Microbiota y disbiosis vaginal

Palabras clave: Microbiota, lactobacillus, disbiosis, vaginosis bacteriana

Resumen

El cuerpo humano está colonizado por una gran cantidad de microbios, los cuales de manera colectiva se les llama microbiota humana. La relación entre ellos y la salud humana ha sido de gran estudio en los últimos años.

A nivel vaginal, la presencia de estos microorganismos se ha correlacionado con el mantenimiento de un ecosistema vaginal dinámico y propio de prevenir la colonización e infección por organismos patógenos oportunistas. El pH vaginal estable de las mujeres en etapa reproductiva se mantiene gracias a los estrógenos, el glucógeno y los lactobacilos, debido a su producto de ácido láctico.

Dichos lactobacilos favorecen la respuesta inmunitaria y combaten la colonización del epitelio periureteral por uropatógenos.

Este ecosistema vaginal se puede alterar por diversos mecanismos intrínsecos del húesped o por factores externos como la ingesta de antibióticos, prácticas intravaginales, alimentación o tabaco.

La importancia de mantener un ecosistema vaginal estable radica en evitar las infecciones vaginales y sus eventuales complicaciones.

Biografía del autor/a

Sofía de los Ángeles Mora Agüero, Dra, Investigadora independiente, Heredia, Costa Rica

Médico general, graduada de la Universidad Ciencias Médicas (UCIMED), médico investigadora independiente, Heredia, Costa Rica.

Código médico: 14657.  Sofimo2291@gmail.com

Citas

1. Wang B, Yao M, Lv L, Ling Z, Li L. The Human Microbiota in Health and Disease. Engineering. 2017 02;3(1):71-82. https://doi.org/10.1016/j.eng.2017.01.008

2. Stoyancheva G, Marzotto M, Dellaglio F, Torriani S. Bacteriocin production and gene sequencing analysis from vaginal Lactobacillus strains. Archives of Microbiology. 2014 06 12;196(9):645-653. https://doi.org/10.1007/s00203-014-1003-1

3. Amabebe E, Anumba DOC. The Vaginal Microenvironment: The Physiologic Role of Lactobacilli. Frontiers in Medicine. 2018 06 13;5. https://doi.org/10.3389/fmed.2018.00181

4. Gartner L, Hiatt J. Texto Atlas de Histología. 3 ed.. McGraw-Hill; 2008.

5. Mossop H, Linhares IM, Bongiovanni AM, Ledger WJ, Witkin SS. Influence of Lactic Acid on Endogenous and Viral RNA-Induced Immune Mediator Production by Vaginal Epithelial Cells. Obstetrics & Gynecology. 2011 Oct;118(4):840-846. https://doi.org/10.1097/aog.0b013e31822da9e9

6. Martín R, Soberón N, Vázquez F, Suárez JE. La microbiota vaginal: composición, papel protector, patología asociada y perspectivas terapéuticas. Enfermedades Infecciosas y Microbiología Clínica. 2008 03;26(3):160-167. https://doi.org/10.1157/13116753

7. Lewis FMT, Bernstein KT, Aral SO. Vaginal Microbiome and Its Relationship to Behavior, Sexual Health, and Sexually Transmitted Diseases. Obstetrics & Gynecology. 2017 04;129(4):643-654. https://doi.org/10.1097/aog.0000000000001932

8. Witkin SS, Mendes-Soares H, Linhares IM, Jayaram A, Ledger WJ, Forney LJ. Influence of Vaginal Bacteria and D- and L-Lactic Acid Isomers on Vaginal Extracellular Matrix Metalloproteinase Inducer: Implications for Protection against Upper Genital Tract Infections. mBio. 2013 08 06;4(4). https://doi.org/10.1128/mbio.00460-13

9. Smith SB, Ravel J. The vaginal microbiota, host defence and reproductive physiology. The Journal of Physiology. 2016 05 05;595(2):451-463. https://doi.org/10.1113/jp271694

10. Nagy E, FROMan G, MARDH P. Fibronectin binding of Lactobacillus species isolated from women with and without bacterial vaginosis. Journal of Medical Microbiology. 1992 07 01;37(1):38-42. https://doi.org/10.1099/00222615-37-1-38

11. Boris S, Suárez JE, Vázquez F, Barbés C. Adherence of Human Vaginal Lactobacilli to Vaginal Epithelial Cells and Interaction with Uropathogens. Infection and Immunity. 1998;66(5):1985-1989.

12. Mas M. Fisiología de la respuesta sexual femenina: actualización. Revista Internacional de Andrología. 2007 01;5(1):11-21. https://doi.org/10.1016/s1698-031x(07)74029-3

13. Boskey E, Cone R, Whaley K, Moench T. Origins of vaginal acidity: high d/l lactate ratio is consistent with bacteria being the primary source. Human Reproduction. 2001 09;16(9):1809-1813. https://doi.org/10.1093/humrep/16.9.1809

14. Tachedjian G, O’Hanlon DE, Ravel J. The implausible “in vivo” role of hydrogen peroxide as an antimicrobial factor produced by vaginal microbiota. Microbiome. 2018 02 06;6(1). https://doi.org/10.1186/s40168-018-0418-3

15. Strus M, Brzychczy-WÅ M, Gosiewski T, Kochan P, Heczko PB. The in vitro effect of hydrogen peroxide on vaginal microbial communities. FEMS Immunology & Medical Microbiology. 2006 Oct;48(1):56-63. https://doi.org/10.1111/j.1574-695x.2006.00120.x

16. Borgogna JC, Yeoman CJ. The Application of Molecular Methods Towards an Understanding of the Role of the Vagina Microbiome in Health Disease. Methods in Microbiology. 2017 Jan;44:37-65. https://doi.org/10.1016/bs.mim.2017.08.003

17. Bradley F, Birse K, Hasselrot K, Noël-Romas L, Introini A, Wefer H, Seifert M, Engstrand L, Tjernlund A, Broliden K, Burgener AD. The vaginal microbiome amplifies sex hormone-associated cyclic changes in cervicovaginal inflammation and epithelial barrier disruption. American Journal of Reproductive Immunology. 2018 04 30;80(1):e12863. https://doi.org/10.1111/aji.12863

18. Muhleisen AL, Herbst-Kralovetz MM. Menopause and the vaginal microbiome. Maturitas. 2016 09;91:42-50. https://doi.org/10.1016/j.maturitas.2016.05.015

19. Brotman R, Gajer P, Holm J, Robinson C, Ma B, Humphrys M, Tuddenham S, Ravel J, Ghanem K. Hormonal contraception is associated with stability and lactobacillus-dominance of the vaginal microbiota in a two-year observational study. American Journal of Obstetrics and Gynecology. 2016 Dec;215(6):S828-S829. https://doi.org/10.1016/j.ajog.2016.09.031

20. Fashemi B, Delaney ML, Onderdonk AB, Fichorova RN. Effects of feminine hygiene products on the vaginal mucosal biome. Microbial Ecology in Health & Disease. 2013 02 25;24(0). https://doi.org/10.3402/mehd.v24i0.19703

21. Amabebe E, Anumba DOC. Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health. Frontiers in Endocrinology. 2018 09 24;9. https://doi.org/10.3389/fendo.2018.00568

22. Hickey R, Abdo Z, Zhou X, Nemeth K, Hansmann M, Osborn T, Wang F, Forney L. Effects of tampons and menses on the composition and diversity of vaginal microbial communities over time. BJOG: An International Journal of Obstetrics & Gynaecology. 2013 02 11;120(6):695-706. https://doi.org/10.1111/1471-0528.12151

23. Miller EA, Beasley DE, Dunn RR, Archie EA. Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?. Frontiers in Microbiology. 2016 Dec 08;7. https://doi.org/10.3389/fmicb.2016.01936

24. Brotman RM, He X, Gajer P, Fadrosh D, Sharma E, Mongodin EF, Ravel J, Glover ED, Rath JM. Association between cigarette smoking and the vaginal microbiota: a pilot study. BMC Infectious Diseases. 2014 08 28;14(1). https://doi.org/10.1186/1471-2334-14-471

25. Romero R, Dey SK, Fisher SJ. Preterm labor: One syndrome, many causes. Science. 2014 08 14;345(6198):760-765. https://doi.org/10.1126/science.1251816

26. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. American Journal of Obstetrics and Gynecology. 2013 Dec;209(6):505-523. https://doi.org/10.1016/j.ajog.2013.05.006

27. Neggers YH, Nansel TR, Andrews WW, Schwebke JR, Yu K, Goldenberg RL, Klebanoff MA. Dietary Intake of Selected Nutrients Affects Bacterial Vaginosis in Women. The Journal of Nutrition. 2007 09 01;137(9):2128-2133. https://doi.org/10.1093/jn/137.9.2128

28. Simon C. Introduction: Do microbes in the female reproductive function matter?. Fertility and Sterility. 2018 08;110(3):325-326. https://doi.org/10.1016/j.fertnstert.2018.06.041

29. Amabebe E, Anumba DOC. Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health. Frontiers in Endocrinology. 2018 09 24;9. https://doi.org/10.3389/fendo.2018.00568

30. Hickey R, Abdo Z, Zhou X, Nemeth K, Hansmann M, Osborn T, Wang F, Forney L. Effects of tampons and menses on the composition and diversity of vaginal microbial communities over time. BJOG: An International Journal of Obstetrics & Gynaecology. 2013 02 11;120(6):695-706. https://doi.org/10.1111/1471-0528.12151

31. Brotman RM, He X, Gajer P, Fadrosh D, Sharma E, Mongodin EF, Ravel J, Glover ED, Rath JM. Association between cigarette smoking and the vaginal microbiota: a pilot study. BMC Infectious Diseases. 2014 08 28;14(1). https://doi.org/10.1186/1471-2334-14-471

32. Neggers YH, Nansel TR, Andrews WW, Schwebke JR, Yu K, Goldenberg RL, Klebanoff MA. Dietary Intake of Selected Nutrients Affects Bacterial Vaginosis in Women. The Journal of Nutrition. 2007 09 01;137(9):2128-2133. https://doi.org/10.1093/jn/137.9.2128

33. Miller EA, Beasley DE, Dunn RR, Archie EA. Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?. Frontiers in Microbiology. 2016 Dec 08;7. https://doi.org/10.3389/fmicb.2016.01936

34. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. American Journal of Obstetrics and Gynecology. 2013 Dec;209(6):505-523. https://doi.org/10.1016/j.ajog.2013.05.006

35. Romero R, Dey SK, Fisher SJ. Preterm labor: One syndrome, many causes. Science. 2014 08 14;345(6198):760-765. https://doi.org/10.1126/science.1251816
Publicado
2019-01-01
Cómo citar
Mora Agüero, S. (2019). Microbiota y disbiosis vaginal. Revista Medica Sinergia, 4(1), 3 - 13. https://doi.org/https://doi.org/10.31434/rms.v4i1.165
Sección
Artículos de Revisión