Association Between Gardnerella vaginalis Vaginolysin Level and Clinical Symptoms of Bacterial Vaginosis

This study examined the role of vaginolysin (VLY), a virulence factor of the bacterium <i>Gardnerella vaginalis</i> (GV), in bacterial vaginosis (BV). In a group of 112 women with BV (diagnosis on the Nugent scale ≥7 points) and 122 control cases with normal microbiota, VLY levels, the state of the vaginal microecology (colposcopy, laboratory markers, pH), GV genotypes (clades 1-4), and clinical symptoms were assessed. It was found that GV also occurs in healthy women, but VLY levels are significantly higher in BV and correlate with inflammatory markers (e.g., leukocyte esterase) and symptom severity. However, the relationship is nonlinear: low and moderate VLY levels have little effect on symptoms, while high levels cause a sharp increase in symptoms. Thus, VLY is potentially important for the pathophysiology and clinical assessment of BV.