Foessleitner Philipp, Cooley Demidkina Briah, El-Arar Wafae, Goldenberg Miles, Murthy Meena, Bergerat Agnes, Bar Ofri, Kwon Douglas S, Mitchell Caroline M
Vincent Center for Reproductive Biology, Massachusetts General Hospital, 55 Fruit St, Their 9, Boston, MA, 02114, USA.
Harvard Medical School, Boston, MA, USA.
Sci Rep. 2025 Jan 28;15(1):3536. doi: 10.1038/s41598-025-88208-9.
Bacterial vaginosis (BV), characterized by an imbalance in the vaginal microbiota, is a prevalent condition among women of reproductive age and a risk factor for human immunodeficiency virus, sexually transmitted infections, and preterm birth. BV is generally considered to induce mucosal inflammation, but the specific pathways and cell types involved are not well characterized. This prospective study aimed to assess associations between microbial changes and mucosal immune responses in BV patients. Therefore, samples from 20 premenopausal women with BV and treated with metronidazole were analyzed. Vaginal swabs, menstrual cup, and endocervical cytobrush samples were collected before treatment, weekly for four weeks, and at 2, 4, and 6 months for Nugent scoring, immune cell populations and cytokine analysis. Of 105 study intervals, 27 (25.7%) showed improvement in Nugent category, 61 (58.1%) remained unchanged, and 17 (16.2%) worsened. Improvement correlated with decreased monocytes (p = 0.005), while worsening was linked to increased monocytes (p < 0.001) and dendritic cells (p = 0.02). B cells (p = 0.02) and IFN-γ-induced chemokines - IP-10 (p = 0.007), MIG (p = 0.049), and ITAC (p = 0.005) - were associated with improvement. In conclusion, although the T-cell-associated chemokines IP-10, ITAC, and MIG were strongly associated with improvements in Nugent category, our findings indicate that antigen-presenting cells, particularly monocytes, show the most dynamic response to shifts in the vaginal microbiota in patients with BV.
细菌性阴道病（BV）以阴道微生物群失衡为特征，是育龄妇女中的常见病症，也是人类免疫缺陷病毒、性传播感染和早产的危险因素。BV通常被认为会诱发黏膜炎症，但具体涉及的途径和细胞类型尚未得到充分表征。这项前瞻性研究旨在评估BV患者微生物变化与黏膜免疫反应之间的关联。因此，对20名患有BV并接受甲硝唑治疗的绝经前妇女的样本进行了分析。在治疗前、每周一次共四周以及在2、4和6个月时收集阴道拭子、月经杯和宫颈内膜细胞刷样本，用于Nugent评分、免疫细胞群体和细胞因子分析。在105个研究时间段中，27个（25.7%）显示Nugent分类有所改善，61个（58.1%）保持不变，17个（16.2%）恶化。改善与单核细胞减少相关（p = 0.005），而恶化与单核细胞增加（p < 0.001）和树突状细胞增加（p = 0.02）有关。B细胞（p = 0.02）以及IFN-γ诱导的趋化因子——IP-10（p = 0.007）、MIG（p = 0.049）和ITAC（p = 0.005）——与改善相关。总之，尽管与T细胞相关的趋化因子IP-10、ITAC和MIG与Nugent分类的改善密切相关，但我们的研究结果表明，抗原呈递细胞，尤其是单核细胞，对BV患者阴道微生物群的变化表现出最活跃的反应。
