The Human Microbiome during Bacterial Vaginosis Original paper
Researched by:
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Divine Aleru
ID
Divine Aleru
Read MoreI 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
Read More
Researched by:
-
Divine Aleru
ID
Divine Aleru
Read More
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 examines the human microbiome during bacterial vaginosis (BV), focusing on microbial shifts, host immune responses, and diagnostic challenges. It evaluates BV as a polymicrobial condition rather than an infection caused by a single pathogen. The review highlights how microbial imbalances contribute to BV symptoms, persistence, and recurrence. Additionally, it explores epidemiological factors, diagnostic methods, and host-microbiome interactions that influence BV progression and treatment response.
Who Was Reviewed?
The review synthesizes findings from studies involving women diagnosed with BV, including those experiencing recurrent infections. It incorporates data from molecular sequencing studies and microbiological research to assess the composition of the vaginal microbiome during BV. Additionally, it examines host immune responses to BV-related microbial changes and evaluates the link between BV and increased susceptibility to sexually transmitted infections (STIs) and pregnancy complications such as preterm birth.
Most Important Findings
BV disrupts the vaginal microbiome by reducing Lactobacillus species and increasing anaerobic bacteria such as Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., Mobiluncus spp., and Sneathia spp. Unlike infections that trigger a strong inflammatory response, BV presents as a microbial imbalance rather than an acute immune reaction. The review also highlights how bacterial biofilms protect BV-associated bacteria from antibiotic treatment, contributing to high recurrence rates.
The study also discusses BV’s complex interaction with the host immune system. BV-associated bacteria produce virulence factors that degrade the vaginal mucosal barrier, leading to increased inflammatory markers such as interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNF-α). This immune dysregulation may explain BV’s association with increased STI susceptibility and adverse pregnancy outcomes.
Diagnosing BV remains challenging due to inconsistencies in clinical and laboratory criteria. Amsel’s clinical criteria and Nugent scoring, which rely on symptom assessment and Gram staining, remain the primary diagnostic tools. However, these methods fail to account for BV’s diverse microbial community, leading to inconsistencies in diagnosing recurrent and persistent cases. The review emphasizes the need for molecular sequencing-based diagnostics that provide a more precise understanding of BV-associated bacterial communities.
Implications of the Review
BV presents a significant clinical challenge due to its high recurrence rate, treatment limitations, and association with reproductive health complications. The review underscores the importance of shifting towards microbiome-targeted therapies rather than relying solely on broad-spectrum antibiotics. Future research should focus on developing treatments that restore Lactobacillus-dominant vaginal microbiota and prevent biofilm formation. Refining molecular diagnostic techniques will help clinicians identify BV-associated bacterial communities more accurately, improving treatment strategies and reducing recurrence.
This review highlights the urgent need for improved diagnostic criteria, personalized treatment approaches, and a deeper understanding of the vaginal microbiome’s role in BV persistence. Advancing these areas of research will help clinicians develop more effective, long-term solutions for BV management.
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.
Amsel’s Criteria
Amsel's Criteria is a clinically established diagnostic method for bacterial vaginosis, offering a practical and accessible alternative to laboratory-based approaches. It evaluates four key clinical indicators, ensuring timely diagnosis and intervention in outpatient settings.
Nugent Score
The Nugent Score is a standardized Gram stain-based scoring system used to diagnose bacterial vaginosis (BV) by assessing key bacterial morphotypes in vaginal samples. With its high specificity, it remains a gold standard in microbiome research, though its complexity and need for trained personnel make it less common in routine clinical practice.