Association between cigarette smoking and the vaginal microbiota: a pilot study

BMC Infectious Diseases

Jessica M Rath⁶  Elbert D Glover¹  Jacques Ravel³  Emmanuel F Mongodin³  Eva Sharma⁴  Doug Fadrosh⁵  Pawel Gajer⁵  Xin He²  Rebecca M Brotman⁷ 

[1]Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA

[2]Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA

[3]Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA

[4]Westat, Rockville, MD, USA

[5]Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA

[6]American Legacy Foundation, Washington, DC, USA

[7]Department of Epidemiology and Public Health, University of Maryland School of Medicine, 801 West Baltimore Street, Room Number 633, Baltimore, MD 21201, USA

关键词: Bacterial vaginosis;    16S rRNA gene analysis;    Cigarette;    Smoking cessation;    Vaginal microbiota;   

Others  :  1125713
DOI  :  10.1186/1471-2334-14-471

 received in 2014-03-10, accepted in 2014-08-18,  发布年份 2014

【 摘 要 】

Background

Smoking has been identified in observational studies as a risk factor for bacterial vaginosis (BV), a condition defined in part by decimation of Lactobacillus spp. The anti-estrogenic effect of smoking and trace amounts of benzo[a]pyrene diol epoxide (BPDE) may predispose women to BV. BPDE increases bacteriophage induction in Lactobacillus spp. and is found in the vaginal secretions of smokers. We compared the vaginal microbiota between smokers and non-smokers and followed microbiota changes in a smoking cessation pilot study.

Methods

In 2010–2011, 20 smokers and 20 non-smokers were recruited to a cross-sectional study (Phase A) and 9 smokers were enrolled and followed for a 12-week smoking cessation program (Phase B). Phase B included weekly behavioral counseling and nicotine patches to encourage smoking cessation. In both phases, participants self-collected mid-vaginal swabs (daily, Phase B) and completed behavioral surveys. Vaginal bacterial composition was characterized by pyrosequencing of barcoded 16S rRNA genes (V1-V3 regions). Vaginal smears were assigned Nugent Gram stain scores. Smoking status was evaluated (weekly, Phase B) using the semi-quantitative NicAlert® saliva cotinine test and carbon monoxide (CO) exhalation.

Results

In phase A, there was a significant trend for increasing saliva cotinine and CO exhalation with elevated Nugent scores (P value <0.005). Vaginal microbiota clustered into three community state types (CSTs); two dominated by Lactobacillus (L. iners, L. crispatus), and one lacking significant numbers of Lactobacillus spp. and characterized by anaerobes (termed CST-IV). Women who were observed in the low-Lactobacillus CST-IV state were 25-fold more likely to be smokers than those dominated by L. crispatus (aOR: 25.61, 95 % CI: 1.03-636.61). Four women completed Phase B. One of three who entered smoking cessation with high Nugent scores demonstrated a switch from CST-IV to a L.iners-dominated profile with a concomitant drop in Nugent scores which coincided with completion of nicotine patches. The other two women fluctuated between CST-IV and L. iners-dominated CSTs. The fourth woman had low Nugent scores with L. crispatus-dominated CSTs throughout.

Conclusion

Smokers had a lower proportion of vaginal Lactobacillus spp. compared to non-smokers. Smoking cessation should be investigated as an adjunct to reducing recurrent BV. Larger studies are needed to confirm these findings.

【 授权许可】

   
2014 Brotman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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