Project description:Differences in vaginal microbiota, host transcriptome and proteins in women with bacterial vaginosis are associated with metronidazole treatment response
Project description:IgA coating of vaginal bacteria is reduced in the setting of bacterial vaginosis (BV) and preferentially targets BV-associated bacteria
Project description:Pelvic organ prolapse (POP), affecting up to 50% of elderly women, disrupts vaginal microbial homeostasis, yet the impact of first-line pessary therapy on microbiome dynamics remains poorly characterized. This prospective cohort study employed metagenomic sequencing and clinical metrics to longitudinally analyze vaginal microbiota in 41 postmenopausal POP-III/IV patients undergoing pessary therapy, compared to surgical intervention and healthy controls. Pre-treatment POP patients exhibited dysbiosis marked by elevated aerobic pathogen (e.g., Gardnerella vaginalis, Streptococcus agalactiae) and bacterial vaginosis (BV)-associated taxa, which may correlating with anatomical oxygen exposure. pessary therapy drove time-dependent microbial stabilization: within 3 months, Lactobacillus crispatus and Lactobacillus jensenii reclaimed dominance (∼90% abundance), suppressing BV-associated genera (Corynebacterium spp., Streptococcus spp.), while surgery failed to improve dysbiosis. Patients developing pessary-associated ulcers showed distinct enrichment of G. vaginalis, S. anginosus, and Atopobium vaginae, enabling a predictive model (AUC: 0.848) for complication risk. Metabolomic profiling revealed pessary-induced activation of pentose phosphate and glycerophospholipid pathways, aligning with microbial recovery. These findings establish pessary therapy as a dual restorative intervention—anatomically and microbially—while identifying actionable biomarkers for complication prevention. Our work advocates integrating microbiome-guided strategies into POP management to optimize therapeutic outcomes.
