The female reproductive tract virome: understanding the dynamic role of viruses in gynecological health and disease

Abstract

The human body is inhabited by a large and complex network of commensal and predatory eukaryotic viruses and bacteriophages collectively termed the virome. Despite being the most abundant and genetically diverse biological entities on the planet, the impact of viruses on human health especially within the female reproductive tract (FRT) remains understudied. To better appreciate current knowledge regarding the dynamic role of viruses in FRT health and disease, in this review we highlight the known constituents of the FRT virome, transkingdom interactions within the FRT and their influence on gynecological disease. A better understanding of the FRT virome may pave the way toward improved outcomes in gynecological, reproductive, and neonatal health.

Figure 1:. Female Reproductive Tract Virome Composition.

Proportion of viral constituents that inhabit the FRT virome displayed as bacteriophages and eukaryotic viruses (inner), and further delineated into viral families (outer). Caudovirales order bacteriophages (Myoviridae, Siphoviridae, and Podoviridae) dominate the virome, accounting for as much as 80% of its composition. The eukaryotic virome is largely comprised of Papillomaviridae family members, but also contains Herpesviridae, Polyomaviridae, Poxviridae, and Anelloviridae among others. Adapted from [21].

Figure 2:. Transkingdom Interactions Between the FRT Virome and Bacteriome.

FRT health is commonly associated with low diversity, lower inflammation bacteriomes dominated by Lactobacillus species (left). This is linked to a phageome dominated by Spounavirinae and Rhodococcus viruses along with an abundance of Lactobacillus prophages. In contrast, high diversity bacteriomes (right) composed of facultative and obligate anaerobes such as Gardnerella, Prevotella and Sneathia are associated with increased bacteriophage diversity and diseases including bacterial vaginosis, acquisition and transmission of sexually transmitted infections, and poor female reproductive health outcomes including preterm birth. Created with Biorender.com