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THE NEOVAGINAL MICROBIOME OF TRANSGENDER WOMEN POST-GENDER REASSIGNMENT SURGERY
Author
Birse, Kenzie D.
Kratzer, Kateryna
Zuend, Christina Farr
Mutch, Sarah
Noël-Romas, Laura
Lamont, Alana
Abou, Max
Jalil, Emilia
Veloso, Valdiléa G.
Grinsztejn, Beatriz
Friedman, Ruth Khalili
Broliden, Kristina
Bradley, Frideborg
Poliquin, Vanessa
Li, Fan
Yanavich, Carolyn
Burgener, Adam
Aldrovandi, Grace
Kratzer, Kateryna
Zuend, Christina Farr
Mutch, Sarah
Noël-Romas, Laura
Lamont, Alana
Abou, Max
Jalil, Emilia
Veloso, Valdiléa G.
Grinsztejn, Beatriz
Friedman, Ruth Khalili
Broliden, Kristina
Bradley, Frideborg
Poliquin, Vanessa
Li, Fan
Yanavich, Carolyn
Burgener, Adam
Aldrovandi, Grace
Affilliation
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Karolinska University Hospital. Karolinska Institutet. Unit of Infectious Diseases. Center for Molecular Medicine. Department of Medicine Solna. Stockholm, Sweden.
Karolinska University Hospital. Karolinska Institutet. Unit of Infectious Diseases. Center for Molecular Medicine. Department of Medicine Solna. Stockholm, Sweden.
University of Manitoba. Department of Obstetrics & Gynecology. Winnipeg, MB, Canada.
University of California. Los Angeles, CA, USA.
University of California. Los Angeles, CA, USA.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada / Karolinska University Hospital. Karolinska Institutet. Unit of Infectious Diseases. Center for Molecular Medicine. Department of Medicine Solna. Stockholm, Sweden / University of Manitoba. Department of Obstetrics & Gynecology. Winnipeg, MB, Canada.
University of California. Los Angeles, CA, USA.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Karolinska University Hospital. Karolinska Institutet. Unit of Infectious Diseases. Center for Molecular Medicine. Department of Medicine Solna. Stockholm, Sweden.
Karolinska University Hospital. Karolinska Institutet. Unit of Infectious Diseases. Center for Molecular Medicine. Department of Medicine Solna. Stockholm, Sweden.
University of Manitoba. Department of Obstetrics & Gynecology. Winnipeg, MB, Canada.
University of California. Los Angeles, CA, USA.
University of California. Los Angeles, CA, USA.
Public Health Agency of Canada. JC Wilt Infectious Disease Research Centre. National HIV and Retrovirology Labs. Winnipeg, MB, Canada / University of Manitoba. Departments of Medical Microbiology and Infectious Disease. Winnipeg, MB, Canada / Karolinska University Hospital. Karolinska Institutet. Unit of Infectious Diseases. Center for Molecular Medicine. Department of Medicine Solna. Stockholm, Sweden / University of Manitoba. Department of Obstetrics & Gynecology. Winnipeg, MB, Canada.
University of California. Los Angeles, CA, USA.
Abstract
Background: Gender reassignment surgery is a procedure some transgender women (TW) undergo for genderaffirming purposes. This often includes the construction of a neovagina using existing penile and scrotal tissue and/or a sigmoid colon graft. There are limited data regarding the composition and function of the neovaginal microbiome representing a major gap in knowledge in neovaginal health. Results: Metaproteomics was performed on secretions collected from the neovaginas (n = 5) and rectums (n = 7) of TW surgically reassigned via penile inversion/scrotal graft with (n = 1) or without (n = 4) a sigmoid colon graft extension and compared with secretions from cis vaginas (n = 32). We identified 541 unique bacterial proteins from 38 taxa. The most abundant taxa in the neovaginas were Porphyromonas (30.2%), Peptostreptococcus (9.2%), Prevotella (9.0%), Mobiluncus (8.0%), and Jonquetella (7.2%), while cis vaginas were primarily Lactobacillus and Gardnerella. Rectal samples were mainly composed of Prevotella and Roseburia. Neovaginas (median Shannon’s H
index = 1.33) had higher alpha diversity compared to cis vaginas (Shannon’s H = 0.35) (p = 7.2E−3, Mann-Whitney U test) and were more similar to the non-Lactobacillus dominant/polymicrobial cis vaginas based on beta diversity (perMANOVA, p = 0.001, r 2 = 0.342). In comparison to cis vaginas, toll-like receptor response, amino acid, and shortchain fatty acid metabolic pathways were increased (p < 0.01), while keratinization and cornification proteins were decreased (p < 0.001) in the neovaginal proteome. Conclusions: Penile skin-lined neovaginas have diverse, polymicrobial communities that show similarities in composition to uncircumcised penises and host responses to cis vaginas with bacterial vaginosis (BV) including increased immune activation pathways and decreased epithelial barrier function. Developing a better understanding of microbiome-associated inflammation in the neovaginal environment will be important for improving our knowledge of neovaginal health.
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