Host-vaginal microbiota interaction: shaping the vaginal microenvironment and bacterial vaginosis

Purpose of review: This review comprehensively examines host-vaginal microbiota interactions, the composition of the vaginal microbiota, and its dynamic changes throughout a woman's lifespan. Furthermore, the intricate interplay between the host and beneficial bacterial communities, such as Lactobacillus species, and opportunistic pathogens, such as Gardnerella spp., associated with BV development, has been explored. Additionally, the current and advanced therapeutic strategies for managing complications related to vaginal microbiota along with the challenges faced in this field have been discussed. Recent findings: Recent findings have shown that the microbial communities inhabiting the female vagina, known as the vaginal microbiota, play a critical role in maintaining women's health and supporting reproductive activities. Imbalanced vaginal microbiota can predispose individuals to a range of diseases, including bacterial vaginosis (BV), sexually transmitted infections (STI), miscarriage, and preterm birth. While the exact mechanisms by which a Lactobacillus-dominated vaginal microenvironment improves vaginal health remain elusive, gaining insight into the interactions between the host and vaginal microbiota, as well as with opportunistic pathogens, can help address unanswered questions. Summary: A deeper understanding of the reciprocal interactions between the host and vaginal microbiota has the potential to pave the way for the development of novel diagnostic and therapeutic interventions and the improvement of women's health.