This month, we're pleased to introduce the newest member of the Sexual Health and Wellness Institute advisory board, and Chief Science Officer of partner company Vaginal Biome Science, Beth DuPriest, PhD. We talk with DuPriest about her background in microbiome research and where she sees the opportunities ahead in the burgeoning field of vaginal biome science.
A molecular physiologist, Elizabeth earned her Ph.D. in Integrative Biomedical Sciences through the Department of Physiology and Pharmacology and completed a postdoctoral research fellowship through the Department of Pathology, both at Oregon Health & Sciences University. She is passionate about educating the next generation of healthcare practitioners and scientists–especially those from underrepresented backgrounds–teaching courses in physiology, pathophysiology, biochemistry, cell biology, and other areas. Her research interests have centered around developmental origins of health and disease, examining how prenatal exposures affect the growth and development of offspring.
SHWI: You've spent many years doing research on women’s reproductive health and in higher education instruction of biology and leadership. What excited you at the prospect of bringing that experience to the pursuit and study of vaginal biome science?
I love science – I get to learn things about the natural world and the human body that have never been known by anyone else before! But science can also be a long haul…you can spend your entire career contributing pieces of data that never translate into real changes for human health. I’ve also loved being a university professor and administrator, getting to use a whole different set of skills to educate students on how the body works and to lead a group of talented people to provide excellent educational opportunities for students. At Vaginal Biome Science, I’m excited to use my scientific training and professional skills to actually change women’s lives for the better – sooner rather than later.
SHWI: Based on your experience and research, what have you learned about how maternal health impacts fetal health and does this create any implications for vaginal biome health?
Most of my research is in the field of Developmental Origins of Health and Disease (DOHaD). I’ve studied how maternal effects, like a mother’s diet or genetic background, affect how offspring grow and develop. It turns out that poor maternal diet or high-risk genetic background can predispose babies to grow into older adults with higher risk of diseases like hypertension, diabetes, heart disease, and stroke. So far, research into how the mother’s vaginal microbiome affects long-term health of her babies is still at an early point. But it is something a lot of scientists are starting to investigate. We know that a mother’s vaginal microbiome is the main source of an infant’s whole-body microbiome initially, and that Cesarean delivery affects this negatively. Even short-term “dysbiosis” in infants has been shown to affect long-term outcomes like allergies, obesity, and even neurodevelopmental disorders. So clearly, supporting a woman’s vaginal microbiome health can have positive effects for decades.
SHWI: As the Chief Science Officer for Vaginal Biome Science, what do you think are the most promising new frontiers for vaginal biome health?
In terms of “low hanging fruit”, I think examining how improving women’s microbiomes can prevent or reduce occurrence of bacterial vaginosis, yeast infections, and urinary tract infections are likely to make the biggest impact on the largest number of women. Beyond that, though, since we know the microbiome interacts with the immune system, I think there are many, many conditions that women have that could be improved with better vaginal health. Though there are varying levels of data available for these, other vulvovaginal disorders, pregnancy complications or infertility, endometriosis, and possibly even autoimmune disorders could all be influenced by the vaginal microbiome.
More seriously, a real threat to global human health is the emergence of antibiotic-resistant bacteria, and antifungal-resistant yeasts. As more strains of drug-resistant microbes develop, our medications will become less effective, and people will start dying of diseases that we could once treat easily. Finding ways to reduce the need to use antibiotics and antifungals is a critical area of research – and one that is underappreciated. Improving the vaginal microbiome is a way to enable women’s bodies to naturally fight off the bad microbes without the need for drugs.
SHWI: What do you think are the most important research questions that need to be addressed to improve women’s vaginal health?
Where do I start with this? There are so many questions still…One of the most fundamental questions is still “What is a healthy vaginal microbiome?” While there have been several important studies contributing to a general agreement of what is healthy, there are still gaps in understanding how one’s racial/ethnic/national background affects vaginal microbiomes and whether “healthy” is the same for all demographic groups. There is also very little understood about how your diet affects your vaginal microbiome.
Beyond that, we need to understand how various vaginal bacteria–and combinations of specific bacteria–affect a woman’s body, both locally (in the vagina) and systemically (throughout the body). The immune system, nervous system, and endocrine system are all likely to be affected by the vaginal microbiome, but we simply don’t have enough data yet to know what’s really happening.
SHWI: What do you believe is some of the most important recent research from the last five years in support of women's vaginal and reproductive health?
To be honest, research on vaginal health has been largely ignored in favor of breast cancer, cervical cancer, and cardiovascular disease research. Reproductive health outcomes related to pregnancy are also commonly studied. These are all obviously worthy areas of research. But research into vaginal health for the sake of a woman’s own health has been stuck in slow motion. (The cynics among us might point to misogyny and patriarchy as reasons for that; others might point to a woman’s tendency to put family before her own health. The reality is probably that all of these are important factors.) This is beginning to change, though. An interesting phenomenon in science is that advances in technology (research techniques) often do more to advance science than new ideas and hypotheses do. The development of next generation sequencing (NGS) techniques has enabled researchers to identify new species of the microbiome that we didn’t know existed before, like BV-associated bacteria (BVAB)1, BVAB2, and BVAB3 (now called Mageeibacillus indolicus). NGS combined with a technique called genome-wide association studies (GWAS) is helping researchers to understand how the vaginal microbiome contributes to vaginal, cervical, and even uterine disorders.
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