Female genital microbiota: health, pathology, ways of correction
- Authors: Punchenko O.E.1,2, Bereznitskaya E.A.1, Ermolenko E.I.1,2
-
Affiliations:
- I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russian Federation
- Institute of Experimental Medicine
- Issue: No 3 (2021)
- Pages: 18-24
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249002
- DOI: https://doi.org/10.18565/aig.2021.3.18-24
- ID: 249002
Cite item
Abstract
The health of the female reproductive sphere correlates with its inhabiting microbiota. Lactobacilli, which dominate over all other representatives of microorganisms in the vagina of a healthy woman of reproductive age, provide colonization resistance, protect against non-communicable diseases of the reproductive sphere, and affect fertility and the physiological course of pregnancy. In turn, the species and quantitative composition of Lactobacilli depends on the hormonal background, race, age, bad habits of a woman, and the intake of hormonal and antimicrobial drugs. Bacterial vaginosis is one of the most common pathologies in gynecology. The signal for its onset may be an increase in the number of L. iners and a change in the morphology of Lactobacilli. In addition to traditional methods based on the collection of history data and morphological pattern, molecular genetic methods are used to diagnose vaginosis. Treatment policy for women includes the prescription of antimicrobial drugs, hormones, probiotics, and bacteriophages. Monotherapy with antibacterial drugs is ineffective in 30-60% of cases and requires repeated treatment. Several multistrain probiotics may be less effective than a single strain probiotic. Conclusion. The use of probiotics both intravaginally and orally causes a change in mucosal immunity, which not only contributes to the correction of normal biota, but also prevents premature delivery, including in pregnant women with gestational diabetes. A new direction in this treatment is vaginal microbiota transplantation that meets the requirements of personalized therapy.
Keywords
Full Text
![Restricted Access](https://pediatria.orscience.ru/lib/pkp/templates/images/icons/text_lock.png)
About the authors
Olga E. Punchenko
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russian Federation; Institute of Experimental Medicine
Email: olga.punchenko@szgmu.ru
PhD, Associate Professor at the Department of Medical Microbiology
Elena A. Bereznitskaya
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russian Federation
Email: predawnpiper@gmail.com
student
Elena I. Ermolenko
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russian Federation; Institute of Experimental Medicine
Email: lermolenko1@yandex.ru
Dr. Med. Sci, Head of the Laboratory of Biomedical Microecology
References
- Рищук С.В., Пунченко О.Е., Малышева А.А. Эндогенная микробиота влагалища и ее регуляция. Бюллетень Оренбургского научного центра УрО РАН. 2013; 4: 9. [Rischuk S.V., Punchenko O.E., Malysheva A.A. Endogenous vaginal microbiota and its regulation. BONTS UrO RAS. 2013; 4: 9. (in Russian)]. https://cyberleninka.ru/article/n/endogennaya-mikrobiota-vlagalischa-i-eyo-regulyatsiya.
- Рищук С.В., Татарова Н.А., Айрапетян М.С. Эндогенная микробиота влагалища. Диагностика и принципы лечения эндогенной инфекции. Гинекология. 2014; 16(5): 31-40. [Rischuk S.V., Tatarova N.A., Airapetyan M.S. Endogenous vaginal microbiota. Diagnostics and principles of treatment of endogenous infection. Gynecology. 2014; 16(5): 31-40. (in Russian)].
- Godha K., Tucker K.M., Biehl С., Archer D.F., Mirkin S. Human vaginal pH and microbiota: an update. Gynecol. Endocrinol. 2018; 34(6): 451-5. https:// dx.doi.org/10.1080/09513590.2017.1407753.
- Witkin S., Linhares I. Why do Lactobacilli dominate the human vaginal microbiota? BJOG. 2016; 124(4): 606-11. https://dx.doi.org/10.1111/ 1471-0528.14390.
- Chen C., Song X., Wei W., Zhong H., Dai J., Lan Z. et al. The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases. Nat. Commun. 2017; 8(1): 1-11. https://dx.doi.org/10.1038/ s41467-017-00901-0.
- Peric A., Weiss J., Vulliemoz N., Baud D., Stojanov M. Bacterial colonization of the female upper genital tract. Int. J. Mol. Sci. 2019; 20(14): 3405.
- Чаплин А.В., Ребриков Д.В., Болдырева М.Н. Микробиом человека. Вестник Российского государственного медицинского университета. 2017; 2: 5-13. [Chaplin A.V., Rebrikov D.V., Boldyreva M.N. Human microbiome. Bulletin of the Russian State Medical University. 2017; 2: 5-13. (in Russian)].
- Mendling W. Vaginal microbiota. Adv. Exp. Med. Biol. 2016; 902: 83-93. https:// dx.doi.org/10.1007/978-3-319-31248-4_6.
- Muhleisen A., Herbst-Kralovetz M. Menopause and the vaginal microbiome. Maturitas. 2016; 91: 42-50. https://dx.doi.org/10.1016/j.maturitas.2016.05.015.
- Корноухова Л.А., Пунченко О.Е. Повышение диагностической ценности лабораторного исследования при диагностике влагалищных инфекций. Инфекционные болезни. 2014; 12(1): 149. [Kornoukhova L.A., Punchenko O.E. Increasing the diagnostic value of laboratory research in the diagnosis of vaginal infections. Infectious diseases. 2014; 12(1): 149. (in Russian)].
- Petrova M.I., Lievens E., Malik S., Imholz N., Lebeer S. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Front. Physiol. 2015; 6: 81. https://dx.doi.org/10.3389/fphys.2015.00081.
- Singer M., Borg M., Ouburg S., Morre S.A. The relation of the vaginal microbiota to early pregnancy development during in vitro fertilization treatment - A meta-analysis. J. Gynecol. Obstet. Hum. Reprod. 2019; 48(4): 223-9. https:// dx.doi.org/10.1016/j.jogoh.2019.01.007.
- Buggio L., Somigliana E., Borghi A., Vercellini P. Probiotics and vaginal microecology: fact or fancy? BMC Women Health. 2019; 19(1): 25-31. https:// dx.doi.org/10.1186/s12905-019-0723-4.
- Olsen P., Williamson M., Traynor V., Georgiou C. The impact of oral probiotics on vaginal group B streptococcal colonisation rates in pregnant women: A pilot randomised control study. Women and Birth. 2018; 31(1): 31-7. https://dx.doi. org/10.1016/j.wombi.2017.06.012.
- Kroon S., Ravel J., Huston W. Cervicovaginal microbiota, women's health, and reproductive outcomes. Fertil. Steril. 2018; 110(3): 327-36. https:// dx.doi.org/10.1016/j.fertnstert.2018.06.036.
- Haahr T., Jensen J., Thomsen L., Duus L., Rygaard K., Humaidan P. Abnormal vaginal microbiota may be associated with poor reproductive outcomes: a prospective study in IVF patients. Hum. Reprod. 2016; 31(4): 795-803. https:// dx.doi.org/10.1093/humrep/dew026.
- Ворошилина Е.С., Плотко Е.Э., Хаютин Л.В., Тищенко Н.А., Зорников Д.Л. Преобладание Lactobacillus iners в микробиоценозе влагалища женщин с умеренным дисбиозом ассоциировано с наличием клинических признаков инфекционно-воспалительной патологии влагалища. Вестник Российского государственного медицинского университета. 2017; 2: 47-51
- Brotman R.M., Shardell M.D., Gajer P., Sharma E., Mongodin E.F., Ravel J. et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2018; 25(11): 1321-30. https:// dx.doi.org/10.1097/GME.0000000000001236.
- Kyrgiou M., Mitra A., Moscicki A. Does the vaginal microbiota play a role in the development of cervical cancer? Transl. Res. 2017; 179: 168-82. https:// dx.doi.org/10.1016/j.trsl.2016.07.004.
- Peelen M., Luef B., Lamont R., Millianod I., Jensene J.S., Limpenset J. et al. The influence of the vaginal microbiota on preterm birth: A systematic review and recommendations for a minimum dataset for future research. Placenta. 2019; 79: 30-9. https://dx.doi.org/10.1016/j.placenta.2019.03.011.
- Ling Z., Liu X., Chen X., Zhu H., Nelson K.E., Xia Y., Li L., Xiang C. Diversity of cervicovaginal microbiota associated with female lower genital tract infections. Microb. Ecol. 2011; 61(3):704-14. https://dx.doi.org/10.1007/ s00248-011-9813-z.
- Brotman R., He X., Gajer P., Sharma E., Mongodin E.F., Ravel J. et al. Association between cigarette smoking and the vaginal microbiota: a pilot study. BMC Infect. Dis. 2014; 28(14): 471-82. https://dx.doi.org/10.1186/ 1471-2334-14-471.
- Gille C., Boer B., Marschal M., Urschitz M.S., Heinecke V., Hund V. et al. Effect of probiotics on vaginal health in pregnancy. EFFPRO, a randomized controlled trial. Am. J. Obstet. Gynecol. 2016; 215(5): 608-15. https://dx.doi. org/10.1016/j.ajog.2016.06.021.
- Smith S., Ravel J. The vaginal microbiota, host defence and reproductive physiology. J. Physiol. 2016; 595(2): 451-63. https://dx.doi.org/10.1113/ JP271694.
- Eastment M.C., McClelland R.S. Vaginal microbiota and susceptibility to HIV. AIDS. 2018; 32(6): 687-98. https://dx.doi.org/10.1097/ QAD.0000000000001768.
- Javed A., Parvaiz F., Manzoor S. Bacterial vaginosis: An insight into the prevalence, alternative treatments regimen and it's associated resistance patterns. Microb. Pathog. 2019; 127: 21-30. https://dx.doi.org/10.1016/j. micpath.2018.11.046.
- Li C., Wang T., Li Y., Zhang T., Wang Q., Heet J. et al. Probiotics for the treatment of women with bacterial vaginosis: A systematic review and metaanalysis of randomized clinical trials. Eur. J. Pharmacol. 2019; 864: 172660. https://dx.doi.org/10.1016/j.ejphar.2019.172660.
- Bassis C.M., Allsworth J.E., Wahl H.N., Sack D.E., Young V.B., Bell J.D. Effects of intrauterine contraception on the vaginal microbiota. Contraception. 2017; 96(3): 189-95. https://dx.doi.org/10.1016/ j.contraception.2017.05.017.
- Russo R., Karadja E., De Seta F. Evidence-based mixture containing Lactobacillus strains and lactoferrin to prevent recurrent bacterial vaginosis: a double blind, placebo controlled, randomised clinical trial. Benef. Microbes. 2019; 10 (1): 19-26. https://dx.doi.org/10.3920/BM2018.0075.
- Homayouni A., Bastani P., Ziyadi S., Mohammad-Alizadeh-Charandabi S., Ghalibaf M., Mortazavian A.M., Mehrabany E.V. Effects of probiotics on the recurrence of bacterial vaginosis: a review. J. Low. Genit. Tract Dis. 2014; 18(1): 79-86. https://dx.doi.org/10.1097/ LGT.0b013e31829156ec.
- Kirihara N., Kamitomo M., Tabira T., Hashimoto T., Taniguchi H., Maeda T. Effect of probiotics on perinatal outcome in patients at high risk of preterm birth. Obstet. Gynaecol. Res. 2017; 44(2): 241-7. https://dx.doi.org/10.1111/ jog.13497
- Lev-Sagie A., Goldman-Wohl D., Cohen Y., Dori-Bachash M., Leshem A., Mor U. et al. Vaginal microbiome transplantation in women with intractable bacterial vaginosis. Nat. Med. 25(10):1500-4. https://dx.doi.org/10.1038/ s41591-019-0600-6.
- Ma D., Chen Y., Chen T. Vaginal microbiota transplantation for the treatment of bacterial vaginosis: a conceptual analysis. FEMS Microbiol. Lett. 2019; 366(4): fnz025. https://dx.doi.org/10.1093/femsle/fnz025.
- Hanson L., VandeVusse L., Jerm e M., Abad C.L., Safdar N. Probiotics for treatment and prevention of urogenital infections in women: a systematic review. J. Midwifery Women’s Health. 2016; 61(3): 339-55. https://dx.doi.org/10.1111/ jmwh.12472.
- Jarde A., Lewis-Mikhael A., Moayyedi P., Stearns J.C., Collins S.M., Beyene J., McDonald S.D. Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018; 18(1):14. https://dx.doi.org/10.1186/s12884-017-1629-5.
- Радзинский В.Е., Ордиянц И.М., Побединская О.С., Буянова Н.В. Современные аспекты коррекции дисбиотических нарушений в гинекологической практике. Акушерство и гинекология: новости, мнения, обучение. 2013; 2: 72-5. [Radzinsky V.E., Ordiyants I.M., Pobedinskaya O.S. et al. Modern aspects of correction of dysbiotic disorders in gynecological practice. Obstetrics and Gynecology: News. Opinions. Training. 2013; 2: 72-5. (in Russian)].
- Калинкина О.Б., Tезиков Ю.В., Липатов И.С., Аравина О.Р. Исследование микробиоты урогенитального тракта и кишечника у женщин с III-IV стадиями эндометриоза яичников. Пермский медицинский журнал. 2020; 37(1): 14-21. [Kalinkina O.B., Tezikov Yu.V., Lipatov I.S., Aravina O.R. Study of the microbiota of the urogenital tract and intestines in women with stages III-IV ovarian endometriosis. Perm Medical Journal. 2020; 37(1): 14-21. (in Russian)].
Supplementary files
![](/img/style/loading.gif)