Socioeconomic and Microenvironmental Factors Associated with the Vaginal Microbiota in Peri- and Post- Menopausal Women

与围绝经期和绝经后妇女阴道微生物群相关的社会经济和微环境因素

• 批准号: 10641869
• 负责人: Christina Stennett
• 金额: $ 7.28万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2023-12-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10641869
• 关键词: Affect; African American; Age; Aging; Anaerobic Bacteria; Anti-Inflammatory Agents; Area; Award; Bacteria; Bacterial Vaginosis; Characteristics; Chronic; Chronic stress; Clinical; Communities; Cross-Sectional Studies; Cues; Data; Disparity; Education; Epidemiology; Estrogen decline; Estrogens; Ethnic Origin; Genitourinary System Infection; Genitourinary system; Gonadal Steroid Hormones; Gynecologic; HIV; Health; Hispanic; Human Microbiome; Immune; Immune response; Immunologic Markers; Income; Individual; Inflammatory; Interferon Type II; Knowledge; Lactobacillus; Link; Longevity; Low income; Matched Case-Control Study; Menopausal Symptom; Menopausal Syndrome; Menopause; Menstruation; Methods; Microbe; Minority Women; Modeling; Molecular; Molecular Epidemiology; Morbidity - disease rate; NIH Program Announcements; National Institute on Aging; Neighborhoods; Observational Study; Organism; Pain; Parents; Pathogenicity; Perimenopause; Personal Satisfaction; Phase; Play; Population; Postmenopause; Predisposition; Premature Menopause; Prevalence; Prevention; Prevotella; Probiotics; Property; Proxy; Race; Reporting; Reproductive Health; Research; Risk; Risk Behaviors; Role; Sampling; Severities; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Shapes; Socioeconomic Factors; Socioeconomic Status; Streptococcus; Surveys; Symptoms; TNF gene; Target Populations; Testing; Time; Training; Urinary tract; Urinary tract infection; Vagina; Vaginal Discharge; Vaginal Douching; Woman; Work; aged; chemokine; clinical diagnosis; condoms; cytokine; demographics; epidemiology study; ethnic disparity; ethnic minority population; experience; indexing; infection risk; inflammatory marker; innovation; microbial host; microbiome; microbiome composition; microbiota; molecular targeted therapies; novel; older women; pathogen; population based; prevent; racial disparity; racial minority population; reproductive; sociodemographic factors; socioeconomics; therapy development; tumor-immune system interactions; vaginal dryness; vaginal lactobacilli; vaginal microbiota

PROJECT SUMMARY The dissertation project described in this re-submission proposes original research questions and utilizes innovative methods in molecular epidemiology to investigate the vaginal microenvironment of older women. Menopausal women are a growing population in the U.S. A major morbidity that affect post-menopausal women is genitourinary symptoms, including vaginal dryness and vulvovaginal pain. This dissertation investigates how vaginal bacteria and immunologic markers are associated with genitourinary symptoms in peri- and postmenopausal women. This dissertation also seeks to reveal how disparities in the vaginal microenvironment for older women vary by socioeconomic statuses (SES). This proposal to the Aging Research Dissertation Awards to Increase Diversity Program Announcement (R36) focuses on key aging- related health concerns and facilitates training in epidemiology of aging and molecular epidemiology. Vaginal microbiota, dominated by Lactobacillus spp., play an important role in preventing colonization by pathogenic organisms, including urinary tract infections and sexually transmitted infections (STIs), and maintain a woman’s gynecologic and reproductive health. The vaginal immunologic microenvironment is profoundly influenced by sex hormones, including estrogens, and has co-evolved with microbes to maintain a homeostatic host-microbial relationship. In reproductive-aged women, depletion of vaginal lactobacilli, such as in the clinical diagnosis of bacterial vaginosis (BV), can cause undesirable symptoms including vaginal discharge and malodor. However, less is known about the molecular cues of vulvovaginal symptoms in the genitourinary syndrome of menopause (GSM). Further, few studies have carefully evaluated the underlying socioeconomic mechanisms, including education, income, and neighborhood characteristics, that, in combination, may help to explain known racial/ethnic disparities in BV, STIs, and GSM. This project will fill critical knowledge gaps related to the role of menopause and SES in shaping the vaginal microbiota. The specific aims of this dissertation are to determine: 1) the time-varying associations between GSM symptoms and the composition of the vaginal microbiota of peri- and postmenopausal women in a 10-week observational study; 2) the association between GSM and vaginal cytokine/chemokine levels in an age- and vaginal microbiota-matched case-control study of peri- and postmenopausal women; and 3) how vaginal microbiota of peri- and postmenopausal women differ by SES using a composite index of SES factors in a large cross-sectional study. The R36 will leverage existing microbiota and immune data for efficient research, and the novel aims and analyses do not overlap with the parent studies. In keeping with a research objective of the National Institute on Aging, to define the factors that influence microbiome composition and functional characteristics during aging, this work will evaluate compositional differences in the vaginal microenvironment of diverse menopausal women and identify molecular targets for treatment and/or prevention of GSM.

项目概要 本次重新提交中描述的论文项目提出了原创的研究问题并利用 分子流行病学的创新方法研究老年女性的阴道微环境。 在美国，更年期妇女的人口不断增长，这是影响绝经后的主要疾病 女性则出现泌尿生殖症状，包括阴道干燥和外阴阴道疼痛。本论文 研究阴道细菌和免疫标记物与泌尿生殖系统症状的关系 围绝经期和绝经后妇女。本论文还试图揭示阴道的差异如何 老年妇女的微环境因社会经济地位（SES）而异。本提案向老龄化 研究论文奖增加多样性计划公告（R36）重点关注关键老龄化- 相关的健康问题并促进衰老流行病学和分子流行病学方面的培训。 以乳杆菌为主的阴道微生物群在防止细菌定植方面发挥着重要作用 病原微生物，包括尿路感染和性传播感染（STI），以及 维护女性妇科和生殖健康。阴道免疫微环境是 深受性激素（包括雌激素）的影响，并与微生物共同进化以维持 宿主-微生物的稳态关系。在育龄妇女中，阴道乳酸杆菌的消耗，例如 在细菌性阴道病 (BV) 的临床诊断中，可能会引起不良症状，包括阴道症状 分泌物和恶臭。然而，人们对外阴阴道症状的分子线索知之甚少。 更年期泌尿生殖系统综合症（GSM）。此外，很少有研究仔细评估潜在的 社会经济机制，包括教育、收入和邻里特征， 结合起来，可能有助于解释 BV、STI 和 GSM 中已知的种族/民族差异。该项目将填补 与更年期和社会经济地位在塑造阴道微生物群中的作用相关的关键知识差距。 本论文的具体目标是确定：1​​）GSM 之间的时变关联性。 围绝经期和绝经后妇女 10 周内的症状和阴道微生物群的组成 观察性研究； 2) GSM 与年龄和阴道细胞因子/趋化因子水平之间的关联 针对围绝经期和绝经后妇女的阴道微生物群匹配病例对照研究； 3) 阴道如何 围绝经期和绝经后妇女的微生物群因 SES 而异，使用 SES 因素的综合指数 大型横断面研究。 R36 将利用现有的微生物群和免疫数据进行有效的研究， 并且新颖的目标和分析与母研究不重叠。为了符合研究目标 国家衰老研究所，定义影响微生物组组成和功能的因素 衰老过程中的特征，这项工作将评估阴道微环境的成分差异 不同的更年期妇女的研究，并确定治疗和/或预防 GSM 的分子靶点。