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A longitudinal analysis of the vaginal microbiota and vaginal immune mediators in women from sub-Saharan Africa.

A longitudinal analysis of the vaginal microbiota and vaginal immune mediators in women from sub-Saharan Africa.
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Jespers V, Kyongo J, Joseph S, Hardy L, Cools P, Crucitti T, Mwaura M, Ndayisaba G, Delany-Moretlwe S, Buyze J, Vanham G, van de Wijgert JHHM,


Jespers V, Kyongo J, Joseph S, Hardy L, Cools P, Crucitti T, Mwaura M, Ndayisaba G, Delany-Moretlwe S, Buyze J, Vanham G, van de Wijgert JHHM, (click to view)

Jespers V, Kyongo J, Joseph S, Hardy L, Cools P, Crucitti T, Mwaura M, Ndayisaba G, Delany-Moretlwe S, Buyze J, Vanham G, van de Wijgert JHHM,

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Scientific reports 2017 09 207(1) 11974 doi 10.1038/s41598-017-12198-6

Abstract

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.

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