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.

项目摘要 在此重新提交建议中描述的论文项目原始研究问题并利用 分子流行病学的创新方法研究老年妇女的阴道微环境。 更年期妇女在美国的人口增长，这是影响绝经后的主要发病率 妇女是泌尿生殖器症状，包括阴道干燥和外阴阴道疼痛。这篇论文 研究阴道细菌和免疫学标记与泌尿生殖器符号有关 绝经后妇女。该论文还旨在揭示阴道中的差异 老年妇女的微环境因社会经济地位（SES）而异。这项提交老化的建议 增加多样性计划公告的研究论文奖（R36）着重于关键的衰老 - 相关的健康问题，并促进了衰老和分子流行病学流行病学培训。 阴道菌群以乳酸杆菌为主导，在防止通过 病原生物，包括尿路感染和性传播感染（STI）和 保持妇女的妇科和生殖健康。阴道免疫学微环境是 受到包括雌激素在内的性恐怖的深刻影响，并与微生物共同发展以维持 体内稳态宿主微生物关系。在生殖时代的妇女中，阴道乳杆菌的耗竭，例如 在细菌阴道（BV）的临床诊断中，可能引起不良症状 排出和疾病。但是，关于外阴阴道症状的分子提示的知之甚少 绝经（GSM）的泌尿生殖综合征。此外，很少有研究仔细评估了基础 社会经济机制，包括教育，收入和邻里特征， 组合可能有助于解释BV，性传播感染和GSM中已知的种族/种族差异。这个项目将填补 与更年期和SES在塑造阴道菌群中的作用相关的关键知识差距。 本文的具体目的是确定：1​​）GSM之间的随时间变化关联 绝经后妇女的症状和阴道菌群的组成为10周 观察性研究； 2）年龄和年龄和阴道细胞因子/趋化因子水平之间的关联 阴道菌群匹配的病例对照研究，对绝经后妇女和后妇女； 3）阴道如何 SES的杂草和绝经后妇女的微生物群使用SES因子的复合指数在A中 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， 小说的目的和分析与父母研究并不重叠。与研究目标保持一致 国家老化研究所，定义影响微生物组组成和功能的因素 衰老期间的特征，这项工作将评估阴道微环境的组成差异 少年妇女的潜水员，并确定用于治疗和/或预防GSM的分子靶标。