How does a man’s seminal microbiome alter a woman’s vaginal microbiome?

There is very little research on the microbiome of semen.  We know that it is not sterile, and some scientists think that some of the bacteria found in semen may be involved in male fertility issues.  However, there is still a lot of research to be done in this area.  Even less is known about how the seminal microbiome influences the vaginal microbiome after sex.  Some research has suggested that specific sexual partners can cause bacterial vaginosis (BV), however the mechanisms for this are unclear.  It is suggested that perhaps the penile and seminal microbiome being transferred to the vagina during sex could cause this, although research has not confirmed these hypotheses.  Researchers from Estonia tried to answer these questions, and studied just how the vaginal and seminal microbiomes change before and after sex.  They published the results of their findings last week in Research in Microbiology. 

The scientists measured the seminal and vaginal microbiomes before and after sex for 23 couples who had sought help for infertility but were otherwise healthy.  They learned that the seminal microbiome, while containing much fewer bacteria, was actually more diverse than the vaginal microbiome.  Still though, each shared many of the same bacteria.  These included Lactobacillus, Veillonella, Streptococcus, Porphyromonas and Atopobium.  Interestingly, Gardnerella vaginalis, a bacterium highly implicated with BV, was found more frequently in women who had sex with men whose semen contained leukocytes, itself a phenotype associated with infertility.  While most of the women’s microbiomes did not shift after sexual intercourse, four of them did.  In these women a decrease in Lactobacillus occurred, and a decrease in Lactobacillus has also been highly implicated in BV.

While this study was preliminary, it marks some of the first research on the dynamics of the seminal and vaginal microbiome during sex.  The scientists suggest that the microbiome may be very important to fertility issues, and at the AMI we would not be surprised to learn that it is involved in at least some causes of infertility.  In the near future we will be devoting an entire podcast to the vaginal microbiome, and interviewing Jacques Ravel, a world leader in this field.  If you have any relavent questions and would like us to ask them on the podcast please call 518-945-8583 and leave your question on the voicemail.

The continent you were born on may increase your risk for diabetes

Researchers are finding that imbalances in the gut microbiome can be linked to many diseases, especially autoimmune diseases like type I diabetes. A study called The Environmental Determinants of Diabetes in the Young (TEDDY) was formed to test what environmental factors can trigger type I diabetes in young children that are genetically at-risk for the disease.

In a study published by Diabetes Care, researchers working on the TEDDY study collected fecal samples from infants,at centers located in Finland, Sweden, Germany, Colorado, Washington state, and Georgia/Florida. The samples were collected monthly, and were tested on factors including age, sex, delivery method, early feeding, and later diet.

 The results of the study showed that young type I diabetes at-risk children have specific patterns of microbiome colonization per study site. In other words, there was a significant geographical association with diversity of gut bacteria. Finland, which has the highest incidence of type I diabetes, had  relatively low microbiome diversity and significantly higher abundances of Bacteroides and Veillonella and a lower abundance of traditional infant microbiome bacteria like  Bifidobacterium.  Interestingly, while there were intracontinental similarities between microbiomes, geography did not appear to be a dominant factor.  For example, Swedish microbiomes were more similar to those from Washington state than from Finaland..

 These results are among the first published from the TEDDY study, from which there should be significant discoveries.  For now, it appears the microbiome may play a role in the incidence of diabetes, but as is always the case, until an actual mechanism is proven it is too early to draw further conclusions.

IBD, Crohn's disease, and the microbiome

There have been several large scale studies that show a definite association between the microbiome and inflammatory bowel diseases like Crohn’s and colitis.  While it is becoming clear that the microbiome plays a pivotal role in these diseases, the exact mechanisms of pathogenesis are not known.  One of the reasons it has been so hard to uncover this link is because of a lack of robust studies, that usually contain small sample sizes.  In response, a team of leading scientists in the field, including multiple scientists from our own scientific advisory board, assembled a brand new cohort, the largest of its kind, to study the disease.  The cohort consisted of 447 children with newly diagnosed, still untreated, Crohn’s disease and 221 healthy children.   They then combined this data with two other cohorts that included adult patients to bring the total number of samples to 1,742.  The first results of this study were published in Cell Host and Microbe, and shed many insights into IBD and its relationship to the microbiome.

In the study the researchers sampled and sequenced the microbiome of the gut mucosa and stool.  From this data, they identified specific bacteria that had higher abundances in diseased patients, like Enterobacteriaceae and Veillonellaceae, and others that had lower than normal abundances, such as Clostridiales and Bacteroidales.  According to the samples, these relative abundances were more pronounced in the mucosal samples, rather than the stool samples, meaning that the mucosa may play a more important role in Crohn’s pathogenesis and diagnosis.  Moreover, children under age 10 did not have large populations of the ‘bad’ bacteria, which were negatively correlated with age.

Another important finding from the study is that antibiotic treatment of the Chrohn’s disease further exacerbated the microbial imbalances (dysbiosis), and caused the bad bacteria to proliferate and the good bacteria to die off.  The researchers are quick to dismiss antibiotics as the cause of the disease, rather hypothesizing that the antibiotics allow for opportunistic bacteria to grow which may cause dysbiosis.  They also encourage further research on the subject and question whether antibiotics should be prescribed to IBD patients.

The researchers used this knowledge of the dysbiosis to create a potential diagnostic for IBD.  They were able to calculate a microbiome diversity index by sampling the mucous for the existence of certain bacteria and for overall microbiome diversity.  The index shows remarkable ability to not only accurately predict the existence of IBD, but also the severity of it.  Also, the researchers showed their microbiome dysbiosis index could be combined with clinical data to better predict the future outcome of the disease.

A final conclusion of the paper is that the gut mucous is a more accurate signal for IBD.  They conclude that stool samples are composed of higher levels of aerobic, oxygen using, bacteria than those in gut, and that stool is not representative of the overall microbiome.

This study is the first to rigorously tackle IBD, specifically, Crohn's disease, and the microbiome.  We now know what bacteria are most highly associated (both positively and negatively) with IBDs, and how this this information can be incorporated into early diagnostic screens.

Asthma, COPD, and the Microbiome

Asthma and chronic obstructive pulmonary disease (COPD) are both illnesses that are caused by chronic inflammation of the respiratory tract, and recent research suggests that the microbiota of the lower respiratory tract may influence the development of these two diseases.  The upper respiratory tract, though, remained unstudied, until a new article was recently published in PLoS ONE.  This article characterized the microbiome of the oropharynx (in the upper respiratory tract) to discover the association between these problems and the microbiome.

Samples were swabbed from the oropharynx of patients who were recently diagnosed with asthma and COPD, as well as from a healthy control group.  Researchers performed 16S rRNA gene sequencing of the bacteria collected from the patients, in order to determine which bacteria were present. They found that there are few differences in microbiome diversity between asthma and COPD patients, however there was a prevalent presence of the bacteria Lactobacillus (phylum Firmicutes) and Pseudomonas (phylum Proteobacteria) in both, which were identified in only very small amounts in healthy patients. On the contrary, the upper respiratory tract of healthy individuals was found to be dominated by Streptococcus, Veillonella, Prevotella, and Neisseria, from the phylum Bacteroidetes, compared to individuals with asthma and COPD.

This study showed distinct differences in the microbiomes of diseased and healthy individuals.  The researchers also note that the low abundance of Neisseria they observed in this study has also been seen in studies of smokers, meaning that this bacteria may be important to respiratory health.  Further work is still needed, though, to determine if the bacteria identified in this study are contributing to the diseased individuals.  Even if they are not, they could still potentially be used in diagnosis.