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The mechanism(s) by which bacterial communities impact susceptibility to infectious diseases, such as HIV, and maintain female genital tract (FGT) health are poorly understood. Evaluation of FGT bacteria has predominantly been limited to studies of species abundance, but not bacterial function. We therefore sought to examine the relationship of bacterial community composition and function with mucosal epithelial barrier health in the context of bacterial vaginosis (BV) using metaproteomic, metagenomic, and  in vitro  approaches. We found highly diverse bacterial communities dominated by  Gardnerella vaginalis  associated with host epithelial barrier disruption and enhanced immune activation, and low diversity communities dominated by  Lactobacillus  species that associated with lower Nugent scores, reduced pH, and expression of host mucosal proteins important for maintaining epithelial integrity. Importantly, proteomic signatures of disrupted epithelial integrity associated with  G .  vaginalis -dominated communities in the absence of clinical BV diagnosis. Because traditional clinical assessments did not capture this, it likely represents a larger underrepresented phenomenon in populations with high prevalence of  G .  vaginalis . We finally demonstrated that soluble products derived from  G .  vaginalis  inhibited wound healing, while those derived from  L .  iners  did not, providing insight into functional mechanisms by which FGT bacterial communities affect epithelial barrier integrity.

Microbiome Composition and Function Drives Wound-Healing Impairment in the Female Genital Tract