Root vaginal microbes

“I’m going to People as people like a vagina *,
a real man is walking”, The

complaint book of the
Moscow cafe
“People as People” ,
mid-2000s

* Vagina (Latin vagina - scabbard, case)

The feeling that the sacred attitude towards the birth of life in our world disappears, just like indigenous microbes (see Indigenous microbes / Habr - Habr ). The ancient attitude towards the vagina as a sacred, life-giving organ is preserved only among indigenous peoples. My recent literary search and experience with indigenous peoples (see d / f “Bacteria. War of the Worlds” ) has led to an interesting understanding of vaginal health, its implications for the evolution of humanity. The birth process and the transfer of microbes from mother to baby at that moment can play a central role, and the possibilities of manipulating the vaginal microbiome can be used for the good of the planet.
My hypothesis is given below.

The problem of bacterial vaginosis

Bacterial vaginosis (BV) is a widespread vaginal disease that, according to some estimates, affects up to 30% of women of reproductive age in developed countries and up to 50% in hot countries with poor economies. According to observations of specialists, up to half of cases are asymptomatic. BV does not have a clear definition and is described as a violation of the normoflora of the vagina. Symptoms are discharge, odor, and itching.

Bacterial vaginosis is a harbinger of STDs, infertility, miscarriages, and premature births. BV removes the natural barrier to the spread of HIV. Naturally, the symptoms of the disease affect self-esteem, harmony in relationships and overall quality of life.

Recommended treatments for today: use of oral and intravaginal antibiotics. According to some estimates, relapse within 12 months reaches 60-80%. Once again: “Existing treatment is only an improvement of no more than 12 months.”

The diagnostic criterion is the Nugent scale, corresponding to the presence of lactobacilli, gardnerella and representatives of the genus Mobiluncus in the crop . Points 0-3 correspond to a healthy state, 4-6 - to an intermediate one, and more than 7 coincides with the clinical manifestations of BV.

Vaginal microbiome

Studies of the vaginal microbiome of healthy women and women with BV revealed typical microbiome configurations characteristic of the disease. Surprisingly enough, the number of configurations of the vaginal microbiome is not high (Fig. 1). Apparently, this is due to special functional requirements for representatives of the microbiome and a strong connection with the host organism. There are 4 “healthy” variants of the composition, in which lactobacilli predominate; one in which lactobacilli are not the predominant species and a separate compositional variant with a variety of pathogenic flora corresponding to BV.



Figure 1. Correspondence of lactobacillus clusters, Nugent scale and pH. ( link to source) “The relationship between vaginal bacterial communities is visualized using the principal component method. Communities dominated by Lactobacillus species and representing groups of communities I, II, III, and V are shown at each of the four outer vertices of the tetrahedron, and communities of group IV are shown at the inner vertex and are shown in the inset. (A) Each dot corresponds to one microbiome and is colored according to the proportions of phylotypes in each community. (B) The pH of each vaginal community shown in A. (C) The Nugent score of each vaginal community shown in A. ”

For European and Asian women, healthy combinations belong to lactobacilli in 90% of cases; in black and Latin American women, lactobacilli configurations occupy no more than 60% of healthy combinations. The first vaginal lactobacilli were described in the 19th century by Doderlein.

“The German obstetrician-gynecologist A. Doderlein (1860-1941), having studied the vaginal flora, discovered in 1887 a vaginal bacillus (Doderlein's bacillus), which helps to protect the woman's genital canal from pathogenic microbes. He developed new obstetric and gynecological operations: lateral dissection of the pelvic ring with a narrow pelvis, extraperitoneal cesarean section, etc. "

(From the textbook “History of Medicine”, M, 1981 / Ed. P.E. Zabludovsky, G.R. Kryuchok, M.K. Kuzmin, M.M. Levit)

The correspondence between the health of the vagina and the predominance of lactobacilli has been known for more than a hundred years, today 4 main drivers of phylotypes are shown: L. crispatus, L. inners, L. jenseni, L. gasserii . Some of them are observed in inversely proportional relationships among themselves, signaling competition for an ecological niche. For vaginal health, it is necessary to maintain the presence of several major types of lactobacilli simultaneously.

A healthy vagina is characterized by pH levels of 3.5–4.5 in most healthy European women. High acidity is maintained due to the synthesis of lactic acid by representatives of lactobacilli (Fig. 2). The vagina does not have its own secretion system. The secret, which contains enzymes (amylases similar to salivary) and desquamated cells, comes from the cervical canal, and this fluid also contains glycogen that nourishes the target bacteria. The amount of fluid in 24 hours is normal from 1 to 4 ml.
It has been shown that high acidity and lactic acid itself are the main antimicrobial factor that protects against pathogens. In addition, lactobacilli synthesize highly specific antimicrobial peptides.

In BV, the pH level usually exceeds 5. In fact, a closed cycle of the disease is observed, the predominance of pathogenic flora reduces the number of lactobacilli and reduces the amount of lactic acid produced by them. A rupture of such a cycle can be achieved by antibiotics, an increase in acidity, and the outgrowth of a large number of lactobacilli (as part of probiotics).

Interestingly, one of the oldest methods of correction is the Ayurvedic approach using fermented cow's milk.


Figure 2. Normal flora and bacterial vaginosis. ( link )

In the menstrual cycle, due to blood flow, the pH increases to 7, and the iron in the blood is a provoking factor for the growth of pathogens. The mechanism of returning to normal is supported by the highly specific composition of mucose polysaccharides, however, systemic inflammation and a diet that does not provide nutrition for the growth of mucose can disrupt the process. Interestingly, intestinal probiotics often help return to homeostasis.

Blood stasis (due to the use of hygiene products), regular sexual activity (introduction of external bacteria), and the use of deodorants and lubricants are risk factors for BV.

Probiotics

One of the solutions to restore a healthy balance is intravaginal probiotics, the global probiotic market is estimated at $ 60 billion, vaginal probiotics occupy at least 5%. The most successful clinical trials show the effectiveness of probiotics in reducing the percentage of relapses after antibiotic therapy. In addition, individual studies have shown efficacy in the treatment of BV, without other means, but no assessment of relapse or long-term recovery of microbiota is given.
The most promising are cocktails from strains (most often several strains of lactobacilli are used, but not of vaginal origin), most likely individual strains have a limited potential for survival (from 30 to 60 percent), so cocktails can increase the chance, if at least one of bacteria fit. Moreover, for different strains of lactobacilli, various optimums of the enzymatic system in the production of lactic acid are characteristic. The task of a probiotic cocktail is to quickly increase the acidity in the vagina, increase the number of lactobacilli and their production of antibacterial peptides.

Interesting probiotics

Peachlife содержит очень много штаммов, хотя выбранные штаммы кажутся не indibiome:
Bifidobacterium Longum, Bifidobacterium Lactis, Lactobacillus Salivarius, Lactobacillus Casei, Lactobacillus Acidophilus, Lactobacillus Brevis, Lactobacillus Fermentum, Lactobacillus Paracasei, Lactobacillus Plantarum, Lactobacillus Reuteri, Lactobacillus Rhamnosus.
Canesflor содержит проприетарный штамм лактобациллы с хорошими данными по уменьшению рецидивов и по способности адгезироваться к поверхности.
Purfem содрежит два штамма, один из которых Lactobacillus gasseri я отношу к индигенным (indibiome).
LACTIN-Va very progressive strain, some good research on it and again indibiome, as it is based on Lactobacillus crispatus CTV-05 . There is a compelling clinical trial pipeline and antibiotic trials for recurrence of BV.

Microbiome of the newborn

Evolutionarily, when passing through the birth canal, the baby is colonized by the microbes of the mother. They will determine the composition of the microbes of his intestines, it is known that cesarean, in which microbes of the skin of the mother are populated, is associated with a greater number of allergies and a high risk of colitis. Vaginal seeding technology is also used , when the maternal vagina microbiome is transferred to the baby with a cotton swab on the tongue, the current risk of infection outweighs the possible benefits.

Proportions between tissues, proper immunity, protection against the first diseases - all this a child can get with root microbes from his mother. She received these microbes from her mother. In the face of a certain evolutionary process, which today is interrupted by environmental factors. Interestingly, at the species level, a less healthy generation appears, both physically and mentally.

Separately, I note that the article does not oppose modern medicine and especially the Cesarean section, rather, on the contrary, it asks to pay attention to a previously unexplored side of the process - the transmission of microbes. It is obvious that it is safe to transfer microbes from mother to child after this operation. Moreover, it is possible and necessary to prepare a woman and a microbiome for birth.

New generation

My question arises: "Is vaginal incidence a mechanism for controlling the development of civilization, a limiting factor?"

The question is rather rhetorical, and it is obvious to me that our conscious choice of food products, hygiene products, attitude to the environment can affect the next generation, especially in our own family. Finally, using the technology of probiotics, it is possible to create a healthier generation by adding percentages of the effectiveness of the entire civilization, or at least the country.