Around the world, more than 175,000,000 women are diagnosed every year with gynaecological disease, in many cases contributing to high morbidity and mortality. For this reason, knowledge of the composition of the vaginal microbiome and its variations represents a real health challenge, as this is key to improving therapeutic management. This review traces the history of the poorly known vaginal microbiome and focuses on the latest findings concerning this ecosystem. Studies in the past decade have targeted complex bacterial communities within the vagina. However, due to the development of technology and the emergence of next generation sequencing (NGS), the exact definition of the vaginal microbiome has changed and can no longer be linked solely to the presence of bacteria. In order to reach a global view of the vaginal microbiome, it is essential to take into account all microorganisms that the vagina harbours, including fungi, viruses, archaea, and candidate phyla radiation. Although these communities represent only a minimal percentage of the vaginal microbiome, they may act as modifiers of its basic physiology and may play a key role in the maintenance of microbial communities, as well as metabolic and immune functions. Studies of the complex interactions between these different microorganisms have recently begun and are not yet fully understood. Results to date indicate that these microbial communities together constitute the first line of defence against infections. On the other hand, the slightest disturbance in this microbiome may lead to disease. For this reason, enhanced knowledge of these associations is critical to better identify predispositions to certain illnesses, which may open new therapeutic avenues. Currently however, only the tip of the iceberg is understood and current research on this ecosystem is revolutionising our knowledge and understanding of human health and disease.

在世界范围内，每年有超过 175,000,000 名妇女被诊断出患有妇科疾病，在许多情况下导致高发病率和死亡率。因此，了解阴道微生物组的组成及其变异是一个真正的健康挑战，因为这是改善治疗管理的关键。这篇综述追溯了鲜为人知的阴道微生物组的历史，并重点关注有关该生态系统的最新发现。过去十年的研究针对阴道内复杂的细菌群落。然而，由于技术的发展和下一代测序（NGS）的出现，阴道微生物组的确切定义已经发生变化，不再仅仅与细菌的存在联系在一起。为了达到阴道微生物组的全局视图，必须考虑阴道内含有的所有微生物，包括真菌、病毒、古细菌和候选门辐射。尽管这些群落仅占阴道微生物群的很小一部分，但它们可能会作为其基本生理学的调节剂，并可能在维持微生物群落以及代谢和免疫功能方面发挥关键作用。最近开始研究这些不同微生物之间复杂的相互作用，但尚未完全了解。迄今为止的结果表明，这些微生物群落共同构成了抵御感染的第一道防线。另一方面，这种微生物组中最轻微的干扰都可能导致疾病。为此原因，增强对这些关联的了解对于更好地识别某些疾病的易感性至关重要，这可能会开辟新的治疗途径。然而，目前我们只了解冰山一角，目前对该生态系统的研究正在彻底改变我们对人类健康和疾病的认识和理解。