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细菌性阴道病与免疫反应的新发现
诸平
据奥地利维也纳医科大学（Medical University of Vienna简称MedUni Vienna）2025年2月14日提供的消息,细菌性阴道病与免疫反应的新发现（New findings on bacterial vaginosis and immune reactions）。
维也纳医科大学最近的一项国际合作研究,为细菌性阴道病提供了新的见解，细菌性阴道病是由细菌引起的女性生殖道最常见的感染。这种疾病与性传播感染( sexually transmitted infections)、艾滋病毒(HIV )和早产(premature births)的风险增加有关。这项研究结果于2025年1月28日已经在在《科学报告》(Scientific Reports)杂志网站发表，此研究结果可能会开辟新的治疗方法。原文详见：Philipp Foessleitner, Briah Cooley Demidkina, Wafae El-Arar, Miles Goldenberg, Meena Murthy, Agnes Bergerat, Ofri Bar, Douglas S. Kwon, Caroline M. Mitchell. Association between changes in genital immune markers and vaginal microbiome transitions in bacterial vaginosis. Scientific Reports, 2025, 15: 3536. DOI: 10.1038/s41598-025-88208-9. Published: 28 January 2025. https://www.nature.com/articles/s41598-025-88208-9
参与此项研究的有来自美国波士顿麻省总医院（Vincent Center for Reproductive Biology, Massachusetts General Hospital, 55 Fruit St, Their 9, Boston, MA, USA）、美国波士顿哈佛医学院（Harvard Medical School, Boston, MA, USA）、奥地利维也纳医科大学（Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria）、以色列耶路撒冷希伯来大学医学院（Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem , Israel）、美国麻省理工学院（MIT）哈佛大学合办的拉贡MGH研究所（Ragon Institute of MGH, MIT, and Harvard, Boston, MA, USA）的研究人员。
此项研究由菲利普·福斯莱特纳（Philipp Fößleitner / Philipp Foessleitner)领导，菲利普·福斯莱特纳来自维也纳医科大学妇产系（Department of Obstetrics and Gynecology at MedUni Vienna），是美国哈佛医学院马萨诸塞州总医院（MGH）生殖生物学中心（Vincent Center for Reproductive Biology at Massachusetts General Hospital (MGH), Harvard Medical School）卡罗琳·米切尔（Caroline M. Mitchell）研究小组的博士后研究员，也是上述研究论文的第一作者，从事阴道微生物群的变化如何影响免疫系统的研究。对20名患有细菌性阴道病的妇女在使用抗生素甲硝唑治疗之前、期间和之后的样本进行了分析。结果表明，微生物平衡的变化与特异性免疫反应有关：单核细胞（一种免疫细胞）的减少表明情况有所改善，而这些细胞和树突状细胞的增加与细菌性阴道病的恶化有关。这表明抗原呈递细胞（antigen-presenting cells）如单核细胞（monocytes）在阴道感染的免疫反应中起着至关重要的作用。
研究人员还发现，感染的改善与B细胞数量的增加和某些免疫反应介导信使物质（IP-10， MIG和ITAC）的增加有关。特别是IP-10可以在重建健康的阴道菌群中发挥核心作用。
这项研究的结果与先前的研究一致，即在成功治疗细菌性阴道病的妇女中单核细胞减少。
研究人员假设，免疫反应的变化可能会影响阴道菌群的细菌组成和感染的风险。然而，仍需要进一步的研究来更好地了解这些免疫变化对感染风险和疾病进程的长期影响。这些新发现有助于开发针对细菌性阴道病的更有针对性的治疗方法，并降低受影响女性的潜在健康风险。
这项研究是由比尔和梅林达·盖茨基金会（Bill & Melinda Gates Foundation）资助的。
上述介绍仅供参考，欲了解更多信息敬请注意浏览原文和相关报道。
Bacterial vaginosis (BV), characterized by an imbalance in the vaginal microbiota, is a prevalent condition among women of reproductive age and a risk factor for human immunodeficiency virus, sexually transmitted infections, and preterm birth. BV is generally considered to induce mucosal inflammation, but the specific pathways and cell types involved are not well characterized. This prospective study aimed to assess associations between microbial changes and mucosal immune responses in BV patients. Therefore, samples from 20 premenopausal women with BV and treated with metronidazole were analyzed. Vaginal swabs, menstrual cup, and endocervical cytobrush samples were collected before treatment, weekly for four weeks, and at 2, 4, and 6 months for Nugent scoring, immune cell populations and cytokine analysis. Of 105 study intervals, 27 (25.7%) showed improvement in Nugent category, 61 (58.1%) remained unchanged, and 17 (16.2%) worsened. Improvement correlated with decreased monocytes (p=0.005), while worsening was linked to increased monocytes (p<0.001) and dendritic cells (p=0.02). B cells (p=0.02) and IFN-γ-induced chemokines - IP-10 (p=0.007), MIG (p=0.049), and ITAC (p=0.005) - were associated with improvement. In conclusion, although the T-cell-associated chemokines IP-10, ITAC, and MIG were strongly associated with improvements in Nugent category, our findings indicate that antigen-presenting cells, particularly monocytes, show the most dynamic response to shifts in the vaginal microbiota in patients with BV.
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