Hardy Liselotte, Jespers Vicky, De Baetselier Irith, Buyze Jozefien, Mwambarangwe Lambert, Musengamana Viateur, van de Wijgert Janneke, Crucitti Tania
HIV and Sexual Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
HIV/STI Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
PLoS One. 2017 Jun 8;12(6):e0178324. doi: 10.1371/journal.pone.0178324. eCollection 2017.
We investigated the presence, density and bacterial composition of contraceptive vaginal ring biomass and its association with the vaginal microbiome. Of 415 rings worn by 120 Rwandese women for three weeks, the biomass density was assessed with crystal violet and the bacterial composition of biomass eluates was assessed with quantitative polymerase chain reaction (qPCR). The biomass was visualised after fluorescence in situ hybridisation (FISH) and with scanning electron microscopy (SEM). The vaginal microbiome was assessed with Nugent scoring and vaginal biofilm was visualised after FISH. All vaginal rings were covered with biomass (mean optical density (OD) of 3.36; standard deviation (SD) 0.64). Lactobacilli were present on 93% of the rings, Gardnerella vaginalis on 57%, and Atopobium vaginae on 37%. The ring biomass density was associated with the concentration of A. vaginae (OD +0.03; 95% confidence interval (CI) 0.01-0.05 for one log increase; p = 0.002) and of G. vaginalis (OD +0.03; (95% CI 0.01-0.05; p = 0.013). The density also correlated with Nugent score: rings worn by women with a BV Nugent score (mean OD +0.26), and intermediate score (mean OD +0.09) had a denser biomass compared to rings worn by participants with a normal score (p = 0.002). Furthermore, presence of vaginal biofilm containing G. vaginalis (p = 0.001) and A. vaginae (p = 0.005) correlated with a denser ring biomass (mean OD +0.24 and +0.22 respectively). With SEM we observed either a loose network of elongated bacteria or a dense biofilm. We found a correlation between vaginal dysbiosis and the density and composition of the ring biomass, and further research is needed to determine if these relationships are causal. As multipurpose vaginal rings to prevent pregnancy, HIV, and other sexually transmitted diseases are being developed, the potential impact of ring biomass on the vaginal microbiota and the release of active pharmaceutical ingredients should be researched in depth.
我们研究了避孕阴道环生物量的存在、密度和细菌组成及其与阴道微生物群的关联。在120名卢旺达女性佩戴三周的415个阴道环中，用结晶紫评估生物量密度，并用定量聚合酶链反应（qPCR）评估生物量洗脱液的细菌组成。在荧光原位杂交（FISH）后以及用扫描电子显微镜（SEM）观察生物量。用 Nugent 评分评估阴道微生物群，并在 FISH 后观察阴道生物膜。所有阴道环均被生物量覆盖（平均光密度（OD）为3.36；标准差（SD）为0.64）。93%的阴道环上存在乳酸杆菌，57%上存在阴道加德纳菌，37%上存在阴道阿托波菌。阴道环生物量密度与阴道阿托波菌浓度相关（每增加一个对数单位，OD增加0.03；95%置信区间（CI）为0.01 - 0.05；p = 0.002）以及与阴道加德纳菌浓度相关（OD增加0.03；95%CI为0.01 - 0.05；p = 0.013）。该密度还与 Nugent 评分相关：细菌性阴道病 Nugent 评分的女性（平均OD增加0.26）和中间评分的女性（平均OD增加0.09）佩戴的阴道环比正常评分参与者佩戴的阴道环生物量更密集（p = 0.002）。此外，含有阴道加德纳菌（p = 0.001）和阴道阿托波菌（p = 0.005）的阴道生物膜的存在与更密集的阴道环生物量相关（平均OD分别增加0.24和0.22）。通过SEM我们观察到要么是细长细菌的松散网络，要么是致密生物膜。我们发现阴道生态失调与阴道环生物量的密度和组成之间存在相关性，需要进一步研究以确定这些关系是否具有因果性。随着用于预防怀孕、艾滋病毒和其他性传播疾病的多功能阴道环的研发，应深入研究阴道环生物量对阴道微生物群的潜在影响以及活性药物成分的释放情况。
