期刊
CURRENT OPINION IN INFECTIOUS DISEASES
卷 33, 期 1, 页码 59-65出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QCO.0000000000000620
关键词
Atopobium vaginae; bacterial vaginosis; biofilm; Gardnerella vaginalis; host-immune response; Prevotella bivia; Sneathiaspecies
资金
- National Institute of Allergy and Infectious Diseases (NIAID) [K23AI106957-01A1]
- NIAID [U19AI113212-01A1, U01AI108509, HHSN 27200011]
- National Cancer Institute [P30CA023074, 2U54CA143924-11]
Purpose of review The cause of bacterial vaginosis, the most common cause of vaginal discharge in women, remains controversial. We recently published an updated conceptual model on bacterial vaginosis pathogenesis, focusing on the roles ofGardnerella vaginalisandPrevotella biviaas early colonizers andAtopobium vaginaeand other bacterial vaginosis-associated bacteria (BVAB) as secondary colonizers in this infection. In this article, we extend the description of our model to include a discussion on the role of host-vaginal microbiota interactions in bacterial vaginosis pathogenesis. Recent findings AlthoughG. vaginalisandP. biviaare highly abundant in women with bacterial vaginosis, neither induce a robust inflammatory response from vaginal epithelial cells. These early colonizers may be evading the immune system while establishing the bacterial vaginosis biofilm. Secondary colonizers, includingA. vaginae,Sneathiaspp., and potentially other BVAB are more potent stimulators of the host-immune response to bacterial vaginosis and likely contribute to its signs and symptoms as well as its adverse outcomes. Elucidating the cause of bacterial vaginosis has important implications for diagnosis and treatment. Our current bacterial vaginosis pathogenesis model provides a framework for key elements that should be considered when designing and testing novel bacterial vaginosis diagnostics and therapeutics.
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