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Exploring a Road Map to Counter Misconceptions About the Cervicovaginal Microbiome and Disease

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Abstract

Urogenital diseases, especially infection and cancer, are major causes of death and morbidity in females. Yet, millions of women in the developing world have no access to basic urogynecological care, and the diagnosis and treatment of widespread aberrant bacterial conditions (bacterial vaginosis [BV] and aerobic vaginitis [AV]) remain suboptimal the world over. Samples from women living in resource-disadvantaged and developed countries have been analyzed by high-throughput sequencing to reveal the diversity of bacteria in the vagina, how rapidly the bacterial population fluctuates over time, and how rapidly the switch occurs between healthy and aberrant conditions. Unfortunately, clinical diagnostic methods are inefficient and too often outdated therapies are administered. The net result is suboptimal care and recurrent disease that adversely affects the quality of life. This viewpoint outlines a scientific and translational road map designed to improve the cervicovaginal health and treatment of disease. This comprises (1) improving education of women and physicians on the vaginal microbiota; (2) having agencies target funding for research to improve diagnosis and test new therapies; and (3) making sure that new approaches are accessible in developing countries, empowering to women, and are acceptable and appropriate for different populations.

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Authors and Affiliations

  1. Department of Biochemistry, The University of Western Ontario, London, Canada

    Jean M. Macklaim BSc (Hons.) & Gregory B. Gloor PhD

  2. Canadian R&D Centre for Probiotics, Lawson Health Research Institute, F2-116, 268 Grosvenor Street, N6A 4V2, London, Canada

    Jean M. Macklaim BSc (Hons.), Gregory B. Gloor PhD & Gregor Reid PhD, MBA

  3. Department of Obstetrics, Gynecology and Reproductive Science, University of California San Francisco, San Francisco, USA

    Craig R. Cohen MD, MPH

  4. Femicare vzw, Clinical Research for Women, Tienen, Belgium

    Gilbert Donders MD, PhD

  5. Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Canada

    Janet E. Hill PhD

  6. Center for Infectious Disease Research in Zambia, Lusaka, Zambia

    Groesbeck P. Parham MD

  7. Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA

    Jacques Ravel PhD

  8. Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL, USA

    Gregory Spear PhD

  9. Academic Medical Center of the University of Amsterdam, and Amsterdam Institute for Global Health and Development, The Netherlands

    Janneke van de Wijgert MSc, MPH, PhD

  10. Department of Microbiology & Immunology, The University of Western Ontario, London, Canada

    Gregor Reid PhD, MBA

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  1. Jean M. Macklaim BSc (Hons.)
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  2. Craig R. Cohen MD, MPH
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  3. Gilbert Donders MD, PhD
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  4. Gregory B. Gloor PhD
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  5. Janet E. Hill PhD
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  9. Janneke van de Wijgert MSc, MPH, PhD
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  10. Gregor Reid PhD, MBA
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Correspondence to Gregor Reid PhD, MBA.

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Macklaim, J.M., Cohen, C.R., Donders, G. et al. Exploring a Road Map to Counter Misconceptions About the Cervicovaginal Microbiome and Disease. Reprod. Sci. 19, 1154–1162 (2012). https://doi.org/10.1177/1933719112446075

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