Specific microbial communities in the female genital tract are linked to health outcomes; for example, a microbiome deficient in Lactobacillus is observed in bacterial vaginosis. However, available therapies may not effectively promote the growth of beneficial bacterial species that could prevent the recurrence of disease. Writing in Cell, Zhu et al. propose that targeting unsaturated long-chain fatty acids (uLCFAs) might differentially modulate vaginal lactobacilli, offering a novel strategy for treating bacterial vaginosis.

uLCFAs serve as building blocks for bacterial membranes, but also possess antimicrobial activity against certain bacterial species. The authors assessed the impact of cis-9-uLCFAs, such as oleic acid, on the growth of various Lactobacillus species. They found that oleic acid selectively inhibited L. iners while promoting the growth of other species, including the health-associated L. crispatus. Transcriptomic analysis revealed that oleic acid treatment upregulates a putative fatty acid efflux pump (farE) and oleate hydratase (ohyA) in other species but not in L. iners. farE was shown to be essential for oleic acid resistance, whereas ohyA converts oleic acid for use in phospholipid synthesis. Oleic acid treatment, either alone or combined with the antibiotic metronidazole, shifted the dominance of bacterial vaginosis-like communities towards L. crispatus in vitro.

女性生殖道中的特定微生物群落与健康结果相关；例如，在细菌性阴道病中观察到缺乏乳酸菌的微生物组。然而，现有的疗法可能无法有效促进可预防疾病复发的有益细菌种类的生长。朱等人在《细胞》中写作。提出针对不饱和长链脂肪酸（uLCFA）可能差异调节阴道乳酸杆菌，为治疗细菌性阴道病提供新策略。

uLCFA 可作为细菌膜的组成部分，但也具有针对某些细菌物种的抗菌活性。作者评估了顺式-9-uLCFA（例如油酸）对各种乳杆菌生长的影响。他们发现油酸选择性地抑制惰性乳杆菌，同时促进其他物种的生长，包括与健康相关的卷曲乳杆菌。转录组学分析表明，油酸处理上调了其他物种中的假定脂肪酸外排泵 (farE) 和油酸水合酶 (ohyA)，但在L. iners中则不然。 FarE被证明对于油酸抗性至关重要，而 ohyA 则将油酸转化为用于磷脂合成。油酸治疗，无论是单独治疗还是与抗生素甲硝唑联合治疗，在体外将类似阴道病的细菌群落的优势转向卷曲乳杆菌。