Journal
NATURE COMMUNICATIONS
Volume 13, Issue 1, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41467-022-28620-1
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Funding
- March of Dimes European Preterm Birth Research Centre at Imperial College London
- National Institute of Health Research (NIHR) Imperial Biomedical Research Centre (BRC)
- Genesis Research Trust
- Wellcome Trust Career Development Fellowship [209560/Z/17/Z]
- UCLH NIHR Biomedical Research Centre
- NIHR Clinical Lectureship Scheme
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This study provides mechanistic insight into the role of vaginal microbiota and immunological factors in spontaneous preterm birth (sPTB). The findings suggest that the complement system, in conjunction with specific vaginal microbial and associated immunological changes, contributes to the development of sPTB.
There has been a surge in studies implicating a role of vaginal microbiota in spontaneous preterm birth (sPTB), but most are associative without mechanistic insight. Here we show a comprehensive approach to understand the causative factors of preterm birth, based on the integration of longitudinal vaginal microbiota and cervicovaginal fluid (CVF) immunophenotype data collected from 133 women at high-risk of sPTB. We show that vaginal depletion of Lactobacillus species and high bacterial diversity leads to increased mannose binding lectin (MBL), IgM, IgG, C3b, C5, IL-8, IL-6 and IL-1 beta and to increased risk of sPTB. Cervical shortening, which often precedes preterm birth, is associated with Lactobacillus iners and elevated levels of IgM, C3b, C5, C5a and IL-6. These data demonstrate a role for the complement system in microbial-driven sPTB and provide a scientific rationale for the development of live biotherapeutics and complement therapeutics to prevent sPTB. Gaining mechanistic insight into the microbiological and immunological factors that are associated with spontaneous preterm birth is important for the development of prevention strategies. Here authors show that the complement system in conjunction with specific vaginal microbial and associated immunological changes are contributing to this condition.
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