical (p = .0001) and mental domains (p = .0014) of short-form 12. Conclusion: Women affected by RDs frequently presented menstruation-related disorders; thus, female patients with RDs should be questioned about gynecological symptoms and referred to the gynecologist for an accurate evaluation.
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Effects of Hemp Sanitary Pads on the Vaginal Microecology.
Sun, Y, Li, C, Yan, Y, Lai, A, Peng, X, Yue, X, Li, Y, Liu, J, Liu, Y
Computational and mathematical methods in medicine. 2022;2022:4435722
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Under ideal situations, women have a variety of microbes that reside in the vagina which form the normal vaginal microbiome. When combined, the vaginal microbial flora, endocrine regulation system, anatomic structure of the vagina, and local endocrine system constitute the vaginal microecosystem, which is in turn part of the entire human microecosystem. In fact, the choice of appropriate sanitary pads is of high importance during the menstrual period. The aim of this study was to evaluate the effect of hemp cotton sanitary pads on the vaginal microecology. The study is a randomised controlled field trial study which recruited women of childbearing age. The patients were randomly divided into two groups (experimental and control groups). The control group was further divided into 2 subgroups. The subjects in the experimental group used hemp sanitary pads. Results show that: - among women with a normal vaginal microecosystem or a vaginal microecologic imbalance at baseline, the vaginal cleanliness grade and overall vaginal microecologic status were better if hemp sanitary pads were used rather than the ordinary cotton sanitary pads. - there was no significant difference in the vaginal pH values between the two groups. - hemp sanitary pads had no therapeutic effect against vaginal infections. Authors conclude that the use of hemp cotton sanitary pads during menstruation, by women without vaginal inflammation, can help maintain balanced vaginal microecology which will help to prevent reproductive tract infections.
Abstract
OBJECTIVE To evaluate the effect of hemp cotton sanitary pads on the vaginal microecology. METHODS A randomized controlled field trial was used to recruit 1002 community-based women of childbearing age. The women were randomly divided into experimental and control groups. The experimental group used hemp cotton sanitary pads, while the control group used two types of cotton sanitary randomly chosen from the top five sanitary pads in terms of market share in China. The vaginal microecology was compared between the two groups after three months. RESULTS According to the vaginal microecologic examination results at baseline, 1002 women were included in 3 groups: normal vaginal microecologic, vaginal microecological disorders, and suspected vaginal infections. The number of patients in three groups were 39 (3.9%), 652 (65.1%), and 311 (31%), respectively. Three months later, the vaginal microecologic status and vaginal pH value of the suspected vaginal infection group were not significantly different between the experimental group and control group. The experimental group outperformed the control group with respect to vaginal cleanliness and vaginal microecology status in the women without a vaginal infection (normal vaginal microecology or microecological disorders group). The rate of abnormal cleanliness in the experimental group was lower than the control group (31.95% [108/338] vs. 43.62% [154/353]). The incidence of suspected vaginitis in the experimental group was lower than the control group (15.29% [51/338] vs. 23.51% [83/353]). CONCLUSION For women without vaginal inflammation, the use of hemp cotton sanitary pads during menstruation can help maintain the balance of the vaginal microecology to prevent reproductive tract infections.
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Interaction of cervical microbiome with epigenome of epithelial cells: Significance of inflammation to primary healthcare.
Holubekova, V, Kolkova, Z, Kasubova, I, Samec, M, Mazurakova, A, Koklesova, L, Kubatka, P, Rokos, T, Kozubik, E, Biringer, K, et al
Biomolecular concepts. 2022;13(1):61-80
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A female health is one medical area of the framework strategies in predictive, preventive, and personalized (3P) medicine. Cervical cancer is preventable and successfully treatable at early stages that makes the disease as an ideal candidate applicable in the context of 3P medicine. The aim of this study was to examine the interaction of the cervical microbiome with epithelial cells in relation to inflammation, and to assess direct evidence of epigenetic changes related to the cervical microbiome. This study is a systematic review of publications in the field of cervical cancer research. This review shows that: - cervical cancer screening in future integration of precision cancer prevention regimes should match an individual’s risk of cancer in context with genomic and environmental factors. - identification of microbiome population might be one of the key aspects of precision medicine in the future. Microbial composition may early identify the potential risk of precancerous lesion formation or permanent bacterial vaginosis. - the composition of the microbiome can be influenced by dietary composition, which will also affect the epigenetic background of the microbiome. However, food forms the microbiome through epigenetic mechanisms, and it is thus necessary to clarify how cancer risk is increased due to food-related microbially produced metabolites. - an examination of the metabolites during inflammation of the cervical epithelium and bacterial vaginosis may improve the precise identification of inflammatory-induced biomarkers that could aid in the precision medicine in prediction of the risk of cervical dysplasia development. - cancer-associated inflammation pathways can be influenced by phytochemicals with anti-inflammatory effects on immune cells, suppression of proinflammatory transcription factors, cytokines, and chemokines. The biological balance between uncontrolled chronic inflammation and controlled inflammation is essential for cancer prevention, prediction, and prognostication. Authors conclude that their review highlighted the pivotal contribution of cervical microbiome, epigenetic changes, and inflammation to the formation of cervical intraepithelial lesion and progression to cervical cancer.
Abstract
One pillar of the predictive, preventive, and personalized medicine framework strategies is the female health. The evaluation of women's lifestyle and dietary habits in context with genetic and modifiable risk factors may reflect the prevention of cervical cancer before the occurrence of clinical symptoms and prediction of cervical lesion behavior. The main aim of this review is to analyze publications in the field of precision medicine that allow the use of research knowledge of cervical microbiome, epigenetic modifications, and inflammation in potential application in clinical practice. Personalized approach in evaluating patient's risk of future development of cervical abnormality should consider the biomarkers of the local microenvironment characterized by the microbial composition, epigenetic pattern of cervical epithelium, and presence of chronic inflammation. Novel sequencing techniques enable a more detailed characterization of actual state in cervical epithelium. Better understanding of all changes in multiomics level enables a better assessment of disease prognosis and selects the eligible targeted therapy in personalized medicine. Restoring of healthy vaginal microflora and reversing the outbreak of cervical abnormality can be also achieved by dietary habits as well as uptake of prebiotics, probiotics, synbiotics, microbial transplantation, and others.
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A Deep Look at the Vaginal Environment During Pregnancy and Puerperium.
Severgnini, M, Morselli, S, Camboni, T, Ceccarani, C, Laghi, L, Zagonari, S, Patuelli, G, Pedna, MF, Sambri, V, Foschi, C, et al
Frontiers in cellular and infection microbiology. 2022;12:838405
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In healthy reproductive-aged women, the vaginal microbiome is generally dominated by members of the Lactobacillus genus. Lactobacilli promote the maintenance of the vaginal health, preventing the colonization and growth of adverse microorganisms through various mechanisms. The composition of the vaginal bacterial communities and related metabolites play a crucial role in maternal-foetal health. The aim of this study was to deepen the characteristics of the vaginal environment in a cohort of Caucasian women with a normal pregnancy throughout their different gestational ages (i.e., first, second, third trimester) and puerperium. This study is a prospective study of sixty-three Caucasian pregnant women. Participants were enrolled and sampled during all gestational ages; for 30 of them, clinical and microbiological data were also available for the puerperium. Additionally, 9 women who had a spontaneous miscarriage at the first trimester of pregnancy (gestational age: 11-13 weeks) during the study were included. Results show that: - irrespective of the period and type of pregnancy, bacterial vaginosis cases were characterised by a dramatic reduction of Lactobacillus and an increase of anaerobic bacteria. - the vaginal microbiome becomes more stable throughout the entire pregnancy, being less diverse and mainly dominated by lactobacilli. - women receiving an intrapartum antibiotic prophylaxis for Group B Streptococcus were characterized by a vaginal abundance of Prevotella compared to untreated women. - at the puerperium, a significantly lower content of Lactobacillus and higher levels of Gardnerella, Prevotella, Atopobium, and Streptococcus were observed. Authors conclude that their findings may help implement ‘prognostic’ criteria (e.g., evaluation of the risk of spontaneous miscarriage based on the microbiome/metabolome profiles), as well as strategies for the prevention of early pregnancy loss, based on the ‘manipulation’ of the vaginal bacterial inhabitants.
Abstract
A deep comprehension of the vaginal ecosystem may hold promise for unraveling the pathophysiology of pregnancy and may provide novel biomarkers to identify subjects at risk of maternal-fetal complications. In this prospective study, we assessed the characteristics of the vaginal environment in a cohort of pregnant women throughout their different gestational ages and puerperium. Both the vaginal bacterial composition and the vaginal metabolic profiles were analyzed. A total of 63 Caucasian women with a successful pregnancy and 9 subjects who had a first trimester miscarriage were enrolled. For the study, obstetric examinations were scheduled along the three trimester phases (9-13, 20-24, 32-34 gestation weeks) and puerperium (40-55 days after delivery). Two vaginal swabs were collected at each time point, to assess the vaginal microbiome profiling (by Nugent score and 16S rRNA gene sequencing) and the vaginal metabolic composition (1H-NMR spectroscopy). During pregnancy, the vaginal microbiome underwent marked changes, with a significant decrease in overall diversity, and increased stability. Over time, we found a significant increase of Lactobacillus and a decrease of several genera related to bacterial vaginosis (BV), such as Prevotella, Atopobium and Sneathia. It is worth noting that the levels of Bifidobacterium spp. tended to decrease at the end of pregnancy. At the puerperium, a significantly lower content of Lactobacillus and higher levels of Gardnerella, Prevotella, Atopobium, and Streptococcus were observed. Women receiving an intrapartum antibiotic prophylaxis for Group B Streptococcus (GBS) were characterized by a vaginal abundance of Prevotella compared to untreated women. Analysis of bacterial relative abundances highlighted an increased abundance of Fusobacterium in women suffering a first trimester abortion, at all taxonomic levels. Lactobacillus abundance was strongly correlated with higher levels of lactate, sarcosine, and many amino acids (i.e., isoleucine, leucine, phenylalanine, valine, threonine, tryptophan). Conversely, BV-associated genera, such as Gardnerella, Atopobium, and Sneathia, were related to amines (e.g., putrescine, methylamine), formate, acetate, alcohols, and short-chain fatty-acids (i.e., butyrate, propionate).
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Towards a deeper understanding of the vaginal microbiota.
France, M, Alizadeh, M, Brown, S, Ma, B, Ravel, J
Nature microbiology. 2022;7(3):367-378
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The vaginal microbiota of reproductive-age cisgender women is often dominated by a single species of Lactobacillus and this is associated with good vaginal health. This review looks at the current understanding of the vaginal microbiota and its connection with host health. Women with vaginal microbiota that are not dominated by Lactobacillus species are often diagnosed with bacterial vaginosis (BV). They have an increased risk for sexually transmitted infections (STI), spontaneous preterm birth, prevalence of human papillomavirus (HPV), increased risk for cervical cancer, urinary tract infections and pelvic inflammatory disease. Factors that affect the vaginal microbiota composition are race, age, pre puberty and menopause where levels of circulating oestrogen are lower. Efforts to modulate the vaginal microbiota with antibiotics, oestrogen therapy, lactic or boric acid and vaginal probiotics have not been that successful. Vaginal microbiota transplants (VMT) are a potential approach to treat recurrent BV but further studies are needed.
Abstract
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.