The human vagina is a dynamic ecosystem in which homeostasis depends on mutually beneficial interactions between the host and their microorganisms. However, the vaginal ecosystem can be thrown off balance by a wide variety of factors. Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age but its etiology is not yet fully understood, with different controversial theories being raised over the years. What is generally accepted is that BV is often characterized by a shift in the composition of the normal vaginal microbiota, from a Lactobacillus species dominated microbiota to a mixture of anaerobic and facultative anaerobic bacteria. During BV, a polymicrobial biofilm develops in the vaginal microenvironment, being mainly composed of Gardnerella species. The interactions between vaginal microorganisms are thought to play a pivotal role in the shift from health to disease and might also increase the risk of sexually transmitted infections acquisition. Here, we review the current knowledge regarding the specific interactions that occur in the vaginal niche and discuss mechanisms by which these interactions might be mediated. Furthermore, we discuss the importance of novel strategies to fight chronic vaginal infections.

中文翻译：

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加德纳菌和阴道健康：真相就在那里。

人的阴道是一个动态的生态系统，其中的动态平衡取决于宿主与其微生物之间的互利相互作用。但是，阴道生态系统会因多种因素而失去平衡。细菌性阴道病（BV）是育龄妇女中最常见的阴道感染，但其病因尚未完全了解，多年来提出了许多有争议的理论。通常公认的是，BV通常以正常阴道微生物群的组成为特征，从以乳酸杆菌属为主的微生物群转变为厌氧和兼性厌氧菌的混合物。在BV期间，阴道微环境中会形成多菌种生物膜，主要由加德纳菌属组成。阴道微生物之间的相互作用被认为在从健康到疾病的转变中起着关键作用，并且还可能增加性传播感染获得的风险。在这里，我们回顾了有关在阴道生态位中发生的特定相互作用的当前知识，并讨论了可能通过这些相互作用介导的机制。此外，我们讨论了对抗慢性阴道感染的新策略的重要性。