一项关于THRIVE（不同阴道环境中宿主-细菌关系与免疫功能研究）细菌性阴道病的观察性研究描述。

A Description of the THRIVE (The Study of Host-Bacterial Relationships and Immune Function in Different Vaginal Environments) Bacterial Vaginosis Observational Study.

作者信息

Berard Alicia R, Knodel Samantha, Zuend Christina Farr, Noël-Romas Laura, Birse Kenzie D, McQueen Peter, De Leon Marlon, Kratzer Kateryna, Taylor Oluwatobiloba A, Bailey Samantha, Pymar Helen, Burgener Adam D, Poliquin Vanessa

机构信息

Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB; Centre for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH.

出版信息

J Obstet Gynaecol Can. 2024 Dec;46(12):102667. doi: 10.1016/j.jogc.2024.102667. Epub 2024 Oct 2.

DOI:10.1016/j.jogc.2024.102667

PMID:39362489

Abstract

OBJECTIVES

Bacterial vaginosis (BV) contributes to poor reproductive health and is characterized by a displacement of Lactobacillus in the vaginal microbiome. However, treatment for BV is limited to antibiotics and half of the women treated experience recurrence within a year. THRIVE (The Study of Host-Bacterial Relationships and Immune Function in Different Vaginal Environments) is a prospective study in Winnipeg, Manitoba, Canada, which is designed to capture the daily variation of the microbiome and host mucosal immunity during treatment. The objective of this study is to identify host and bacterial factors that associate with vaginal microbiome stability to better inform therapeutic interventions.

METHODS

Women treated for BV, and controls, are followed for 6 months collecting daily vaginal swabs and monthly questionnaires. Comprehensive mucosal sampling, including swabs, cytobrushes, biopsies, and blood are collected at baseline, months 1 and 6 post-enrolment.

RESULTS

We performed analysis on the first 52 participants, (19 BV+, 33 BV-). Molecular profiling by 16s RNA sequencing showed 20 women with non-Lactobacillus-dominant microbiomes and 32 with Lactobacillus-dominant microbiomes, with increased microbial diversity in non-Lactobacillus-dominant microbiomes (P = 3.1E-05). A pilot analysis in 2 participants demonstrates that multi-omics profiling of self-collected daily swabs provides high-quality data identifying 73 bacterial species, 1773 mucosal proteins and 117 metabolites. Initial flow cytometry analysis showed an increased cluster of differentiation (CD)4+ T cells and neutrophil activation (CD11b+CD62L) in the positive participant at baseline, while after treatment these shifted and resembled the control participant.

CONCLUSIONS

This study provides a framework to comprehensively investigate the kinetics of vaginal mucosal microbiome alterations, providing further insight into host and molecular features predicting BV recurrence.

摘要

目的

细菌性阴道病（BV）会导致生殖健康状况不佳，其特征是阴道微生物群中乳酸杆菌被取代。然而，BV的治疗仅限于使用抗生素，且半数接受治疗的女性在一年内会复发。THRIVE（不同阴道环境中宿主-细菌关系及免疫功能研究）是在加拿大曼尼托巴省温尼伯市进行的一项前瞻性研究，旨在捕捉治疗期间微生物群和宿主黏膜免疫的每日变化。本研究的目的是确定与阴道微生物群稳定性相关的宿主和细菌因素，以便为治疗干预提供更充分的信息。

方法

对接受BV治疗的女性和对照组进行为期6个月的随访，每天收集阴道拭子并每月进行问卷调查。在基线、入组后第1个月和第6个月收集包括拭子、细胞刷、活检组织和血液在内的综合黏膜样本。

结果

我们对前52名参与者（19名BV阳性，33名BV阴性）进行了分析。通过16s RNA测序进行的分子谱分析显示，20名女性的微生物群以非乳酸杆菌为主，32名女性的微生物群以乳酸杆菌为主，非乳酸杆菌为主的微生物群中微生物多样性增加（P = 3.1E - 05）。对2名参与者的初步分析表明，对自行收集的每日拭子进行多组学分析可提供高质量数据，识别出73种细菌、1773种黏膜蛋白和117种代谢物。初始流式细胞术分析显示，阳性参与者在基线时分化簇（CD）4 + T细胞增加，中性粒细胞活化（CD11b + CD62L）增加，而治疗后这些指标发生变化，与对照参与者相似。