TY - JOUR
T1 - A longitudinal analysis of the vaginal microbiota and vaginal immune mediators in women from sub-Saharan Africa
AU - Jespers, Vicky
AU - Kyongo, Jordan
AU - Joseph, Sarah
AU - Hardy, Liselotte
AU - Cools, Piet
AU - Crucitti, Tania
AU - Mwaura, Mary
AU - Ndayisaba, Gilles
AU - Delany-Moretlwe, Sinead
AU - Buyze, Jozefien
AU - Vanham, Guido
AU - Van De Wijgert, Janneke H.H.M.
N1 - Funding Information:
This work was supported by the European and Developing Countries Clinical Trials Partnership (EDCTP) as part of a grant titled “Characterisation of novel microbicide safety biomarkers in East and South Africa”; grant number: IP_2007_33070_001. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of EDCTP. The authors wish to thank the study participants and the Vaginal Biomarkers Study teams at the International Centre for Reproductive Health in Mombasa, Kenya (PIs: Mary Mwaura and Kishor Mandaliya), and in Ghent, Belgium; the Wits Reproductive Health and HIV Institute, Johannesburg, South-Africa (PI: Sinead Delany-Moretlwe); Rinda Ubuzima in Kigali, Rwanda (PI: Gilles Ndayisaba); the Institute of Tropical Medicine in Antwerp, Belgium; the Amsterdam Institute of Global Health and Development in Amsterdam, the Netherlands; the MRC Clinical Trials Unit at University College London, United Kingdom; and the London School of Hygiene and Tropical Medicine in London, United Kingdom. The authors also thank Kevin Ariën and Raina Fichorova for contributions to the immunology testing, and Joris Menten for contributions to the statistical analyses.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/12/1
Y1 - 2017/12/1
N2 - In cross-sectional studies increased vaginal bacterial diversity has been associated with vaginal inflammation which can be detrimental for health. We describe longitudinal changes at 5 visits over 8 weeks in vaginal microbiota and immune mediators in African women. Women (N = 40) with a normal Nugent score at all visits had a stable lactobacilli dominated microbiota with prevailing Lactobacillus iners. Presence of prostate-specific antigen (proxy for recent sex) and being amenorrhoeic (due to progestin-injectable use), but not recent vaginal cleansing, were significantly associated with microbiota diversity and inflammation (controlled for menstrual cycle and other confounders). Women (N = 40) with incident bacterial vaginosis (Nugent 7-10) had significantly lower concentrations of lactobacilli and higher concentrations of Gardnerella vaginalis, Atopobium vaginae, and Prevotella bivia, at the incident visit and when concentrations of proinflammatory cytokines (IL-1β, IL-12p70) were increased and IP-10 and elafin were decreased. A higher 'composite-qPCR vaginal-health-score' was directly associated with decreased concentrations of proinflammatory cytokines (IL-1α, IL-8, IL-12(p70)) and increased IP-10. This longitudinal study confirms the inflammatory nature of vaginal dysbiosis and its association with recent vaginal sex and progestin-injectable use. A potential role for proinflammatory mediators and IP-10 in combination with the vaginal-health-score as predictive biomarkers for vaginal dysbiosis merits further investigation.
AB - In cross-sectional studies increased vaginal bacterial diversity has been associated with vaginal inflammation which can be detrimental for health. We describe longitudinal changes at 5 visits over 8 weeks in vaginal microbiota and immune mediators in African women. Women (N = 40) with a normal Nugent score at all visits had a stable lactobacilli dominated microbiota with prevailing Lactobacillus iners. Presence of prostate-specific antigen (proxy for recent sex) and being amenorrhoeic (due to progestin-injectable use), but not recent vaginal cleansing, were significantly associated with microbiota diversity and inflammation (controlled for menstrual cycle and other confounders). Women (N = 40) with incident bacterial vaginosis (Nugent 7-10) had significantly lower concentrations of lactobacilli and higher concentrations of Gardnerella vaginalis, Atopobium vaginae, and Prevotella bivia, at the incident visit and when concentrations of proinflammatory cytokines (IL-1β, IL-12p70) were increased and IP-10 and elafin were decreased. A higher 'composite-qPCR vaginal-health-score' was directly associated with decreased concentrations of proinflammatory cytokines (IL-1α, IL-8, IL-12(p70)) and increased IP-10. This longitudinal study confirms the inflammatory nature of vaginal dysbiosis and its association with recent vaginal sex and progestin-injectable use. A potential role for proinflammatory mediators and IP-10 in combination with the vaginal-health-score as predictive biomarkers for vaginal dysbiosis merits further investigation.
UR - https://www.scopus.com/pages/publications/85029635923
U2 - 10.1038/s41598-017-12198-6
DO - 10.1038/s41598-017-12198-6
M3 - Article
AN - SCOPUS:85029635923
SN - 2045-2322
VL - 7
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 11974
ER -