Scientists say that new research might be the starting point for personalized medicine for women. Research undertaken by The University of Maryland School of Medicine’s Institute for Genome Sciences and the University of Idaho shows that the delicate balance of microbes in the vagina can vary dramatically, even over short periods of time.

Just as there are good and bad bacteria in the intestinal tract, the female system is a home to a variety of symbiotic bacteria that help maintain good health. A woman’s susceptibility to infection and other diseases can obviously be affected by this balance. In the same way that probiotics are sometimes needed to balance the intestinal florar, medicines can be devised to take into account a woman’s microbial make-up.

The study, published in May 2, 2012 in the journal Science Translational Medicine, looked at the vaginal microbes found in 32 women, specifically at how they varied over time. The work was led by Jacques Ravel, Ph.D., associate professor of microbiology and immunology and associate director of the Institute for Genome Sciences at the University of Maryland School of Medicine, along with colleague Larry Forney, Ph.D., a professor in Biological Sciences and director of the Institute for Bioinformatics and Evolutionary Studies at the University of Idaho. Their work is the first time genomic technology that has been used to look at vaginal microbial communities over time.

Known as the human microbiome, the study of the microbes that live on or in the human body is rapidly becoming an emerging field in genomics. The symbiotic relationship that they develop with the human body is far more complex and important than scientists previously thought. Even the concept of probiotics is a relatively new one. They regulate health and prevent disease in the vagina producing lactic acid which prevents infection, as acidity is hostile to many bacteria that might otherwise lead to acute or even chronic infection.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs of the University of Maryland and John Z. and Akiko K. Bowers Distinguished Professor and dean, University of Maryland School of Medicine says that :

“This cutting edge basic research is revolutionizing the way that we practice medicine, forming the foundation of the emerging field of personalized medicine … Personalized medicine truly is the future of patient care, allowing us to tailor care to each patient’s individual needs. Our Institute for Genome Sciences is a world leader in advancing this new field, and this research is a great example of their groundbreaking work.”

A previous study identified five main groups of microbes, which varied widely according to ethnicity. It also seems that asian and white women are better protected by their microbial communities that black and Hispanic women.

Dr. Ravel continues that:

“Those data highlighted potential ethnic disparities and a need for more personalized medicine … The present study builds upon those results. It shows that the types and quantity of microbes found in the vagina can vary slightly or even markedly over short periods of time in some women, while other women show no change. These changes can coincide with a woman’s menstrual period, but often do not. The kinds of changes vary between women and seem highly individualized. Most studies or treatments traditionally are based upon the idea that all women are the same and will react similarly to treatments. But our research shows that each woman seems to have her own ‘healthy’ state.”

His associate Dr. Forney add that :

“Our findings pave the way for organizing women into groups based upon the type of microbes they have in the vagina over time … Each group could receive personalized therapies tailored to the make-up of their vaginal microbial community.”

Dr. Ravel thinks that the research could change the way women are treated and diagnosed, as women are usually evaluated with a single snapshot and this could be a false picture as the makeup of the microbes can vary over time. By understanding the changes that are taking place, misdiagnosis and unnecessary treatments for bacteria vaginosis can be avoided. Ravel continues that it’s unlikely that gynecologists will be able to alter their practices immediately, but it does represent an important starting point for the future.

It is estimated that around 25% of women have some kind of bacterial or fungal infection at any one time, and it’s the leading reason that women of reproductive age visit their doctor. Vaginal infections have also been linked to premature births and tend to produce a higher risk of catching a sexually transmitted disease. It’s certainly an interesting work and one that is bound to play a role in the future of women’s health.

Written by Rupert Shepherd