Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana, USA.
Department of Animal and Range Sciences, Montana State University, Bozeman, Montana, USA.
Sex Transm Infect. 2023 Nov;99(7):489-496. doi: 10.1136/sextrans-2022-055667. Epub 2023 May 31.
The vaginal metabolome is a significant factor in the vaginal microenvironment, and data are emerging on its independent role in urogenital health. Condomless vaginal intercourse and personal lubricant use are common practices that may affect the vaginal metabolome. The aim of the present study is to describe the associations between condomless intercourse and lubricant use on the vaginal metabolome.
This study used archived mid-vaginal swabs from a 10-week observational cohort of reproductive age women who self-collected samples and recorded behavioural diaries daily. Cases and controls were defined as participants who self-reported condomless vaginal intercourse with or without lubricant use, respectively. Samples were drawn prior to and following condomless vaginal intercourse. Twenty-two case participants were race/ethnicity matched to 22 control participants. Mid-vaginal swabs were subjected to 16S rRNA gene amplicon sequencing and untargeted ultrahigh performance liquid chromatography tandem mass spectroscopy metabolomics. Bayesian mixed-effects regression (unadjusted and adjusted for the vaginal microbiota) was used to evaluate differences in metabolite concentration associated with vaginal intercourse and lubricant use.
Both condomless penile-vaginal intercourse and lubricant use were independently associated with higher (up to 8.3-fold) concentrations of metabolites indicative of epithelial damage (eg, sarcosine) and many host-produced antioxidants. Lubricant use was significantly associated with increases in lipids related to cellular damage, host-produced sphingolipids (antimicrobials), antioxidants and salicylate, a cooling agent common to lubricants, in a study design which controls for the independent effect of intercourse. Metabolites involved in oxidative stress and salicylate were strongly correlated with several molecular bacterial vaginosis-associated bacteria.
This study provides important foundational data on how condomless vaginal-penile intercourse and lubricant use affect the vaginal metabolome and may affect the protective mechanisms in the vaginal microenvironment.
阴道代谢组是阴道微环境的一个重要因素，其在泌尿生殖健康方面具有独立作用的相关数据正在不断涌现。无保护的阴道性交和使用个人润滑剂是常见的做法，可能会影响阴道代谢组。本研究旨在描述无保护的阴道性交和使用润滑剂与阴道代谢组之间的关联。
本研究使用了一个为期 10 周的观察性育龄妇女队列的存档中阴道中段拭子，这些妇女自行采集样本并每天记录行为日记。病例和对照组分别定义为报告有无保护的阴道性交和使用润滑剂的参与者。在无保护的阴道性交前后采集样本。22 名病例参与者与 22 名对照参与者按种族/民族匹配。对阴道中段拭子进行 16S rRNA 基因扩增子测序和非靶向超高液相色谱串联质谱代谢组学分析。采用贝叶斯混合效应回归（未调整和调整阴道微生物群）评估与阴道性交和润滑剂使用相关的代谢物浓度差异。
无保护的阴茎-阴道性交和使用润滑剂均与更高（高达 8.3 倍）浓度的代谢物相关，这些代谢物提示上皮损伤（如肌氨酸）和许多宿主产生的抗氧化剂。在控制性交独立影响的研究设计中，润滑剂的使用与细胞损伤相关的脂质、宿主产生的鞘脂（抗微生物剂）、抗氧化剂和水杨酸（一种常见的润滑剂冷却剂）显著增加相关。涉及氧化应激和水杨酸的代谢物与几种与细菌性阴道病相关的细菌密切相关。
本研究提供了关于无保护的阴道-阴茎性交和使用润滑剂如何影响阴道代谢组以及可能影响阴道微环境中保护机制的重要基础数据。
