TABLE 2.
Bacterial vaginosis-associated virulence factorsa
| Mechanism | Bacterial product(s) | Species |
|---|---|---|
| Disruption of mucosal barrier | Sialidase | Gardnerella vaginalis, Prevotella bivia, Mycoplasma hominis, Bacteroides fragilis (267, 268) and Prevotella timonensis (269) |
| Glycosulfatase | Prevotella spp. (270) | |
| Disruption of epithelial barrier | Vaginolysin | G. vaginalis (268, 271) |
| Inerolysin | Lactobacillus iners (84) | |
| Phospholipase C | G. vaginalis (268), Ureaplasma urealyticum (272) | |
| Hemolysin | G. vaginalis (273), Sneathia amnii (106) | |
| Urease | U. urealyticum (274) | |
| Increase of the vaginal pH | Amine production | P. bivia (275), BVAB1, Dialister micraerophilus (276) |
| Antibiotic resistance | Resistance gene: 5-nitroimidazole, macrolides, tetracycline, β-lactam and aminoglycoside antibiotics | Widely distributed in the vaginal microbiome (277) |
| Immune evasion | IgA protease | U. urealyticum (278) |
| Organic acids (succinic acid, acetic acid, etc.) | Prevotella spp., Mobiluncus spp. (68, 279) | |
| Growth of diseases-associated bacteria | Amino acids | P. bivia (280) |
| Ammonia | P. bivia (275) | |
| Proinflammatory responses | Organic acids (53, 68) | G. vaginalis (71), Atopobium vaginae (264), P. timonensis (269, 281), Megasphaera elsdenii (281) |
| Biofilm formation | G. vaginalis, Atopobium vaginae, Mobiluncus spp., Fusobacterium nucleatum (107) | |
a
BVAB1, “Candidatus Lachnocurva vaginae.”