Perceived Stress and Molecular Bacterial Vaginosis in the National Institutes of Health Longitudinal Study of Vaginal Flora.
Perceived Stress and Molecular Bacterial Vaginosis in the National Institutes of Health Longitudinal Study of Vaginal Flora.
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美国国立卫生研究院阴道菌群纵向研究中的感知压力和分子细菌性阴道病。
DOI：
10.1093/aje/kwab147
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发表时间：
2021
影响因子：
5
通讯作者：
Brotman,RebeccaM
中科院分区：
文献类型：
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作者：
Turpin,Rodman;Slopen,Natalie;Borgogna,Joanna-LynnC;Yeoman,CarlJ;He,Xin;Miller,RyanS;Klebanoff,MarkA;Ravel,Jacques;Brotman,RebeccaM
阴道微生物区系主要通过乳杆菌的保护作用提供对泌尿生殖系统感染的第一道防线，感受到的应激通过几种机制增加对感染的敏感性，包括抑制免疫功能。我们调查了1999-2002年间在阴道菌群纵向研究中的572名妇女的子样本中，压力是否与阴道细菌组成的有害变化有关。使用COX比例风险模型，未调整和调整社会人口因素和性行为，我们发现，科恩的感知压力量表增加5个单位的参与者患上分子细菌性阴道病(BV)的风险更大(调整后的风险比(HR)=1.40，95%可信区间(CI)：1.13，1.74)，这是一种乳杆菌丰度较低和厌氧细菌种类繁多的状态。压力分数增加5个单位也与从THL过渡的风险更大相关。Iners主导的社区状态类型(高26%)到分子BV(调整后HR=1.26，95%CI：1.01，1.56)或从基线维持分子BV(调整后HR=1.23，95%CI：1.01，1.47)。相反，基线分子BV报告5个单位应激增加的女性不太可能过渡到以BYL为主的微生物区系。Crispatus、加瑟氏乳杆菌(L.asseri)、或.Jensenii(调整后HR=0.81，95%CI：0.68，0.99)。这些发现表明，心理社会压力与阴道微生物区系组成有关，这引发了对心理社会压力和分子BV之间关系的更机械性的探索。
Vaginal microbiota provide the first line of defense against urogenital infections primarily through protective actions ofLactobacillusspecies Perceived stress increases susceptibility to infection through several mechanisms, including suppression of immune function. We investigated whether stress was associated with deleterious changes to vaginal bacterial composition in a subsample of 572 women in the Longitudinal Study of Vaginal Flora, sampled from 1999 through 2002. Using Cox proportional hazards models, both unadjusted and adjusted for sociodemographic factors and sexual behaviors, we found that participants who exhibited a 5-unit-increase in Cohen’s Perceived Stress Scale had greater risk (adjusted hazard ratio (HR) = 1.40, 95% confidence interval (CI): 1.13, 1.74) of developing molecular bacterial vaginosis (BV), a state with lowLactobacillusabundance and diverse anaerobic bacteria. A 5-unit increase in stress score was also associated with greater risks of transitioning from theL. iners-dominated community state type (26% higher) to molecular-BV (adjusted HR = 1.26, 95% CI: 1.01, 1.56) or maintaining molecular-BV from baseline (adjusted HR = 1.23, 95% CI: 1.01, 1.47). Inversely, women with baseline molecular-BV reporting a 5-unit stress increase were less likely to transition to microbiota dominated byL. crispatus,L. gasseri, orL. jensenii(adjusted HR = 0.81, 95% CI: 0.68, 0.99). These findings suggest that psychosocial stress is associated with vaginal microbiota composition, inviting a more mechanistic exploration of the relationship between psychosocial stress and molecular-BV.