Properties of Epithelial Cells and Vaginal Secretions in Pregnant Women When Lactobacillus crispatus or Lactobacillus iners Dominate the Vaginal Microbiome

Leizer, Julie; Nasioudis, Dimitrios; Forney, Larry J.; Schneider, Gudrun; Gliniewicz, Karol; Boester, Allison

doi:10.1177/1933719117698583

Cited by 32 publications

(21 citation statements)

References 36 publications

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“…The characteristics of each study that reported ( n = 13) ( Fettweis et al., 2014 ; Ghartey et al., 2014 ; Romero et al., 2014a ; Romero et al., 2014b ; Bisanz et al., 2015 ; MacIntyre et al., 2015 ; Kindinger et al., 2017 ; Brown et al., 2018 ; Hočevar et al., 2019 ; Purkayastha et al., 2019 ; Romero et al., 2019 ; Tabatabaei et al., 2019 ; Al-Memar et al., 2020 ) or did not report GBS ( n = 32) ( Dominguez-Bello et al., 2010 ; Hernández-Rodríguez et al., 2011 ; Aagaard et al., 2012 ; Frank et al., 2012 ; Hyman et al., 2012 ; Hyman et al., 2014 ; Walther-António et al., 2014 ; Baldwin et al., 2015 ; DiGiulio et al., 2015 ; Huang et al., 2015 ; Brumbaugh et al., 2016 ; Jayaprakash et al., 2016 ; Lauder et al., 2016 ; Nelson et al., 2016 ; Subramaniam et al., 2016 ; Callahan et al., 2017 ; Freitas et al., 2017 ; Nasioudis et al., 2017b ; Nasioudis et al., 2017a ; Roesch et al., 2017 ; Stout et al., 2017 ; Goltsman et al., 2018 ; Leizer et al., 2018 ; Matsumoto et al., 2018 ; Wylie et al., 2018 ; Chen et al., 2019 ; Dobbler et al., 2019 ; He et al., 2019 ; Jefferson et al., 2019 ; Liu et al., 2019 ; Price et al., 2019 ; Witkin et al., 2019 ) are described in Tables S1 and S2 respectively.…”

Section: Resultsmentioning

confidence: 99%

“…However, there was large variability in sample size and number of specimens collected in studies that reported and did not report GBS. Additionally, four manuscripts that did not report GBS within the taxonomy analyzed, or overall metagenomic results, did report positive culture-based GBS clinical screening results for women within the study ( Brumbaugh et al., 2016 ; Jayaprakash et al., 2016 ; Roesch et al., 2017 ; Leizer et al., 2018 ).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, four studies that did not report GBS in their results or microbiome data identified GBS-positive women in their study based on culture-based clinical testing ( Brumbaugh et al., 2016 ; Jayaprakash et al., 2016 ; Roesch et al., 2017 ; Leizer et al., 2018 ). This suggests that there may be a benefit to using both sequence-based and culture-based methods to verify presence or absence of low abundance microbes within vaginal microbiome communities.…”

Section: Discussionmentioning

confidence: 99%

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Group B Streptococcus and the vaginal microbiome among pregnant women: a systematic review

Lim

Rajagopal

Jeong

et al. 2021

PeerJ

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Background Vaginal microbiome studies frequently report diversity metrics and communities of microbiomes associated with reproductive health outcomes. Reports of Streptococcus agalactiae (also known as Group B Streptococcus or GBS), the leading cause of neonatal infectious morbidity and mortality, are notably lacking from the studies of the vaginal microbiome, despite being a known contributor to preterm birth and other complications. Therefore, the purpose of this systematic review was to explore the frequency of GBS reporting in vaginal microbiome literature pertaining to pregnancy and to examine methodological bias that contributes to differences in species and genus-level microbiome reporting. Lack of identification of GBS via sequencing-based approaches due to methodologic or reporting bias may result incomplete understanding of bacterial composition during pregnancy and subsequent birth outcomes. Methodology A systematic review was conducted following the PRISMA guideline. Three databases (PubMed, CINAHL, and Web of Science) were used to identify papers for review based on the search terms “vaginal microbiome”, “pregnancy”, and “16S rRNA sequencing”. Articles were evaluated for methods of DNA extraction and sequencing, 16S region, taxonomy classification database, number of participants or vaginal specimens, and pregnancy trimester. Results Forty-five research articles reported employing a metagenomic approach or 16S approach for vaginal microbiome analysis during pregnancy that explicitly reported taxonomic composition and were included in this review. Less than 30% of articles reported the presence of GBS (N = 13). No significant differences in methodology were identified between articles that reported versus did not report GBS. However, there was large variability across research methods used for vaginal microbiome analysis and species-level bacterial community reporting. Conclusion Considerable differences in study design and data formatting methods may contribute to underrepresentation of GBS, and other known pathogens, in existing vaginal microbiome literature. Previous studies have identified considerable variation in methodology across vaginal microbiome studies. This study adds to this body of work because in addition to laboratory or statistical methods, how results and data are shared (e.g., only analyzing genus level data or 20 most abundant microbes), may hinder reproducibility and limit our understanding of the influence of less abundant microbes. Sharing detailed methods, analysis code, and raw data may improve reproducibility and ability to more accurately compare microbial communities across studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Group B Streptococcus and the vaginal microbiome among pregnant women: a systematic review

Lim

Rajagopal

Jeong

et al. 2021

PeerJ

View full text Add to dashboard Cite

show abstract

“…Moreover, four studies that did not report GBS in their results or microbiome data identified GBS-positive women in their study based on culture-based clinical testing [32][33]41,44 . This suggests that there may be a benefit to using both sequence-based and culture-based methods to verify presence or absence of low abundance microbes within vaginal microbiome communities.…”

Section: Limited Assessment and Lack Of Focus On Low Abundance Organismsmentioning

confidence: 99%

Peer Review #2 of "Group B Streptococcus and the vaginal microbiome among pregnant women: a systematic review (v0.1)"

Patras¹

2021

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Background.Vaginal microbiome studies frequently report diversity metrics and communities of microbiomes associated with reproductive health outcomes. Reports of Streptococcus agalactiae (also known as Group B Streptococcus or GBS), the leading cause of neonatal infectious morbidity and mortality, are notably lacking from the studies of the vaginal microbiome, despite being a known contributor to preterm birth and other complications. Therefore, the purpose of this systematic review was to explore the frequency of GBS reporting in vaginal microbiome literature pertaining to pregnancy and to examine methodological bias that contributes to differences in species and genus-level microbiome reporting. Lack of identification of GBS via sequencing-based approaches due to methodologic or reporting bias may result incomplete understanding of bacterial composition during pregnancy and subsequent birth outcomes. Methodology.A systematic review was conducted following the PRISMA guideline. Three databases (PubMed, CINAHL, and Web of Science) were used to identify papers for review based on the search terms "vaginal microbiome", "pregnancy", and "16S rRNA sequencing". Articles were evaluated for methods of DNA extraction and sequencing, 16S region, taxonomy classification database, number of participants or vaginal specimens, and pregnancy trimester.Results. Forty-five research articles reported employing a metagenomic approach or 16S approach for vaginal microbiome analysis during pregnancy that explicitly reported taxonomic composition and were included in this review. Less than 30% of articles reported the presence of GBS (N=13). No significant differences in methodology were identified between articles that reported versus did not report GBS. However, there was large variability across research methods used for vaginal microbiome analysis and species-level bacterial community reporting. Conclusion.Considerable differences in study design and data formatting methods may contribute to underrepresentation of GBS, and other known pathogens, in existing vaginal microbiome literature. Previous studies have identified considerable variation in methodology across vaginal microbiome studies. This study adds to this body of work because in addition to laboratory or statistical methods, how results and data are shared (e.g., only analyzing genus level data or 20 most abundant microbes), may hinder reproducibility and limit our understanding of the influence of less abundant microbes. Sharing detailed methods, analysis code, and raw data may improve reproducibility and ability to more accurately compare microbial communities across studies.

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“…We have measured autophagy in vaginal epithelial cells and observed that the highest levels occur when L. crispatus, a potent lactic acid producer (Witkin et al 2013), is the dominant bacterium in the vaginal microbiota (Leizer et al 2017). Similar to the influence of lactic acid on inhibition of HDAC, the induction of autophagy in vaginal epithelial cells by lactic acid would expedite removal of potentially toxic agents as well as microorganisms and, thereby, assure optimal functioning of this component of the local innate immune system.…”

Section: Autophagymentioning

confidence: 99%

Lactic acid alleviates stress: good for female genital tract homeostasis, bad for protection against malignancy

Witkin

2018

Cell Stress and Chaperones

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Women are unique from all other mammals in that lactic acid is present at high levels in the vagina during their reproductive years. This dominance may have evolved in response to the unique human lifestyle and a need to optimally protect pregnant women and their fetuses from endogenous and exogenous insults. Lactic acid in the female genital tract inactivates potentially pathogenic bacteria and viruses, maximizes survival of vaginal epithelial cells, and inhibits inflammation that may be damaging to the developing fetus and maintenance of the pregnancy. In an analogous manner, lactic acid production facilitates survival of malignantly transformed cells, inhibits activation of immune cells, and prevents the release of pro-inflammatory mediators in response to tumor-specific antigens. Thus, the same stress-reducing properties of lactic acid that promote lower genital tract health facilitate malignant transformation and progression.

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Properties of Epithelial Cells and Vaginal Secretions in Pregnant Women When Lactobacillus crispatus or Lactobacillus iners Dominate the Vaginal Microbiome

Abstract: Epithelial cells exhibit a higher level of autophagy, lower induction of stress-related hsp70, and release lower level of mediators when L crispatus is most abundant as compared to when L iners dominates the vaginal microbiota.

Cited by 32 publications

References 36 publications

Group B Streptococcus and the vaginal microbiome among pregnant women: a systematic review

Group B Streptococcus and the vaginal microbiome among pregnant women: a systematic review

Peer Review #2 of "Group B Streptococcus and the vaginal microbiome among pregnant women: a systematic review (v0.1)"

Lactic acid alleviates stress: good for female genital tract homeostasis, bad for protection against malignancy

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