Research Topic

Microbiota and Biomolecule Biomarkers for Gynecological Pathologies and their Appearance in Cervicovaginal Fluid

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The cervicovaginal fluid (CVF) covers the epithelial layer of the lower female genital tract and hydrates the mucosa, thereby creating a physical barrier for microbial invasion. This body fluid contains a wealth of components that can inform us about the condition of the organs of the female reproductive ...

The cervicovaginal fluid (CVF) covers the epithelial layer of the lower female genital tract and hydrates the mucosa, thereby creating a physical barrier for microbial invasion. This body fluid contains a wealth of components that can inform us about the condition of the organs of the female reproductive system. CVF is composed of vulvar secretions from several glands, plasma transudate, exfoliated cells, bacteria and bacterial products, cervical mucus, endometrial and oviductal fluids and secretions from vaginal immune cells. As a result, this fluid contains a wide array of components ranging from inorganic ions over lipids, carbohydrates and proteins to microorganisms such as commensal Lactobacillus species. It is believed that in a healthy individual these factors are in subtle equilibrium, an equilibrium that may nevertheless be modulated during processes such as menstruation or pregnancy. It can therefore be expected that when a pathology arises at some part in the female genital tract, it may very well disturb this equilibrium and change the abundance of one or more of its components, thereby producing a fingerprint for the disease. The changed components, whether they are small compounds, biopolymers or microorganisms, are then biomarkers corresponding to the disease.
As CVF is relatively easy to collect without invasive techniques (by the practitioner or even by the woman herself), it is a body fluid, well suitable for biomarker detection and thus for diagnosis and follow-up purposes. The fluid is usually collected in milliliter quantities, thereby keeping the dilution of the biomarker to a minimum and thus promoting the detection of low abundance biomarkers without prior concentration. Moreover, only the organs of the female genital tract (vagina, cervix, uterus, endometrium, Fallopian tubes and ovaries) release their biomarkers into the CVF. Therefore, although CVF contains plasma components following transudation, the ratio of gynecological biomarkers over plasma components is high and drastically increases the specificity of CVF for detection of malignancies of the female genital tract. Since criteria like sensitivity, specificity and predictive value for a diagnostic test may markedly increase with the use of biomarker sets instead of individual components, researchers must aim at finding several biomarkers and test their combinations in order to improve above mentioned criteria. For this, it might very well be that combinations of components of different types (ions, small compounds, proteins or peptides, presence of microorganisms…) work out best.
In addition to the direct application of CVF for clinical purposes, understanding the composition-function relationship of this body fluid may give us many clues about its molecular working mechanism, in particular the mechanism of the innate and adaptive immune system from which many proteins reside in CVF.
The goal of this topic is therefore to collect data of current research on CVF that may help us in unravelling the composition of this fluid and its alterations at the molecular and microbiological level, thereby further exploring its use for clinical applications.


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