Vaginal microbiota ecosystem (VME)

The vaginal microbiota ecosystem is a complex community of microorganisms inhabiting the female reproductive tract, primarily dominated by Lactobacillus species in healthy individuals [1]. This ecosystem serves as a critical biological barrier, where beneficial bacteria produce lactic acid, hydrogen peroxide, and bacteriocins to maintain an acidic environment (pH < 4.5) that inhibits the growth of pathogenic microbes [2]. A shift in this balance, known as dysbiosis, is characterized by a decrease in lactobacilli and an increase in anaerobic diversity, leading to conditions such as bacterial vaginosis and increased susceptibility to sexually transmitted infections and adverse pregnancy outcomes [3]. Pharmacological and therapeutic strategies target this ecosystem through the use of narrow-spectrum antibiotics to clear overgrowth, or through live biotherapeutic products (probiotics) and vaginal microbiota transplants (VMT) designed to re-establish a protective microbial community [4, 5]. Monitoring the health of this ecosystem involves assessing biomarkers like the Nugent score and vaginal pH to guide clinical interventions [2]. Sources: [1] Ravel J, et al. (2011). Vaginal microbiome of reproductive-age women. PNAS. [2] Petrova MI, et al. (2015). Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Frontiers in Physiology. [3] Redelinghuys MJ, et al. (2020). Normal Flora and Bacterial Vaginosis. MDPI. [4] Cohen CR, et al. (2020). Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis. NEJM. [5] Lev-Sagie A, et al. (2019). Vaginal microbiota transplantation for the treatment of intractable bacterial vaginosis. Nature Medicine.

Other names

Vaginal microbiomeVaginal floraVaginal microfloraVaginal microbial community

Antibiotics (e.g., metronidazole) inhibit anaerobic bacterial growth; live biotherapeutics (e.g., Lactin-V) restore Lactobacillus dominance and acidify the environment; vaginal microbiota transplants (VMT) replace the dysbiotic community with a healthy donor microbiome [3, 4, 5].