VAGINAL MICROBIOME AS A BIOMARKER OF WOMEN'S REPRODUCTIVE HEALTH
DOI:
https://doi.org/10.32782/1998-6475.2025.59.20Keywords:
vaginal microbiome, eubiosis, dysbiosis, bacterial vaginosis, reproductive health, biomarkersAbstract
The vaginal microbiome is a complex ecosystem that plays a key role in maintaining a woman’s reproductive health. The aim of the study was to analyze the composition and structure of the vaginal microbiota in women of reproductive age and to determine the possibility of using its characteristics as potential biomarkers of the physiological or pathological state of the reproductive system. The study involved 30 patients of reproductive age, from whom vaginal samples were collected and 16S rRNA sequencing was performed with subsequent taxonomic identification of microorganisms. The results showed that in 55 % of the examined women, the vaginal microbiota was eubiotic in nature with a predominance of representatives of the genus Lactobacillus, while in 45 % signs or suspicion of bacterial vaginosis were detected. Lactobacillus crispatus (45 %), L. iners (36 %), L. gasseri (18 %) and L. jensenii (9 %) were most often detected, which corresponds to typical physiological profiles of CST I–III. In samples with dysbiosis, anaerobic taxa predominated: Gardnerella vaginalis (83 %), Atopobium vaginae (75 %), Prevotella spp. (67 %), Bacteroides spp. (58 %) and Mobiluncus spp. (42 %). The detected profiles are consistent with the classical CST IV types, characterized by high microbial diversity and alkaline pH. Correlation analysis showed an inverse relationship between the frequency of detection of L. crispatus and the level of anaerobic contamination, confirming the antagonistic interaction between lactobacilli and dysbiotic biota. Lactobacilli dominance prevailed in pregnant women, indicating hormonally-induced stabilization of the microbiome, while temporary shifts to the anaerobic type were observed after antibiotic therapy. Thus, the results confirm that the vaginal microbiome is a sensitive biomarker of a woman's reproductive health, reflecting the state of local immunity, hormonal balance and the risk of developing pathological processes. The preservation of the dominance of Lactobacillus spp. is an indicator of eubiosis, while the increase in the proportion of anaerobes indicates dysbiotic changes that may precede the clinical manifestations of bacterial vaginosis. Thus, the assessment of the composition of the vaginal microbiota can be used as a diagnostic and prognostic tool in reproductive medicine, as well as for the development of personalized microbiome therapeutic strategies.
References
ANAHTAR, M. N., GOOTENBERG, D. B., MITCHELL, C. M., KWON, D. S. (2018) Cervicovaginal Microbiota and Reproductive Health: The Virtue of Simplicity. Cell Host & Microbe, 23(2), 159–168. DOI: https://doi.org/10.1016/j.chom.2018.01.013A
BANSKAR, S., BHUTE, S. (2021) Structure and Function of Healthy Human Microbiome. Microbiome-Host Interactions, 69–90. DOI: https://doi.org/10.1201/9781003037521-7
BORREGO-RUIZ, A., BORREGO, J. J. (2025) Microbial Pathogens Linked to Vaginal Microbiome Dysbiosis and Therapeutic Tools for Their Treatment. Acta Microbiologica Hellenica, 70(2), 19. DOI: https://doi.org/10.3390/amh70020019
BROTMAN, R. M., SHARDELL, M. D., GAJER, P., FADROSH, D., CHANG, K., SILVER, M. I., VISCIDI, R. P., BURKE, A. E., RAVEL, J., GRAVITT, P. E. (2014) Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause, 21(5), 450–458. DOI: https://doi.org/10.1097/gme.0b013e3182a4690b
FETTWEIS, J. M., SERRANO, M. G., BROOKS, J. P., … BUCK, G. A. (2019) The vaginal microbiome and preterm birth. Nature Medicine, 25(6), 1012–1021. DOI: https://doi.org/10.1038/s41591-019-0450-2
FICHOROVA, R. N., MORRISON, C. S., CHEN, P.-L., DONCEL, G. F. (2020) Aberrant cervical innate immunity predicts onset of dysbiosis and sexually transmitted infections in women of reproductive age. PLOS ONE, 15(1), e0224359. DOI: https://doi.org/10.1371/journal.pone.0224359
FRANCE, M., ALIZADEH, M., BROWN, S., MA, B., RAVEL, J. (2022) Towards a deeper understanding of the vaginal microbiota. Nature Microbiology, 7, 367–378. DOI: 10.1038/s41564-022-01083-2
GAJER, P., BROTMAN, R. M., BAI, G., SAKAMOTO, J., SCHÜTTE, U. M., ZHONG, X., KOENIG, S. S., FU, L., MA, Z. S., ZHOU, X., ABDO, Z., FORNEY, L. J., RAVEL, J. (2012) Temporal Dynamics of the Human Vaginal Microbiota. Science Translational Medicine, 4(132). DOI: https://doi.org/10.1126/scitranslmed.3003605
GHOLIOF, M., ADAMSON-DE LUCA, E., WESSELS, J. M. (2022) The female reproductive tract microbiotas, inflammation, and gynecological conditions. Frontiers in Reproductive Health, 4. https://doi.org/10.3389/frph.2022.963752
KINDINGER, L. M., BENNETT, P. R., LEE, Y. S., MARCHESI, J. R., SMITH, A., CACCIATORE, S., HOLMES, E., NICHOLSON, J. K., TEOH, T. G., MACINTYRE, D. A. (2017) The interaction between vaginal microbiota, cervical length, and vaginal progesterone treatment for preterm birth risk. Microbiome, 5(1). DOI: https://doi.org/10.1186/s40168-016-0223-9
KLINDWORTH, A., PRUESSE, E., SCHWEER, T., PEPLIES, J., QUAST, C., HORN, M., GLÖCKNER, F. O. (2012) Evaluation of general 16S ribosomal RNA gene PCR primers for classical and next-generation sequencing-based diversity studies. Nucleic Acids Research, 41(1), e1–e1. DOI: https://doi.org/10.1093/nar/gks808
KOEDOODER, R., SINGER, M., BUDDING, D. E., SCHOENMAKERS, S., SAVELKOUL, P. H., MORRE, S. A., LAVEN, J. S. (2018) The vaginal microbiome as predictor for in vitro fertilization with or without intracytoplasmic sperm injection outcome: a prospective study. Fertility and Sterility, 110(4), e210–e211. DOI: https://doi.org/10.1016/j.fertnstert.2018.07.609
MACHADO, D., CASTRO, J., PALMEIRA-DEOLIVEIRA, A., MARTINEZ-DE-OLIVEIRA, J., CERCA, N. (2016) Bacterial Vaginosis Biofilms: Challenges to Current Therapies and Emerging Solutions. Frontiers in Microbiology, 6. DOI: https://doi.org/10.3389/fmicb.2015.01528
MILLER, E. A., BEASLEY, D. E., DUNN, R. R., ARCHIE, E. A. (2016) Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique? Frontiers in Microbiology, 7. DOI: https://doi.org/10.3389/fmicb.2016.01936
MUZNY, C. A., BLANCHARD, E., TAYLOR, C. M., AARON, K. J., TALLURI, R., GRISWOLD, M. E., REDDEN, D. T., LUO, M., WELSH, D. A., VAN DER POL, W. J., LEFKOWITZ, E. J., MARTIN, D. H., SCHWEBKE, J. R. (2018) Identification of key bacteria involved in the induction of incident bacterial vaginosis: A prospective study. The Journal of Infectious Diseases, 218, 966–978. DOI: 10.1093/infdis/jiy243
ONDERDONK, A. B., DELANEY, M. L., FICHOROVA, R. N. (2016) The Human Microbiome during Bacterial Vaginosis. Clinical Microbiology Reviews, 29(2), 223–238. DOI: https://doi.org/10.1128/cmr.00075-15
PATRAS, K. (2024) Host-microbe interactions in the vaginal microenvironment. DOI: https://doi.org/10.52843/cassyni.3xhhkh
PELTAK, S. N., STEEN, T. Y. (2025) The Impact of Antibiotic Use on the Human Gut Microbiome: A Review. Georgetown Medical Review. DOI: https://doi.org/10.52504/001c.143628
PETROVA, M. I., LIEVENS, E., MALIK, S., IMHOLZ, N., LEBEER, S. (2015) Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Frontiers in Physiology, 6. https://doi.org/10.3389/fphys.2015.00081
RAVEL, J., GAJER, P., ABDO, Z., SCHNEIDER, G.M., KOENIG, S.S., McCULLE, S.L., KARLEBACH, S., GORLE, R., RUSSELL, J., TACKET, C. O., BROTMAN, R. M., DAVIS, C. C., AULT, K., PERALTA, L., FORNEY, L. J. (2010) Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences, 108 (suppl. 1), 4680–4687. DOI: https://doi.org/10.1073/pnas.1002611107
ROMERO, R., MIRANDA, J., CHAIWORAPONGSA, T., KORZENIEWSKI, S. J., CHAEMSAITHONG, P., GOTSCH, F., DONG, Z., AHMED, A. I., YOON, B.H., HASSAN, S.S., KIM, C. J., YEO, L. (2014) Prevalence and Clinical Significance of Sterile Intra-amniotic Inflammation in Patients with Preterm Labor and Intact Membranes. American Journal of Reproductive Immunology, 72(5), 458–474. DOI: https://doi.org/10.1111/aji.12296
TENCHOV, R., ZHOU, Q. A. (2025) Assisted Reproductive Technology: A Ray of Hope for Infertility. 2025 Feb. 21. Available from: http://dx.doi.org/10.26434/chemrxiv-2025-5sfk1
URUIMAGOVA, A. T., PRILEPSKAYA, V. N., MEZHEVITINOVA, E. A., DONNIKOV, A. E., IVANOVA, A. A. (2021) Bacterial vaginosis: modern concepts, approaches to diagnosis and treatment. Gynecology, 23(4), 286–293. https://doi.org/10.26442/20795696.2021.4.200954
VAN DE WIJGERT, J.H.H.M., VERWIJS, M. C., GILL, A. C., BORGDORFF, H., VAN DER VEER, C., MAYAUD, P. (2020) Pathobionts in the Vaginal Microbiota: Individual Participant Data Meta-Analysis of Three Sequencing Studies. Frontiers in Cellular and Infection Microbiology. Apr. 15;10:129. DOI: 10.3389/fcimb.2020.00129
YEFET, E., SULEIMAN, A., COLODNER, R., BATTINO, S., WATTAD, M., KUZMIN, O., NACHUM, Z. (2024) Efficacy of Oral Probiotic Supplementation in Preventing Vulvovaginal Infections During Pregnancy: A Randomized and Placebo-Controlled Clinical Trial. Nutrients, 16(24), 4406. DOI: https://doi.org/10.3390/nu16244406
ZHOU, R., LU, J., WANG, J., XIAO, B. (2022) Vaginal Lactobacillus iners abundance is associated with outcome in antibiotic treatment of bacterial vaginosis and capable of inhibiting Gardnerella. Frontiers in Cellular and Infection Microbiology, 12. DOI: https://doi.org/10.3389/fcimb.2022.1033431
ZIKLO, N., VIDGEN, M. E., TAING, K., HUSTON, W. M., TIMMS, P. (2018) Dysbiosis of the Vaginal Microbiota and Higher Vaginal Kynurenine/Tryptophan Ratio Reveals an Association with Chlamydia trachomatis Genital Infections. Frontiers in Cellular and Infection Microbiology, 8. DOI: https://doi.org/10.3389/fcimb.2018.00001
