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Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review.
Ann Clin Microbiol Antimicrob. 2020 Jan 28; 19(1):5.AC

Abstract

Recurrent vulvovaginal infections (RVVI) has not only become an epidemiological and clinical problem but also include large social and psychological consequences. Understanding the mechanisms of both commensalism and pathogenesis are necessary for the development of efficient diagnosis and treatment strategies for these enigmatic vaginal infections. Through this review, an attempt has been made to analyze vaginal microbiota (VMB) from scratch and to provide an update on its current understanding in relation to health and common RVVI i.e. bacterial vaginosis, vulvovaginal candidiaisis and Trichomoniasis, making the present review first of its kind. For this, potentially relevant studies were retrieved from data sources and critical analysis of the literature was made. Though, culture-independent methods have greatly unfolded the mystery regarding vaginal bacterial microbiome, there are only a few studies regarding the composition and diversity of vaginal mycobiome and different Trichomonas vaginalis strains. This scenario suggests a need of further studies based on comparative genomics of RVVI pathogens to improve our perceptive of RVVI pathogenesis that is still not clear (Fig. 5). Besides this, the review details the rationale for Lactobacilli dominance and changes that occur in healthy VMB throughout a women's life. Moreover, the list of possible agents continues to expand and new species recognised in both health and VVI are updated in this review. The review concludes with the controversies challenging the widely accepted dogma i.e. "VMB dominated with Lactobacilli is healthier than a diverse VMB". These controversies, over the past decade, have complicated the definition of vaginal health and vaginal infections with no definite conclusion. Thus, further studies on newly recognised microbial agents may reveal answers to these controversies. Conversely, VMB of women could be an answer but it is not enough to just look at the microbiology. We have to look at the woman itself, as VMB which is fine for one woman may be troublesome for others. These differences in women's response to the same VMB may be determined by a permutation of behavioural, cultural, genetic and various other anonymous factors, exploration of which may lead to proper definition of vaginal health and disease.

Authors+Show Affiliations

Department of Molecular Biology & Biochemistry, Guru Nanak Dev University, Amritsar, 143005, India.Department of Molecular Biology & Biochemistry, Guru Nanak Dev University, Amritsar, 143005, India. jatinderarora2009@gmail.com.Department of Human Genetics, Guru Nanak Dev University, Amritsar, 143005, India. dr.manpreetdhuna@gmail.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31992328

Citation

Kalia, Namarta, et al. "Microbiota in Vaginal Health and Pathogenesis of Recurrent Vulvovaginal Infections: a Critical Review." Annals of Clinical Microbiology and Antimicrobials, vol. 19, no. 1, 2020, p. 5.
Kalia N, Singh J, Kaur M. Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. Ann Clin Microbiol Antimicrob. 2020;19(1):5.
Kalia, N., Singh, J., & Kaur, M. (2020). Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. Annals of Clinical Microbiology and Antimicrobials, 19(1), 5. https://doi.org/10.1186/s12941-020-0347-4
Kalia N, Singh J, Kaur M. Microbiota in Vaginal Health and Pathogenesis of Recurrent Vulvovaginal Infections: a Critical Review. Ann Clin Microbiol Antimicrob. 2020 Jan 28;19(1):5. PubMed PMID: 31992328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. AU - Kalia,Namarta, AU - Singh,Jatinder, AU - Kaur,Manpreet, Y1 - 2020/01/28/ PY - 2018/09/10/received PY - 2020/01/22/accepted PY - 2020/1/30/entrez PY - 2020/1/30/pubmed PY - 2020/5/15/medline KW - Bacteriobiota KW - Community state types (CSTs) KW - Menopause KW - Mixed infections KW - Mycobiota KW - Non-albicans Candida (NAC) Species KW - Vaginal Mycobiome KW - Vaginal ecosystem and vaginal dysbiosis SP - 5 EP - 5 JF - Annals of clinical microbiology and antimicrobials JO - Ann Clin Microbiol Antimicrob VL - 19 IS - 1 N2 - Recurrent vulvovaginal infections (RVVI) has not only become an epidemiological and clinical problem but also include large social and psychological consequences. Understanding the mechanisms of both commensalism and pathogenesis are necessary for the development of efficient diagnosis and treatment strategies for these enigmatic vaginal infections. Through this review, an attempt has been made to analyze vaginal microbiota (VMB) from scratch and to provide an update on its current understanding in relation to health and common RVVI i.e. bacterial vaginosis, vulvovaginal candidiaisis and Trichomoniasis, making the present review first of its kind. For this, potentially relevant studies were retrieved from data sources and critical analysis of the literature was made. Though, culture-independent methods have greatly unfolded the mystery regarding vaginal bacterial microbiome, there are only a few studies regarding the composition and diversity of vaginal mycobiome and different Trichomonas vaginalis strains. This scenario suggests a need of further studies based on comparative genomics of RVVI pathogens to improve our perceptive of RVVI pathogenesis that is still not clear (Fig. 5). Besides this, the review details the rationale for Lactobacilli dominance and changes that occur in healthy VMB throughout a women's life. Moreover, the list of possible agents continues to expand and new species recognised in both health and VVI are updated in this review. The review concludes with the controversies challenging the widely accepted dogma i.e. "VMB dominated with Lactobacilli is healthier than a diverse VMB". These controversies, over the past decade, have complicated the definition of vaginal health and vaginal infections with no definite conclusion. Thus, further studies on newly recognised microbial agents may reveal answers to these controversies. Conversely, VMB of women could be an answer but it is not enough to just look at the microbiology. We have to look at the woman itself, as VMB which is fine for one woman may be troublesome for others. These differences in women's response to the same VMB may be determined by a permutation of behavioural, cultural, genetic and various other anonymous factors, exploration of which may lead to proper definition of vaginal health and disease. SN - 1476-0711 UR - https://www.unboundmedicine.com/medline/citation/31992328/Microbiota_in_vaginal_health_and_pathogenesis_of_recurrent_vulvovaginal_infections:_a_critical_review_ L2 - https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-020-0347-4 DB - PRIME DP - Unbound Medicine ER -