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The neovaginal microbiome of transgender women post-gender reassignment surgery.
Microbiome ( IF 15.5 ) Pub Date : 2020-05-05 , DOI: 10.1186/s40168-020-00804-1
Kenzie D Birse 1, 2 , Kateryna Kratzer 1, 2 , Christina Farr Zuend 1, 2 , Sarah Mutch 1, 2 , Laura Noël-Romas 1, 2 , Alana Lamont 1, 2 , Max Abou 1 , Emilia Jalil 3 , Valdiléa Veloso 3 , Beatriz Grinsztejn 3 , Ruth Khalili Friedman 3 , Kristina Broliden 4 , Frideborg Bradley 4 , Vanessa Poliquin 5 , Fan Li 6 , Carolyn Yanavich 6 , Adam Burgener 1, 2, 4, 5 , Grace Aldrovandi 6
Affiliation  

BACKGROUND Gender reassignment surgery is a procedure some transgender women (TW) undergo for gender-affirming purposes. This often includes the construction of a neovagina using existing penile and scrotal tissue and/or a sigmoid colon graft. There are limited data regarding the composition and function of the neovaginal microbiome representing a major gap in knowledge in neovaginal health. RESULTS Metaproteomics was performed on secretions collected from the neovaginas (n = 5) and rectums (n = 7) of TW surgically reassigned via penile inversion/scrotal graft with (n = 1) or without (n = 4) a sigmoid colon graft extension and compared with secretions from cis vaginas (n = 32). We identified 541 unique bacterial proteins from 38 taxa. The most abundant taxa in the neovaginas were Porphyromonas (30.2%), Peptostreptococcus (9.2%), Prevotella (9.0%), Mobiluncus (8.0%), and Jonquetella (7.2%), while cis vaginas were primarily Lactobacillus and Gardnerella. Rectal samples were mainly composed of Prevotella and Roseburia. Neovaginas (median Shannon's H index = 1.33) had higher alpha diversity compared to cis vaginas (Shannon's H = 0.35) (p = 7.2E-3, Mann-Whitney U test) and were more similar to the non-Lactobacillus dominant/polymicrobial cis vaginas based on beta diversity (perMANOVA, p = 0.001, r2 = 0.342). In comparison to cis vaginas, toll-like receptor response, amino acid, and short-chain fatty acid metabolic pathways were increased (p < 0.01), while keratinization and cornification proteins were decreased (p < 0.001) in the neovaginal proteome. CONCLUSIONS Penile skin-lined neovaginas have diverse, polymicrobial communities that show similarities in composition to uncircumcised penises and host responses to cis vaginas with bacterial vaginosis (BV) including increased immune activation pathways and decreased epithelial barrier function. Developing a better understanding of microbiome-associated inflammation in the neovaginal environment will be important for improving our knowledge of neovaginal health. Video Abstract.

中文翻译:

变性后女性的变性手术后的新阴道微生物组。

背景技术性别再分配手术是一些跨性别女性(TW)为了确认性别而接受的程序。这通常包括使用现有的阴茎和阴囊组织和/或乙状结肠移植物构建新阴道。关于新阴道微生物组的组成和功能的数据有限,代表着新阴道健康知识方面的主要空白。结果对通过阴茎倒置/阴囊植入术(n = 1)或不存在(n = 4)乙状结肠移植物手术切除的TW的新阴道(n = 5)和直肠(n = 7)收集的分泌物进行了蛋白质组学研究并与顺式阴道分泌物进行比较(n = 32)。我们从38个分类中鉴定了541个独特的细菌蛋白。在新阴道中,最丰富的分类群是卟啉单胞菌(30.2%),肽链球菌(9.2%),普氏杆菌(9.0%),Mobiluncus(8.0%)和Jonquetella(7.2%),而顺式阴道主要是乳杆菌和Gardnerella。直肠样本主要由普氏杆菌和玫瑰菌组成。与顺式阴道(Shannon的H = 0.35)(p = 7.2E-3,Mann-Whitney U检验)相比,Neovaginas(Shannon的H指数中位数为1.33)具有更高的alpha多样性,并且与非乳酸杆菌显性/多聚细菌顺式更相似基于β多样性的阴道(perMANOVA,p = 0.001,r2 = 0.342)。与顺式阴道相比,新阴道蛋白质组中的收费样受体反应,氨基酸和短链脂肪酸代谢途径增加(p <0.01),而角质化和角化蛋白减少(p <0.001)。结论阴茎皮肤衬里的新阴道具有多种多样的特征,多菌种群落,其组成与未割包皮的阴茎相似,并且对细菌性阴道病(BV)的顺式阴道具有宿主反应,包括增加的免疫激活途径和降低的上皮屏障功能。更好地了解新阴道环境中与微生物组相关的炎症,对于提高我们对新阴道健康的认识至关重要。录像摘要。
更新日期:2020-05-05
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