Background: Young South African women are at disproportionate risk of bacterial vaginosis (BV) and HIV infection, and strategies to reduce these outcomes are urgently needed. Cervicovaginal Lactobacillus species such as L. crispatus protect against HIV, while L. iners is considered less protective. To understand this difference, this study compared the protein and functional profiles of cervicovaginal L. iners and L. crispatus communities in young South African women.
Methods: Vaginal swab samples collected from women (aged 16-22 years) with cervicovaginal microbiota dominated by either L. crispatus (n=19) or L. iners (n=50), were analysed using liquid chromatography-tandem mass spectrometry, a custom cervicovaginal database and MaxQuant. Data analysis comprised moderated t-tests, principal component analysis and hierarchical clustering.
Results: A total of 218 L. iners and 276 L. crispatus proteins were identified, and of the 105 proteins shared by both species, 39 were significantly differentially abundant. Proteins including glucose-6-phosphate isomerase and LPXTG-motif anchor-domain protein were overabundant in L. crispatus communities, and enolase and L-lactate dehydrogenase overabundant in L. iners. Comparison of L. iners protein relative abundance between BV positive versus negative women revealed that several L. iners proteins involved in pathogenesis and carbohydrate metabolism were significantly upregulated in women with non-optimal microbiota. Additionally, 40 host proteins were overabundant in women with L. iners and 13 in those with L. crispatus. After excluding participants with BV, L. iners dominance was correlated with immune markers (IgG H chain, clusterin and calpain small-subunit 1), while L. crispatus cytokeratin-8 overabundance suggests greater epithelial barrier integrity.
Discussion: Metaproteomic analyses provided valuable insight into the function of Lactobacillus spp. in vivo, demonstrating significant differences in the metabolic activities of L. iners versus L. crispatus. The functional activities of L. iners were linked to host BV status, suggesting that bacterial gene expression is influenced by environmental factors or strain level differences.