Elevated expression of inflammation and wound healing pathways in recurrent BV 3988

Abstract Description Metronidazole (MET) treatment for Bacterial vaginosis (BV) is effective for initial symptom resolution, but 40% of women experience recurrent BV within 6 months and the underlying immune factors that contribute to BV recurrence remain unknown. We studied BV recurrence in a cohort of women diagnosed with BV by Amsel’s criteria. Participants were treated with a 7-day course of MET (500mg, BID oral). Cervical cytobrush samples and biobehavioral data were collected at enrollment, and at 1 and 6-month post-enrollment visits. We generated human and bacterial transcriptome data using cytobrush RNA samples to determine expression differences between BV types. We found significant differences in bacterial beta diversity between women with recurrent and non-recurrent BV after treatment as measured by PCA and PERMANOVA. We also identified differentially expressed human genes between recurrent and non-recurrent BV. Of note, we identified genes associated with immune activation (IL6, C1QB) and wound healing (CEACAM 5,6, and 7; EREG). We found that CEACAM genes were also associated with vaginal douching and number of sexual partners. Modulated inflammatory and wound healing pathways in women with recurrent BV indicate that damage-induced mucosal immune activation could contribute to BV recurrence. The association of those genes with vaginal practices indicates that immune behavioral interventions may help decrease recurrent BV and its associated risks including preterm birth and STI risk. Funding Sources This work was supported by NIH NIAID Grant Number R01Al138718, and the Miami CFAR NIAID P30AI073961 Topic Categories Mucosal and Regional Immunology (MUC)