Raglan Olivia, MacIntyre David A, Mitra Anita, Lee Yun S, Smith Ann, Assi Nada, Nautiyal Jaya, Purkayastha Sanjay, Gunter Marc J, Gabra Hani, Marchesi Julian R, Bennett Phillip R, Kyrgiou Maria
IRDB, Department of Metabolism, Digestion and Reproduction - Surgery and Cancer, Hammersmith Campus, Imperial College London, W12 0NN, London, UK.
Queen Charlotte's and Chelsea-Hammersmith Hospital, Imperial College NHS Trust, W12 OHS, London, UK.
Microbiome. 2021 May 28;9(1):124. doi: 10.1186/s40168-021-01011-2.
Obesity and vaginal microbiome (VMB) dysbiosis are each risk factors for adverse reproductive and oncological health outcomes in women. Here, we investigated the relationship between obesity, vaginal bacterial composition, local inflammation and bariatric surgery.
Vaginal bacterial composition assessed by high-throughput sequencing of bacterial 16S rRNA genes and local cytokine levels measured using a multiplexed Magnetic Luminex Screening Assay were compared between 67 obese and 42 non-obese women. We further assessed temporal changes in the microbiota and cytokines in a subset of 27 women who underwent bariatric surgery.
The bacterial component of the vaginal microbiota in obese women was characterised by a lower prevalence of a Lactobacillus-dominant VMB and higher prevalence of a high diversity (Lactobacillus spp., and Gardnerella- spp. depleted) VMB, compared with non-obese subjects (p<0.001). Obese women had higher relative abundance of Dialister species (p<0.001), Anaerococcus vaginalis (p=0.021), and Prevotella timonensis (p=0.020) and decreased relative abundance of Lactobacillus crispatus (p=0.014). Local vaginal IL-1β, IL-4, IL-6, IL-8, IFNγ, MIP-1α and TNFα levels were all higher among obese women, however, only IL-1β and IL-8 correlated with VMB species diversity. In a subset of obese women undergoing bariatric surgery, there were no significant overall differences in VMB following surgery; however, 75% of these women remained obese at 6 months. Prior to surgery, there was no relationship between body mass index (BMI) and VMB structure; however, post-surgery women with a Lactobacillus-dominant VMB had a significantly lower BMI than those with a high diversity VMB.
Obese women have a significantly different vaginal microbiota composition with increased levels of local inflammation compared to non-obese women. Bariatric surgery does not change the VMB; however, those with the greatest weight loss 6-month post-surgery are most likely to have a Lactobacillus-dominant VMB. Video abstract.
肥胖和阴道微生物群（VMB）失调均为女性不良生殖和肿瘤健康结局的风险因素。在此，我们研究了肥胖、阴道细菌组成、局部炎症与减肥手术之间的关系。
对67名肥胖女性和42名非肥胖女性进行比较，通过细菌16S rRNA基因的高通量测序评估阴道细菌组成，并使用多重磁珠Luminex筛选测定法测量局部细胞因子水平。我们进一步评估了27名接受减肥手术的女性亚组中微生物群和细胞因子的时间变化。
与非肥胖受试者相比，肥胖女性阴道微生物群的细菌成分特点是乳酸杆菌占主导的VMB患病率较低，高多样性（乳酸杆菌属和加德纳菌属减少）VMB患病率较高（p<0.001）。肥胖女性中迪氏菌属（p<0.001）、阴道厌氧球菌（p=0.021）和蒂莫内普雷沃菌（p=0.020）的相对丰度较高，卷曲乳酸杆菌的相对丰度降低（p=0.014）。肥胖女性局部阴道IL-1β、IL-4、IL-6、IL-8、IFNγ、MIP-1α和TNFα水平均较高，然而，只有IL-1β和IL-8与VMB物种多样性相关。在接受减肥手术的肥胖女性亚组中，术后VMB总体上无显著差异；然而，这些女性中有75%在6个月时仍肥胖。手术前，体重指数（BMI）与VMB结构之间无关联；然而，术后乳酸杆菌占主导的VMB女性的BMI显著低于高多样性VMB女性。
与非肥胖女性相比，肥胖女性的阴道微生物群组成明显不同，局部炎症水平升高。减肥手术不会改变VMB；然而，术后6个月体重减轻最多的女性最有可能拥有乳酸杆菌占主导的VMB。视频摘要。
