The interplay between microbiota, metabolites, immunity during BV Original paper
Researched by:
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Divine Aleru
ID
Divine Aleru
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Bacterial Vaginosis
Bacterial Vaginosis
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiota, where the typically dominant Lactobacillus species are significantly reduced, leading to an overgrowth of anaerobic and facultative bacteria.
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Divine Aleru
Researched by:
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Divine Aleru
ID
Divine Aleru
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was Reviewed?
This review explored the complex interplay between the vaginal microbiota, metabolite production, and local immune responses in the pathogenesis of bacterial vaginosis (BV). The authors synthesized existing research on how shifts in the vaginal microbiome from Lactobacillus-dominant communities to polymicrobial anaerobic communities contribute to BV development, symptoms, and recurrence. The review particularly emphasized the combined role of microbiota composition, bacterial metabolic products, and vaginal immune responses in driving clinical outcomes and disease persistence.
Who was Reviewed?
The review covered a wide body of research focusing on reproductive-age women diagnosed with or at risk for BV. It drew from studies examining the vaginal microbiota, including key bacteria such as Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., Mobiluncus spp., and Sneathia sanguinegens, as well as the protective Lactobacillus species like L. crispatus and L. iners. It also reviewed studies on the vaginal metabolome and immune responses in BV-positive and BV-negative women.
Most Important Findings
The review consolidated evidence that BV is a multifactorial condition characterized by dysbiosis of the vaginal microbiota, metabolic disruption, and altered immune responses. It described how healthy vaginal microbiomes are dominated by Lactobacillus species, particularly L. crispatus, which maintain vaginal acidity and protect against pathogens. In contrast, BV involves a shift toward a polymicrobial anaerobic community, with increased abundance of Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., Mobiluncus spp., and Sneathia spp., collectively referred to as major microbial associations (MMA) of BV.
These BV-associated bacteria produce key metabolites, including short-chain fatty acids (SCFAs) like acetate and propionate, and volatile amines like putrescine and cadaverine, which raise vaginal pH and produce the characteristic fishy odor of BV. Additionally, BV-associated biofilm formation, particularly involving G. vaginalis and A. vaginae, enhances bacterial persistence and resistance to treatment.
The review highlighted that these microbial and metabolic changes interact with the host’s immune system. BV patients exhibit elevated pro-inflammatory cytokines, especially IL-1β, without a corresponding increase in neutrophil recruitment. This unique immune profile likely results from SCFA-mediated suppression of neutrophil chemotaxis and explains why BV lacks overt inflammatory symptoms despite microbial overgrowth.
Implications of this Review
This review emphasizes the need to redefine BV beyond a simple microbial imbalance. It emphasizes that the metabolic products of BV-associated bacteria and their impact on host immunity are central to disease progression and recurrence. Clinicians should consider not only microbial community shifts but also metabolite profiles and immune responses when diagnosing and managing BV. The review calls for the integration of multi-omic data, microbiome, metabolome, and immunome, to develop more accurate diagnostics and targeted therapeutic strategies. Understanding these interactions may guide the design of personalized interventions to restore microbial and metabolic homeostasis, reduce BV recurrence, and mitigate associated reproductive health risks.
Bacterial Vaginosis
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiota, where the typically dominant Lactobacillus species are significantly reduced, leading to an overgrowth of anaerobic and facultative bacteria.