Linhares Iara M, Sisti Giovanni, Minis Evelyn, de Freitas Gabriela B, Moron Antonio F, Witkin Steven S
Department of Gynecology and Obstetrics, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA.
Curr Infect Dis Rep. 2019 Aug 1;21(9):30. doi: 10.1007/s11908-019-0686-5.
The vaginal milieu in women differs from that of other mammals, including non-human primates, in composition of secretions, the endogenous microbiota, and level of acidity. These changes apparently reflect evolutionary variations that maximized productive responses to a uniquely human vaginal environment. This review will highlight recent findings on properties of human vaginal epithelial cells that contribute to maintenance of a healthy vaginal environment.
Vaginal epithelial cells are responsive to the composition of the vaginal microbiome even in women who are in apparently good health and do not exhibit any adverse physical symptoms. This is especially important during pregnancy when immune defenses are modified and an effective epithelial cell-derived anti-microbial activity is essential to prevent the migration to the uterus of bacteria potentially harmful to pregnancy progression. When Lactobacillus crispatus numerically predominates in the vagina, epithelial cell activity is low. Conversely, predominance of Lactobacillus iners, Gardnerella vaginalis, or other non-Lactobacilli evokes production and release of a large variety of compounds to minimize the potentially negative consequences of an altered microbiome. The extent of autophagy in vaginal epithelial cells, a basic process that functions to maintain intracellular homeostasis and engulf microbial invaders, is also sensitive to the external microbial environment Vaginal epithelial cells bind and release norepinephrine and upregulate their anti-microbial activity in response to external stress. Vaginal epithelial cells in women are responsive to local conditions that are unique to humans and, thereby, contribute to maintenance of a healthy milieu.
女性阴道环境在分泌物组成、内源性微生物群和酸度水平方面与其他哺乳动物（包括非人类灵长类动物）不同。这些变化显然反映了进化变异，这些变异使机体对独特的人类阴道环境产生了最大化的有效反应。本综述将重点介绍人类阴道上皮细胞特性的最新研究结果，这些特性有助于维持健康的阴道环境。
即使在表面健康且未表现出任何不良身体症状的女性中，阴道上皮细胞也会对阴道微生物群的组成做出反应。这在怀孕期间尤为重要，因为此时免疫防御会发生改变，有效的上皮细胞衍生抗菌活性对于防止可能对妊娠进展有害的细菌迁移至子宫至关重要。当卷曲乳杆菌在阴道中数量占主导时，上皮细胞活性较低。相反，惰性乳杆菌、阴道加德纳菌或其他非乳杆菌占主导时，会引发大量化合物的产生和释放，以尽量减少微生物群改变带来的潜在负面影响。阴道上皮细胞中的自噬程度，这一维持细胞内稳态和吞噬微生物入侵者的基本过程，也对外部微生物环境敏感。阴道上皮细胞结合并释放去甲肾上腺素，并在外部应激时上调其抗菌活性。女性的阴道上皮细胞对人类特有的局部条件有反应，从而有助于维持健康的环境。
