以乳酸菌为主的平衡的阴道微生物组可以帮助促进女性的生殖健康,其中crispatus表现出最有益的效果。然而,阴道微生物在妊娠期高血压疾病(HDP)发展中的潜在作用尚未完全探讨。在这项基于辅助生殖技术随访队列的巢式病例对照研究中,我们通过收集75例HDP病例(HDP组)和150例对照(NP组)的阴道拭子,并使用16S扩增子测序进行细菌鉴定,前瞻性评估了孕前阴道微生物组与HDP之间的相关性.HDP组的阴道微生物组成与NP组明显不同。crispatus的丰度明显较低,阴道加德纳菌的丰度明显更高,在HDP组中比在NP组中。值得注意的是,以crispatus为主的阴道社区状态类型与HDP风险降低相关(比值比=0.436;95%置信区间,0.229至0.831)与其他相比。此外,网络分析揭示了在NP和HDP组中具有61和57个专有边缘的不同细菌相互作用,分别。与HDP组相比,NP组表现出较高的加权度和接近度中心性。几个分类单元,包括G.vaginalis,L.iners,和细菌性阴道病相关细菌(普雷沃氏菌,Megasphaera,Finegoldia,和卟啉虫),被标识为网络重新布线的“驱动程序”。与氨基酸有关的预测途径的显着改变,辅因子,和维生素代谢;膜转运;在HDP组中观察到细菌毒素。重要性HDP的病因至今仍不清楚。缺乏有效的个体化预测和预防方法。妊娠阴道菌群失调先于HDP的诊断,为HDP的病因提供了新的视角。妊娠早期是胎盘发育的关键时期,异常胎盘启动HDP发育。因此,怀孕前应考虑疾病预防。怀孕前阴道微生物组表征和益生菌干预是首选,因为它们具有早期预防的安全性和潜力。这项研究是第一个前瞻性评估孕前阴道微生物组和HDP之间的关联。以crispatus为主的阴道群落状态类型与HDP风险降低有关。这些发现表明,阴道微生物组表征可能有助于识别HDP高危个体,并为开发新的孕前干预方法提供潜在目标。
A balanced vaginal microbiome dominated by Lactobacillus can help promote women\'s reproductive health, with Lactobacillus crispatus showing the most beneficial effect. However, the potential role of vaginal microbiomes in hypertensive disorders of pregnancy (HDP) development is not thoroughly explored. In this nested
case-control study based on an assisted reproductive technology follow-up cohort, we prospectively assessed the association between pregestational vaginal microbiomes with HDP by collecting vaginal swabs from 75 HDP cases (HDP group) and 150 controls (NP group) and using 16S amplicon sequencing for bacterial identification. The vaginal microbial composition of the HDP group significantly differed from that of the NP group. The abundance of L. crispatus was significantly lower, and the abundances of Gardnerella vaginalis was significantly higher, in the HDP group than in the NP group. Of note, L. crispatus-dominated vaginal community state type was associated with a decreased risk for HDP (odds ratio = 0.436; 95% confidence interval, 0.229 to 0.831) compared with others. Additionally, network analysis revealed different bacterial interactions with 61 and 57 exclusive edges in the NP and HDP groups, respectively. Compared with the HDP group, the NP group showed a higher weighted degree and closeness centrality. Several taxa, including G. vaginalis, L. iners, and bacterial vaginosis-associated bacteria (Prevotella, Megasphaera, Finegoldia, and Porphyromonas), were identified as \"drivers\" for network rewiring. Notable alterations of predicted pathways involved in amino acid, cofactor, and vitamin metabolism; membrane transport; and bacterial toxins were observed in the HDP group. IMPORTANCE The etiology of HDP remains unclear to date. Effective methods for the individualized prediction and prevention are lacking. Pregestational vaginal dysbiosis precedes the diagnosis of HDP, providing a novel perspective on the etiology of HDP. Early pregnancy is the critical period of placental development, and abnormal placentation initiates HDP development. Thus, disease prevention should be considered before pregnancy. Vaginal microbiome characterization and probiotic interventions before pregnancy are preferred because of their safety and potential for early prevention. This study is the first to prospectively assess associations between pregestational vaginal microbiome and HDP. L. crispatus-dominated vaginal community state type is linked to a reduced risk for HDP. These findings suggest that vaginal microbiome characterization may help identify individuals at high risk for HDP and offer potential targets for the development of novel pregestational intervention methods.