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Особенности вагинальной микробиоты у женщин на различных стадиях постменопаузы
Особенности вагинальной микробиоты у женщин на различных стадиях постменопаузы
Зиганшина Л.З., Муслимова С.Ю., Сахаутдинова И.В. Особенности вагинальной микробиоты у женщин на различных стадиях постменопаузы. Гинекология. 2023;25(4):447–451.
DOI: 10.26442/20795696.2023.4.202381
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
DOI: 10.26442/20795696.2023.4.202381
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель. Изучить динамику микробиоты влагалища в зависимости от стадии постменопаузы по STRAW+10.
Материалы и методы. После получения добровольного информированного согласия от каждой пациентки и определения соответствия критериям отбора мы провели обследование 139 женщин постменопаузального возраста. Участниц распределили в 3 группы в зависимости от продолжительности постменопаузы в соответствии с этапами старения репродуктивной системы STRAW+10. Для оценки состояния вагинального микробиома использовали метод полимеразной цепной реакции в реальном времени Фемофлор 16.
Результаты. После менопаузы у женщин в группе облигатных аэробов Lactobacillus spp. и Enterobacteriaceae полностью замещались Streptococcus spp. и Staphylococcus spp., количество которых увеличивалось. Значительное обеднение состава происходило в группе облигатных анаэробов. Если на стадии +1a и b эта группа практически в равных долях представлена 5 сообществами микроорганизмов (Gardnerella vaginalis + Prevotella bivia + Porphyromonas и Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp., Lachnobacterium spp. + Clostridium spp.), то на стадии +1с в общей бактериальной массе превалировали всего 3 группы (G. vaginalis + P. bivia + Porphyromonas и Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp.). На стадии постменопаузы +2 общую бактериальную массу составляли только 2 группы микроорганизмов: G. vaginalis + P. bivia + Porphyromonas и Peptostreptococcus spp.
Заключение. Таким образом, основным итогом возрастных изменений микробиоты влагалища явилось обеднение состава его микробиома.
Ключевые слова: вагинальная микробиота, постменопауза
Materials and methods. After obtaining voluntary informed consent from each patient and determining eligibility criteria, we conducted a survey of 139 postmenopausal women. Participants were divided into 3 groups depending on the duration of postmenopause in accordance with the stages of aging of the reproductive system STRAW+10. Femoflor 16 real-time polymerase chain reaction was used to assess the state of the vaginal microbiome.
Results. After menopause in women in the group of obligate aerobes Lactobacillus spp. and Enterobacteriaceae were completely replaced by Streptococcus spp. and Staphylococcus spp., which increased in number. A significant depletion of the composition occurred in the group of obligate anaerobes. If at stages +1a and b this group is almost equally represented by 5 communities of microorganisms (Gardnerella vaginalis + Prevotella bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp., Lachnobacterium spp. + Clostridium spp.), then only 3 groups prevailed in the total bacterial mass at the +1c stage (G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp + Corynebacterium spp.). At the postmenopausal stage +2, the total bacterial mass consisted of only 2 groups of microorganisms: G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp.
Conclusion. Thus, the main result of age-related changes in the vaginal microflora was the impoverishment of the composition of its microbiome.
Keywords: vaginal microbiota, postmenopause
Материалы и методы. После получения добровольного информированного согласия от каждой пациентки и определения соответствия критериям отбора мы провели обследование 139 женщин постменопаузального возраста. Участниц распределили в 3 группы в зависимости от продолжительности постменопаузы в соответствии с этапами старения репродуктивной системы STRAW+10. Для оценки состояния вагинального микробиома использовали метод полимеразной цепной реакции в реальном времени Фемофлор 16.
Результаты. После менопаузы у женщин в группе облигатных аэробов Lactobacillus spp. и Enterobacteriaceae полностью замещались Streptococcus spp. и Staphylococcus spp., количество которых увеличивалось. Значительное обеднение состава происходило в группе облигатных анаэробов. Если на стадии +1a и b эта группа практически в равных долях представлена 5 сообществами микроорганизмов (Gardnerella vaginalis + Prevotella bivia + Porphyromonas и Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp., Lachnobacterium spp. + Clostridium spp.), то на стадии +1с в общей бактериальной массе превалировали всего 3 группы (G. vaginalis + P. bivia + Porphyromonas и Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp.). На стадии постменопаузы +2 общую бактериальную массу составляли только 2 группы микроорганизмов: G. vaginalis + P. bivia + Porphyromonas и Peptostreptococcus spp.
Заключение. Таким образом, основным итогом возрастных изменений микробиоты влагалища явилось обеднение состава его микробиома.
Ключевые слова: вагинальная микробиота, постменопауза
________________________________________________
Materials and methods. After obtaining voluntary informed consent from each patient and determining eligibility criteria, we conducted a survey of 139 postmenopausal women. Participants were divided into 3 groups depending on the duration of postmenopause in accordance with the stages of aging of the reproductive system STRAW+10. Femoflor 16 real-time polymerase chain reaction was used to assess the state of the vaginal microbiome.
Results. After menopause in women in the group of obligate aerobes Lactobacillus spp. and Enterobacteriaceae were completely replaced by Streptococcus spp. and Staphylococcus spp., which increased in number. A significant depletion of the composition occurred in the group of obligate anaerobes. If at stages +1a and b this group is almost equally represented by 5 communities of microorganisms (Gardnerella vaginalis + Prevotella bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp., Lachnobacterium spp. + Clostridium spp.), then only 3 groups prevailed in the total bacterial mass at the +1c stage (G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp + Corynebacterium spp.). At the postmenopausal stage +2, the total bacterial mass consisted of only 2 groups of microorganisms: G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp.
Conclusion. Thus, the main result of age-related changes in the vaginal microflora was the impoverishment of the composition of its microbiome.
Keywords: vaginal microbiota, postmenopause
Полный текст
Список литературы
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5. Kim S, Seo H, Rahim MA, et al. Changes in the Microbiome of Vaginal Fluid after Menopause in Korean Women. J Microbiol Biotechnol. 2021;31(11):1490-500. DOI:10.4014/jmb.2106.06022
6. Shardell M, Gravitt PE, Burke AE, et al. Association of Vaginal Microbiota With Signs and Symptoms of the Genitourinary Syndrome of Menopause Across Reproductive Stages. J Gerontol A Biol Sci Med Sci. 2021;76(9):1542-50. DOI:10.1093/gerona/glab120
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8. Gliniewicz K, Schneider GM, Ridenhour BJ, et al. Comparison of the Vaginal Microbiomes of Premenopausal and Postmenopausal Women. Front Microbiol. 2019;10:193. DOI:10.3389/fmicb.2019.00193
9. Diop K, Dufour JC, Levasseur A, Fenollar F. Exhaustive Repertoire of Human Vaginal Microbiota. Hum Microb J. 2019;11:100051. DOI:10.1016/j.humic.2018.11.002
10. De Filippis F, Pasolli E, Tett A, et al. Distinct Genetic and Functional Traits of Human Intestinal Prevotella Copri Strains Are Associated With Different Habitual Diets. Cell Host Microbe. 2019;25(3):444-53.e3. DOI:10.1016/j.chom.2019.01.004
11. de Oliveira NS, de Lima ABF, de Brito JCR, et al. Postmenopausal Vaginal Microbiome and Microbiota. Front Reprod Health. 2022;3:780931. DOI:10.3389/frph.2021.780931
12. Wang Y, Zhang Y, Zhang Q, et al. Characterization of pelvic and cervical microbiotas from patients with pelvic inflammatory disease. J Med Microbiol. 2018;67(10):1519-26. DOI:10.1099/jmm.0.000821
13. Hillier SL, Lau RJ. Vaginal Microflora in Postmenopausal Women Who Have Not Received Estrogen Replacement Therapy. Clin Infect Dis. 1997;25(Suppl. 2):S123-6. DOI:10.1086/516221
14. Cauci S, Driussi S, De Santo D, et al. Prevalence of Bacterial Vaginosis and Vaginal Flora Changes in Peri- and Postmenopausal Women. J Clin Microbiol. 2002;40(6):2147-52. DOI:10.1128/JCM.40.6.2147-2152.2002
15. Randis TM, Ratner AJ. Gardnerella and Prevotella: Co-Conspirators in the Pathogenesis of Bacterial Vaginosis. J Infect Dis. 2019;220(7):1085-8. DOI:10.1093/infdis/jiy705
16. Park MG, Cho S, Oh MM. Menopausal Changes in the Microbiome – A Review Focused on the Genitourinary Microbiome. Diagnostics (Basel). 2023;13(6):1193. DOI:10.3390/diagnostics13061193
17. Mitchell CM, Ma N, Mitchell AJ, et al. Association between postmenopausal vulvovaginal discomfort, vaginal microbiota, and mucosal inflammation. Am J Obstet Gynecol. 2021;225(2):159.e1-15. DOI:10.1016/j.ajog.2021.02.034
18. Auriemma RS, Scairati R, Del Vecchio G, et al. The Vaginal Microbiome: A Long Urogenital Colonization Throughout Woman Life. Front Cell Infect Microbiol. 2021;11:686167. DOI:10.3389/fcimb.2021.686167
2. Godha K, Tucker KМ, Biehl С, et al. Human vaginal pH and microbiota: an update. Gynecol Endocrinol. 2018;34(6):451-5. DOI:10.1080/09513590.2017.1407753
3. Buchta V. Vaginal microbiome. Ceska Gynekol. 2018;83(5):371-9.
4. Barrientos-Durán A, Fuentes-López A, de Salazar A, et al. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis. Nutrients. 2020;12(2):419. DOI:10.3390/nu12020419
5. Kim S, Seo H, Rahim MA, et al. Changes in the Microbiome of Vaginal Fluid after Menopause in Korean Women. J Microbiol Biotechnol. 2021;31(11):1490-500. DOI:10.4014/jmb.2106.06022
6. Shardell M, Gravitt PE, Burke AE, et al. Association of Vaginal Microbiota With Signs and Symptoms of the Genitourinary Syndrome of Menopause Across Reproductive Stages. J Gerontol A Biol Sci Med Sci. 2021;76(9):1542-50. DOI:10.1093/gerona/glab120
7. Brotman RM, Shardell MD, Gajer P, et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2018;25(11):1321-30. DOI:10.1097/GME.0000000000001236
8. Gliniewicz K, Schneider GM, Ridenhour BJ, et al. Comparison of the Vaginal Microbiomes of Premenopausal and Postmenopausal Women. Front Microbiol. 2019;10:193. DOI:10.3389/fmicb.2019.00193
9. Diop K, Dufour JC, Levasseur A, Fenollar F. Exhaustive Repertoire of Human Vaginal Microbiota. Hum Microb J. 2019;11:100051. DOI:10.1016/j.humic.2018.11.002
10. De Filippis F, Pasolli E, Tett A, et al. Distinct Genetic and Functional Traits of Human Intestinal Prevotella Copri Strains Are Associated With Different Habitual Diets. Cell Host Microbe. 2019;25(3):444-53.e3. DOI:10.1016/j.chom.2019.01.004
11. de Oliveira NS, de Lima ABF, de Brito JCR, et al. Postmenopausal Vaginal Microbiome and Microbiota. Front Reprod Health. 2022;3:780931. DOI:10.3389/frph.2021.780931
12. Wang Y, Zhang Y, Zhang Q, et al. Characterization of pelvic and cervical microbiotas from patients with pelvic inflammatory disease. J Med Microbiol. 2018;67(10):1519-26. DOI:10.1099/jmm.0.000821
13. Hillier SL, Lau RJ. Vaginal Microflora in Postmenopausal Women Who Have Not Received Estrogen Replacement Therapy. Clin Infect Dis. 1997;25(Suppl. 2):S123-6. DOI:10.1086/516221
14. Cauci S, Driussi S, De Santo D, et al. Prevalence of Bacterial Vaginosis and Vaginal Flora Changes in Peri- and Postmenopausal Women. J Clin Microbiol. 2002;40(6):2147-52. DOI:10.1128/JCM.40.6.2147-2152.2002
15. Randis TM, Ratner AJ. Gardnerella and Prevotella: Co-Conspirators in the Pathogenesis of Bacterial Vaginosis. J Infect Dis. 2019;220(7):1085-8. DOI:10.1093/infdis/jiy705
16. Park MG, Cho S, Oh MM. Menopausal Changes in the Microbiome – A Review Focused on the Genitourinary Microbiome. Diagnostics (Basel). 2023;13(6):1193. DOI:10.3390/diagnostics13061193
17. Mitchell CM, Ma N, Mitchell AJ, et al. Association between postmenopausal vulvovaginal discomfort, vaginal microbiota, and mucosal inflammation. Am J Obstet Gynecol. 2021;225(2):159.e1-15. DOI:10.1016/j.ajog.2021.02.034
18. Auriemma RS, Scairati R, Del Vecchio G, et al. The Vaginal Microbiome: A Long Urogenital Colonization Throughout Woman Life. Front Cell Infect Microbiol. 2021;11:686167. DOI:10.3389/fcimb.2021.686167
2. Godha K, Tucker KМ, Biehl С, et al. Human vaginal pH and microbiota: an update. Gynecol Endocrinol. 2018;34(6):451-5. DOI:10.1080/09513590.2017.1407753
3. Buchta V. Vaginal microbiome. Ceska Gynekol. 2018;83(5):371-9.
4. Barrientos-Durán A, Fuentes-López A, de Salazar A, et al. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis. Nutrients. 2020;12(2):419. DOI:10.3390/nu12020419
5. Kim S, Seo H, Rahim MA, et al. Changes in the Microbiome of Vaginal Fluid after Menopause in Korean Women. J Microbiol Biotechnol. 2021;31(11):1490-500. DOI:10.4014/jmb.2106.06022
6. Shardell M, Gravitt PE, Burke AE, et al. Association of Vaginal Microbiota With Signs and Symptoms of the Genitourinary Syndrome of Menopause Across Reproductive Stages. J Gerontol A Biol Sci Med Sci. 2021;76(9):1542-50. DOI:10.1093/gerona/glab120
7. Brotman RM, Shardell MD, Gajer P, et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2018;25(11):1321-30. DOI:10.1097/GME.0000000000001236
8. Gliniewicz K, Schneider GM, Ridenhour BJ, et al. Comparison of the Vaginal Microbiomes of Premenopausal and Postmenopausal Women. Front Microbiol. 2019;10:193. DOI:10.3389/fmicb.2019.00193
9. Diop K, Dufour JC, Levasseur A, Fenollar F. Exhaustive Repertoire of Human Vaginal Microbiota. Hum Microb J. 2019;11:100051. DOI:10.1016/j.humic.2018.11.002
10. De Filippis F, Pasolli E, Tett A, et al. Distinct Genetic and Functional Traits of Human Intestinal Prevotella Copri Strains Are Associated With Different Habitual Diets. Cell Host Microbe. 2019;25(3):444-53.e3. DOI:10.1016/j.chom.2019.01.004
11. de Oliveira NS, de Lima ABF, de Brito JCR, et al. Postmenopausal Vaginal Microbiome and Microbiota. Front Reprod Health. 2022;3:780931. DOI:10.3389/frph.2021.780931
12. Wang Y, Zhang Y, Zhang Q, et al. Characterization of pelvic and cervical microbiotas from patients with pelvic inflammatory disease. J Med Microbiol. 2018;67(10):1519-26. DOI:10.1099/jmm.0.000821
13. Hillier SL, Lau RJ. Vaginal Microflora in Postmenopausal Women Who Have Not Received Estrogen Replacement Therapy. Clin Infect Dis. 1997;25(Suppl. 2):S123-6. DOI:10.1086/516221
14. Cauci S, Driussi S, De Santo D, et al. Prevalence of Bacterial Vaginosis and Vaginal Flora Changes in Peri- and Postmenopausal Women. J Clin Microbiol. 2002;40(6):2147-52. DOI:10.1128/JCM.40.6.2147-2152.2002
15. Randis TM, Ratner AJ. Gardnerella and Prevotella: Co-Conspirators in the Pathogenesis of Bacterial Vaginosis. J Infect Dis. 2019;220(7):1085-8. DOI:10.1093/infdis/jiy705
16. Park MG, Cho S, Oh MM. Menopausal Changes in the Microbiome – A Review Focused on the Genitourinary Microbiome. Diagnostics (Basel). 2023;13(6):1193. DOI:10.3390/diagnostics13061193
17. Mitchell CM, Ma N, Mitchell AJ, et al. Association between postmenopausal vulvovaginal discomfort, vaginal microbiota, and mucosal inflammation. Am J Obstet Gynecol. 2021;225(2):159.e1-15. DOI:10.1016/j.ajog.2021.02.034
18. Auriemma RS, Scairati R, Del Vecchio G, et al. The Vaginal Microbiome: A Long Urogenital Colonization Throughout Woman Life. Front Cell Infect Microbiol. 2021;11:686167. DOI:10.3389/fcimb.2021.686167
________________________________________________
2. Godha K, Tucker KМ, Biehl С, et al. Human vaginal pH and microbiota: an update. Gynecol Endocrinol. 2018;34(6):451-5. DOI:10.1080/09513590.2017.1407753
3. Buchta V. Vaginal microbiome. Ceska Gynekol. 2018;83(5):371-9.
4. Barrientos-Durán A, Fuentes-López A, de Salazar A, et al. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis. Nutrients. 2020;12(2):419. DOI:10.3390/nu12020419
5. Kim S, Seo H, Rahim MA, et al. Changes in the Microbiome of Vaginal Fluid after Menopause in Korean Women. J Microbiol Biotechnol. 2021;31(11):1490-500. DOI:10.4014/jmb.2106.06022
6. Shardell M, Gravitt PE, Burke AE, et al. Association of Vaginal Microbiota With Signs and Symptoms of the Genitourinary Syndrome of Menopause Across Reproductive Stages. J Gerontol A Biol Sci Med Sci. 2021;76(9):1542-50. DOI:10.1093/gerona/glab120
7. Brotman RM, Shardell MD, Gajer P, et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2018;25(11):1321-30. DOI:10.1097/GME.0000000000001236
8. Gliniewicz K, Schneider GM, Ridenhour BJ, et al. Comparison of the Vaginal Microbiomes of Premenopausal and Postmenopausal Women. Front Microbiol. 2019;10:193. DOI:10.3389/fmicb.2019.00193
9. Diop K, Dufour JC, Levasseur A, Fenollar F. Exhaustive Repertoire of Human Vaginal Microbiota. Hum Microb J. 2019;11:100051. DOI:10.1016/j.humic.2018.11.002
10. De Filippis F, Pasolli E, Tett A, et al. Distinct Genetic and Functional Traits of Human Intestinal Prevotella Copri Strains Are Associated With Different Habitual Diets. Cell Host Microbe. 2019;25(3):444-53.e3. DOI:10.1016/j.chom.2019.01.004
11. de Oliveira NS, de Lima ABF, de Brito JCR, et al. Postmenopausal Vaginal Microbiome and Microbiota. Front Reprod Health. 2022;3:780931. DOI:10.3389/frph.2021.780931
12. Wang Y, Zhang Y, Zhang Q, et al. Characterization of pelvic and cervical microbiotas from patients with pelvic inflammatory disease. J Med Microbiol. 2018;67(10):1519-26. DOI:10.1099/jmm.0.000821
13. Hillier SL, Lau RJ. Vaginal Microflora in Postmenopausal Women Who Have Not Received Estrogen Replacement Therapy. Clin Infect Dis. 1997;25(Suppl. 2):S123-6. DOI:10.1086/516221
14. Cauci S, Driussi S, De Santo D, et al. Prevalence of Bacterial Vaginosis and Vaginal Flora Changes in Peri- and Postmenopausal Women. J Clin Microbiol. 2002;40(6):2147-52. DOI:10.1128/JCM.40.6.2147-2152.2002
15. Randis TM, Ratner AJ. Gardnerella and Prevotella: Co-Conspirators in the Pathogenesis of Bacterial Vaginosis. J Infect Dis. 2019;220(7):1085-8. DOI:10.1093/infdis/jiy705
16. Park MG, Cho S, Oh MM. Menopausal Changes in the Microbiome – A Review Focused on the Genitourinary Microbiome. Diagnostics (Basel). 2023;13(6):1193. DOI:10.3390/diagnostics13061193
17. Mitchell CM, Ma N, Mitchell AJ, et al. Association between postmenopausal vulvovaginal discomfort, vaginal microbiota, and mucosal inflammation. Am J Obstet Gynecol. 2021;225(2):159.e1-15. DOI:10.1016/j.ajog.2021.02.034
18. Auriemma RS, Scairati R, Del Vecchio G, et al. The Vaginal Microbiome: A Long Urogenital Colonization Throughout Woman Life. Front Cell Infect Microbiol. 2021;11:686167. DOI:10.3389/fcimb.2021.686167
Авторы
Л.З. Зиганшина*, С.Ю. Муслимова, И.В. Сахаутдинова
ФГБОУ ВО «Башкирский государственный медицинский университет», Уфа, Россия
*medicalscience@bk.ru
Bashkir State Medical University, Ufa, Russia
*medicalscience@bk.ru
ФГБОУ ВО «Башкирский государственный медицинский университет», Уфа, Россия
*medicalscience@bk.ru
________________________________________________
Bashkir State Medical University, Ufa, Russia
*medicalscience@bk.ru
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