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Microorganisms
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Vaginal Microbiota: Impact on Health and Disease
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Vaginal Microbiota: Impact on Health and Disease

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 20064

Special Issue Editors

Prof. Dr. Claudia Monari

E-Mail Website
Guest Editor
Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy
Interests: vulvovaginal candidiasis; bacterial vaginosis; microbial pathogenesis; probiotics; microorganism-host interaction; microbiome and mycobiome
Dr. Samuele Sabbatini

E-Mail Website
Guest Editor
Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06129 Perugia, Italy
Interests: SARS-CoV-2; antivirals; COVID-19; VOCs; Candida albicans; biofilm infections; probiotics; antimicrobial resistance
Special Issues, Collections and Topics in MDPI journals
Dr. Roberta Gaziano

E-Mail Website
Guest Editor
Department of Experimental Medicine, Microbiology and Clinical Microbiology, University of Rome Tor Vergata, 00133 Rome, Italy
Interests: Aspergillus ssp.; Candida spp.; fungal infections; antimycotic drugs; fungal biofilm; fungi-host interaction; antifungal resistance; natural compounds
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The vaginal microbial community is characterized by the presence of numerous microorganisms in a dynamic balance between themselves and the host. Maintaining this balance is essential for safeguarding vaginal health, as any disturbances of these complex interactions can cause vaginal dysbiosis; thus, promoting the onset of vaginal infections, i.e., bacterial vaginosis (BV), aerobic vaginitis, vulvovaginal candidiasis, and sexually transmitted infections (STIs).

Deciphering the interactions of vaginal microorganisms between themselves and the host is of crucial importance to increase our knowledge regarding the pathogenesis of vaginal infections as well as for the development of novel diagnostic tools and effective therapeutic approaches.

This Microorganisms Special Issue aims to offer deep insight into the latest research developments dedicated to novel aspects regarding the interplay of vaginal microbial communities between themselves and their host. Articles proposing novel potential approaches, i.e., probiotics and/or prebiotics, for the prevention or treatment of vaginal infections are also desired.

Prof. Dr. Claudia Monari
Dr. Samuele Sabbatini
Dr. Roberta Gaziano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • microbiota
  • vaginal dysbiosis
  • microorganism–host interaction
  • vulvovaginal candidiasis
  • bacterial vaginosis
  • biofilms
  • probiotics
  • prebiotics

Published Papers (7 papers)

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Research

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14 pages, 2283 KiB  
Article
Anti-Candida and Anti-Inflammatory Properties of a Vaginal Gel Formulation: Novel Data Concerning Vaginal Infection and Dysbiosis
by Luca Spaggiari, Gianfranco B. Squartini Ramos, Caterina A. Squartini Ramos, Andrea Ardizzoni, Natalia Pedretti, Elisabetta Blasi, Francesco De Seta and Eva Pericolini
Microorganisms 2023, 11(6), 1551; https://doi.org/10.3390/microorganisms11061551 - 10 Jun 2023
Viewed by 1545
Abstract
Vaginal ecosystem is a unique environment where, in physiological conditions, lactobacilli dominate. However, pathogenic microbial species responsible for vaginitis and vaginosis can also harbor vaginal microbiota. To extend our previously published data, we analyzed here both the anti-Candida and anti-inflammatory properties of [...] Read more.
Vaginal ecosystem is a unique environment where, in physiological conditions, lactobacilli dominate. However, pathogenic microbial species responsible for vaginitis and vaginosis can also harbor vaginal microbiota. To extend our previously published data, we analyzed here both the anti-Candida and anti-inflammatory properties of the vaginal gel formulation, Respecta® Balance Gel (RBG), commercialized as an adjuvant to treat vaginitis and vaginosis. We evaluated its activity by an in vitro model where a monolayer of A-431 vaginal epithelial cells was infected by Candida albicans in the presence of RBG or the placebo formulation (pRBG). Specifically, we tested the RBG capacity to counteract C. albicans virulence factors and their anti-inflammatory properties. Our results show that, unlike the placebo, RBG reduces C. albicans adhesion, its capacity to form hyphae and C. albicans-induced vaginal cell damage. Interestingly, both RBG and pRBG reduce LPS-induced IL-8 secretion (with RBG being the most effective), demonstrating that also the placebo retains anti-inflammatory properties. From our experimental approach, we highlighted the possible role of farnesol on such effects, but we would like to point out that lactic acid, polydextrose and glycogen too must be relevant in the actual application. In summary, our results show that RBG impairs C. albicans virulence and is able to reduce the inflammation in the vaginal environment, ultimately allowing the establishment of a balanced vaginal ecosystem. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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10 pages, 1302 KiB  
Communication
Transcriptomic and Proteomic Analysis of Gardnerella vaginalis Responding to Acidic pH and Hydrogen Peroxide Stress
by Kundi Zhang, Mengyao Lu, Yuxin Qiu, Xiaoxuan Zhu, Hongwei Wang, Yan Huang, Hongjie Dong and Lichuan Gu
Microorganisms 2023, 11(3), 695; https://doi.org/10.3390/microorganisms11030695 - 8 Mar 2023
Cited by 1 | Viewed by 1816
Abstract
Gardnerella vaginalis is the main pathogen that causes bacterial vaginosis. In the healthy vaginal microecological environment of a woman, the lactobacilli produce lactate and hydrogen peroxide to inhibit the growth of pathogens such as G. vaginalis. The lack of lactobacilli results in [...] Read more.
Gardnerella vaginalis is the main pathogen that causes bacterial vaginosis. In the healthy vaginal microecological environment of a woman, the lactobacilli produce lactate and hydrogen peroxide to inhibit the growth of pathogens such as G. vaginalis. The lack of lactobacilli results in a high pH and low hydrogen peroxide in the vagina which facilitate G. vaginalis growth, leading to the imbalance of the vaginal microecology. In this study, lactate and hydrogen peroxide were added to a G. vaginalis culture medium to simulate the co-culture of the lactobacilli and G. vaginalis, and then the genes related to the stress response of G. vaginalis were identified using transcriptomics and proteomics. It was indicated that, among all the upregulated genes, most of them encoded transporters associated with the efflux of harmful substances, and the majority of the downregulated genes were related to the biofilm formation and epithelial cell adhesion. This study may help find new drug targets for G. vaginalis for the development of novel therapies for bacterial vaginosis. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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24 pages, 1470 KiB  
Article
A Healthy Vaginal Microbiota Remains Stable during Oral Probiotic Supplementation: A Randomised Controlled Trial
by Anna Lyra, Reeta Ala-Jaakkola, Nicolas Yeung, Neeta Datta, Kara Evans, Ashley Hibberd, Markus J. Lehtinen, Sofia D. Forssten, Alvin Ibarra, Tommi Pesonen, Jouni Junnila, Arthur C. Ouwehand, Keith Baranowski, Johanna Maukonen, Gordon Crawford and Liisa Lehtoranta
Microorganisms 2023, 11(2), 499; https://doi.org/10.3390/microorganisms11020499 - 16 Feb 2023
Cited by 2 | Viewed by 3432
Abstract
The primary objective of this randomised, placebo-controlled, triple-blind study was to assess whether orally consumed Lactobacillus acidophilus La-14 (La-14) and Lacticaseibacillus rhamnosus HN001 (HN001) colonise a healthy human vagina. Furthermore, potential effects on vaginal microbiota and immune markers were explored. Fifty women devoid [...] Read more.
The primary objective of this randomised, placebo-controlled, triple-blind study was to assess whether orally consumed Lactobacillus acidophilus La-14 (La-14) and Lacticaseibacillus rhamnosus HN001 (HN001) colonise a healthy human vagina. Furthermore, potential effects on vaginal microbiota and immune markers were explored. Fifty women devoid of vaginal complaints (Nugent score 0–3 and vaginal pH ≤ 4.5) were randomised into a 2-week intervention with either La-14 and HN001 as the verum product or a comparable placebo. Vaginal swab samples were collected at baseline, after one and two weeks of intervention, and after a one-week follow-up, for assessing colonisation of the supplemented lactobacilli, vaginal microbiota, and six specific immune markers. Colonisation of L. acidophilus and L. rhamnosus was not observed above the assay detection limit (5.29 and 5.11 log 10 genomes/swab for L. acidophilus and L. rhamnosus, respectively). Vaginal microbiotas remained stable and predominated by lactobacilli throughout the intervention, and vaginal pH remained optimal (at least 90% of participants in both groups had pH 4.0 or 4.5 throughout the study). Immune markers elafin and human β-defensin 3 (HBD-3) were significantly decreased in the verum group (p = 0.022 and p = 0.028, respectively) but did not correlate with any microbiota changes. Adverse events raised no safety concerns, and no undesired changes in the vaginal microbiota or immune markers were detected. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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11 pages, 1905 KiB  
Article
Vaginal Leptothrix: An Innocent Bystander?
by Pedro Vieira-Baptista, Joana Lima-Silva, Mario Preti, Carlos Sousa, Fernanda Caiano, Colleen K. Stockdale and Jacob Bornstein
Microorganisms 2022, 10(8), 1645; https://doi.org/10.3390/microorganisms10081645 - 15 Aug 2022
Cited by 1 | Viewed by 2484
Abstract
Leptothrix are long bacteria of rare occurrence; although these bacteria have been implicated in causing vaginal symptoms identical to candidiasis, studies on prevalence and effect on overall vaginal health are lacking. In this study, we evaluated data of women referred to a private [...] Read more.
Leptothrix are long bacteria of rare occurrence; although these bacteria have been implicated in causing vaginal symptoms identical to candidiasis, studies on prevalence and effect on overall vaginal health are lacking. In this study, we evaluated data of women referred to a private clinic for treating vulvovaginal symptoms (n = 1847) and reassessed data of our previous and ongoing studies (n = 1773). The overall rate of leptothrix was 2.8% (102/3620), and the mean age of affected women was 38.8 ± 10.65 years (range 18−76). The majority of the women with leptothrix had normal vaginal flora (63.7% [65/102]). Leptothrix was associated with a higher risk of candidiasis (relative risk (RR) 1.90, 95% confidence interval (CI) 1.1600–3.1013; p = 0.010) and a lower risk of bacterial vaginosis (RR 0.55, 95% CI, 0.3221–0.9398; p = 0.029) and cytolytic vaginosis (RR 0.11, 95% CI, 0.0294–0.4643; p = 0.002). No cases of trichomoniasis were observed. Human immunodeficiency virus infection increased the risk of leptothrix (RR 3.0, 95% CI, 1.6335–5.7245; p = 0.000). Among the women evaluated for vulvovaginal symptoms, 2.4% (45/1847) had leptothrix, and in 26.7% (12/45), leptothrix was considered the causative entity. This study suggests that leptothrix occurrence is rare; it remains unresolved if it can be a cause of vulvar symptoms. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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Review

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13 pages, 1487 KiB  
Review
The Impact of the Female Genital Microbiota on the Outcome of Assisted Reproduction Treatments
by Giovanna Cocomazzi, Silvia De Stefani, Lino Del Pup, Simone Palini, Matteo Buccheri, Mariangela Primiterra, Natale Sciannamè, Raffaele Faioli, Annamaria Maglione, Giorgio Maria Baldini, Domenico Baldini and Valerio Pazienza
Microorganisms 2023, 11(6), 1443; https://doi.org/10.3390/microorganisms11061443 - 30 May 2023
Cited by 6 | Viewed by 3309
Abstract
The vaginal microbiota plays a critical role in the health of the female genital tract, and its composition contributes to gynecological disorders and infertility. Lactobacilli are the dominant species in the female genital tract: their production of lactic acid, hydrogen peroxide, and bacteriocins [...] Read more.
The vaginal microbiota plays a critical role in the health of the female genital tract, and its composition contributes to gynecological disorders and infertility. Lactobacilli are the dominant species in the female genital tract: their production of lactic acid, hydrogen peroxide, and bacteriocins prevents the invasion and growth of pathogenic microorganisms. Several factors such as hormonal changes, age of reproduction, sexual practices, menstrual cycle, pregnancy, and antimicrobial drugs use can cause imbalance and dysbiosis of the vaginal microbiota. This review aims to highlight the impact of the vaginal microbiota in Assisted Reproductive Technology techniques (ART) and it examines the factors that influence the vaginal microbiota, the consequences of dysbiosis, and potential interventions to restore a healthy female genital tract. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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28 pages, 2011 KiB  
Review
The Interplay between Candida albicans, Vaginal Mucosa, Host Immunity and Resident Microbiota in Health and Disease: An Overview and Future Perspectives
by Roberta Gaziano, Samuele Sabbatini and Claudia Monari
Microorganisms 2023, 11(5), 1211; https://doi.org/10.3390/microorganisms11051211 - 5 May 2023
Cited by 7 | Viewed by 4094
Abstract
Vulvovaginal candidiasis (VVC), which is primarily caused by Candida albicans, is an infection that affects up to 75% of all reproductive-age women worldwide. Recurrent VVC (RVVC) is defined as >3 episodes per year and affects nearly 8% of women globally. At mucosal [...] Read more.
Vulvovaginal candidiasis (VVC), which is primarily caused by Candida albicans, is an infection that affects up to 75% of all reproductive-age women worldwide. Recurrent VVC (RVVC) is defined as >3 episodes per year and affects nearly 8% of women globally. At mucosal sites of the vagina, a delicate and complex balance exists between Candida spp., host immunity and local microbial communities. In fact, both immune response and microbiota composition play a central role in counteracting overgrowth of the fungus and maintaining homeostasis in the host. If this balance is perturbed, the conditions may favor C. albicans overgrowth and the yeast-to-hyphal transition, predisposing the host to VVC. To date, the factors that affect the equilibrium between Candida spp. and the host and drive the transition from C. albicans commensalism to pathogenicity are not yet fully understood. Understanding the host- and fungus-related factors that drive VVC pathogenesis is of paramount importance for the development of adequate therapeutic interventions to combat this common genital infection. This review focuses on the latest advances in the pathogenic mechanisms implicated in the onset of VVC and also discusses novel potential strategies, with a special focus on the use of probiotics and vaginal microbiota transplantation in the treatment and/or prevention of recurrent VVC. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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Other

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4 pages, 204 KiB  
Opinion
How Do Lactobacilli Search and Find the Vagina?
by Gregor Reid
Microorganisms 2023, 11(1), 148; https://doi.org/10.3390/microorganisms11010148 - 6 Jan 2023
Cited by 2 | Viewed by 1888
Abstract
With the advent of omics technology and the improved culturing of anaerobic microbes, there is a good understanding of the microorganisms present in a healthy and diseased vagina. This has led to the identification of a select few Lactobacillus species associated with health. [...] Read more.
With the advent of omics technology and the improved culturing of anaerobic microbes, there is a good understanding of the microorganisms present in a healthy and diseased vagina. This has led to the identification of a select few Lactobacillus species associated with health. However, the origin of these species and how they reach the vagina remains unclear, as does their timing of colonization. In an effort to create badly needed therapies for women, these gaps in knowledge need to be addressed. Full article
(This article belongs to the Special Issue Vaginal Microbiota: Impact on Health and Disease)
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