Local vaginal microenvironment (VME)

The local vaginal microenvironment is a dynamic and complex ecosystem consisting of the vaginal microbiota, host mucosal epithelium, and various biochemical constituents such as lactic acid, hydrogen peroxide, and antimicrobial peptides (Ravel et al., 2011). Its primary biological function is to maintain a protective barrier against urogenital pathogens, largely through the dominance of Lactobacillus species that produce lactic acid to maintain an acidic pH, typically between 3.5 and 4.5 (Miller et al., 2016). Dysregulation of this environment, often termed dysbiosis, is a hallmark of conditions such as bacterial vaginosis (BV) and vulvovaginal candidiasis, and it significantly increases the risk of acquiring sexually transmitted infections (STIs) and experiencing adverse pregnancy outcomes like preterm birth (Borges et al., 2014). While the microenvironment itself is not a single molecular target, it is a therapeutic focus for interventions aimed at restoring homeostasis, including the use of probiotics, pH-restoring gels, and localized anti-infectives (Mendling et al., 2019). Drugs like metronidazole and clindamycin are used to eliminate overgrowth of anaerobic bacteria, while emerging live biotherapeutic products (LBPs) seek to re-establish a Lactobacillus-dominant state (Cohen et al., 2020). Monitoring the health of this microenvironment involves assessing biomarkers such as vaginal pH, the Nugent score, and specific cytokine profiles to evaluate the efficacy of treatments and the risk of disease progression (Amabebe & Anumba, 2018).

Other names

Vaginal ecosystemVaginal nicheVaginal microbiota-host interfaceVaginal environment

Modulation of microbial composition, restoration of acidic pH, and enhancement of mucosal barrier integrity.