Review and opinion articles on the vaginal microbiota

We have published two new papers on the vaginal microbiota. The first one is a review written with Steve Smith, who is a talented graduate student in the group working at the interface of biology and computational biology. The review is on the interplay between the vaginal microbiota, the host immune systems and the reproductive physiology. Here is the abstract:

The interaction between the human host and the vaginal microbiota is highly dynamic. Major changes in the vaginal physiology and microbiota over a woman's lifetime are largely shaped by transitional periods such as puberty, menopause, or pregnancy, while daily fluctuations in microbial composition observed through culture-independent studies are more likely the results of daily life activities and behaviours. The vaginal microbiota of reproductive-aged women is largely made up of at least five different community state types. Four of these community state types are dominated by lactic-acid producing Lactobacillus spp. while the fifth is commonly composed of anaerobes and strict anaerobes and is sometimes associated with vaginal symptoms. The production of lactic acid has been associated with contributing to the overall health of the vagina due to its direct and indirect effects on pathogens and host defense. Some species associated with non-Lactobacillus vaginal microbiota may trigger immune responses as well as degrade the host mucosa, processes that ultimately increase susceptibility to infections and contribute to negative reproductive outcomes such as infertility and preterm birth. Further studies are needed to better understand the functional underpinnings of how the vaginal microbiota affect host physiology but also how host physiology affects the vaginal microbiota. Understanding this fine-tuned interaction is key to maintaining women's reproductive health.

The second paper is an opinion paper/commentary on the gaps and challenges to translating vaginal microbiome research. I co-authored the paper with Rebecca Brotman at IGS. The commentary addresses the potential of management, manipulation, and restoration of a robust vaginal microbiota  to improve women’s health and disease prevention. It makes a case for the development of a systems level understanding of how the vaginal microbiota is associated with gynecologic and reproductive health in order to develop effective interventional strategies. Consideration of timing of intervention and aspect of immune tolerance to vaginal microbes are also discussed.