Insights into the assembly of the neovaginal microbiota in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients

Neovaginas are surgically constructed to correct uterovaginal agenesis in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome or as part of gender-affirming surgery for transfeminine individuals. Understanding the assembly of the neovaginal microbiota is crucial for guiding its management. To address this, we conducted a longitudinal study on MRKH patients following laparoscopic peritoneal vaginoplasty. Our findings reveal that the early microbial assemblage exhibited stochastic characteristics, accompanied with a notable bloom of Enterococcus faecalis and genital Mycoplasmas. While both the pre-surgery dimple microbiota and the fecal microbiota constituted the primary species pool, the neovaginal microbiota developed into a microbiota that resembled that of a normal vagina at 6-12 months post-surgery, albeit with a bacterial vaginosis (BV)-like structure. By 2-4 years post-surgery, the neovaginal microbiota had further evolved into a structure closely resembling with the homeostatic pre-surgery dimple microbiota. This concords with the development of the squamous epithelium in the neovagina and highlights the pivotal roles of progressive selective forces imposed by the evolving neovaginal environment and the colonization tropism of vaginal species. Notably, we observed that strains of Lactobacillus crispatus colonizing the neovagina primarily originated from the dimple. Since L. crispatus is generally associated with vaginal health, this finding suggests potential avenues for future research to promote its colonization.

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Publication Details

Journal
Nature Communications
Published
2024-09-06
DOI
https://doi.org/10.1038/s41467-024-52102-1
Citations
3
Primary Topic
Reproductive tract infections research
Type
article
Field-Weighted Citation Impact
1.03

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article

Insights into the assembly of the neovaginal microbiota in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients

Zhiyuan Dou, Huanming Yang, Liang Xiao, Karsten Kristiansen et al.
3 citations
Nature Communications
Reproductive tract infections research
1.03
article

Insights into the assembly of the neovaginal microbiota in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients

Zhiyuan Dou, Huanming Yang, Liang Xiao, Karsten Kristiansen, Hongxin Pan, Huijue Jia, Hongqin Gao, Lan Zhu, Zhuye Jie, Yunhong Zhang, Shaoqiao Zhang, Xin Jin, Lilan Hao, Jian Wang, Chen Chen, Zhe Zhang, Xun Xu, Tao Zhang, Na Chen, Jiali Duan, Xincheng Huang, Jinqiu Shi, Tianshu Sun, Qianqian Gao, Jianbin Guo, Xiaoyue Zhao, Ruike Lu, Chenglu Qin, Maolian Liang, Hua Yang
article en
3 citations

Abstract

Neovaginas are surgically constructed to correct uterovaginal agenesis in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome or as part of gender-affirming surgery for transfeminine individuals. Understanding the assembly of the neovaginal microbiota is crucial for guiding its management. To address this, we conducted a longitudinal study on MRKH patients following laparoscopic peritoneal vaginoplasty. Our findings reveal that the early microbial assemblage exhibited stochastic characteristics, accompanied with a notable bloom of Enterococcus faecalis and genital Mycoplasmas. While both the pre-surgery dimple microbiota and the fecal microbiota constituted the primary species pool, the neovaginal microbiota developed into a microbiota that resembled that of a normal vagina at 6-12 months post-surgery, albeit with a bacterial vaginosis (BV)-like structure. By 2-4 years post-surgery, the neovaginal microbiota had further evolved into a structure closely resembling with the homeostatic pre-surgery dimple microbiota. This concords with the development of the squamous epithelium in the neovagina and highlights the pivotal roles of progressive selective forces imposed by the evolving neovaginal environment and the colonization tropism of vaginal species. Notably, we observed that strains of Lactobacillus crispatus colonizing the neovagina primarily originated from the dimple. Since L. crispatus is generally associated with vaginal health, this finding suggests potential avenues for future research to promote its colonization.

Nature CommunicationsVol. 15(1)
BGI Group (China) (CN), University of Copenhagen (DK), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Fudan University (CN), Peking Union Medical College Hospital (CN), Southern University of Science and Technology (CN), Guangzhou University (CN), Industrial Development Bureau (TW), Human Computer Interaction (Switzerland) (CH), Qingdao Academy of Agricultural Sciences (CN), Shenzhen Luohu People's Hospital (CN), China National GeneBank (CN), National Research Center for Maternal and Child Health (KZ), Qingdao Center of Resource Chemistry and New Materials (CN), BGI Research (CN)
National Natural Science Foundation of China, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, National Key Research and Development Program of China
Zero hunger
Openalex Percentile: Top 24%
Reproductive tract infections research
1.03
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