{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:34:10Z","timestamp":1792089250859,"version":"4.4.0"},"reference-count":181,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T00:00:00Z","timestamp":1604448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Preterm births are a global health priority that affects 15 million babies every year worldwide. There are no effective prognostic and therapeutic strategies relating to preterm delivery, but uterine infections appear to be a major cause. The vaginal epithelium is covered by the cervicovaginal mucus, which is essential to health because of its direct involvement in reproduction and functions as a selective barrier by sheltering the beneficial lactobacilli while helping to clear pathogens. During pregnancy, the cervical canal is sealed with a cervical mucus plug that prevents the vaginal flora from ascending toward the uterine compartment, which protects the fetus from pathogens. Abnormalities of the cervical mucus plug and bacterial vaginosis are associated with a higher risk of preterm delivery. This review addresses the current understanding of the cervicovaginal mucus and the cervical mucus plug and their interactions with the microbial communities in both the physiological state and bacterial vaginosis, with a focus on gel-forming mucins. We also review the current state of knowledge of gel-forming mucins contained in mouse cervicovaginal mucus and the mouse models used to study bacterial vaginosis.<\/jats:p>","DOI":"10.3390\/ijms21218266","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T10:32:36Z","timestamp":1604485956000},"page":"8266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":151,"title":["The Cervicovaginal Mucus Barrier"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2408-5267","authenticated-orcid":false,"given":"Guillaume","family":"Lacroix","sequence":"first","affiliation":[{"name":"Inserm U1286, Infinite, Univ. Lille, CHU Lille, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Gouyer","sequence":"additional","affiliation":[{"name":"Inserm U1286, Infinite, Univ. Lille, CHU Lille, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5290-0436","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Gottrand","sequence":"additional","affiliation":[{"name":"Inserm U1286, Infinite, Univ. Lille, CHU Lille, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6876-8049","authenticated-orcid":false,"given":"Jean-Luc","family":"Desseyn","sequence":"additional","affiliation":[{"name":"Inserm U1286, Infinite, Univ. Lille, CHU Lille, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.cis.2017.12.005","article-title":"Gel-forming mucin interactome drives mucus viscoelasticity","volume":"252","author":"Demouveaux","year":"2018","journal-title":"Adv. Colloid Interface Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/978-1-4615-9254-9_50","article-title":"Cervical mucus: Its physiological role and clinical significance","volume":"144","author":"Elstein","year":"1982","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/oxfordjournals.bmb.a071464","article-title":"Functions and physical properties of mucus in the female genital tract","volume":"34","author":"Elstein","year":"1978","journal-title":"Br. Med. Bull."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.chom.2018.01.013","article-title":"Cervicovaginal Microbiota and Reproductive Health: The Virtue of Simplicity","volume":"23","author":"Anahtar","year":"2018","journal-title":"Cell Host Microbe"},{"key":"ref_5","first-page":"589","article-title":"The global health impact of vaginal dysbiosis","volume":"168","author":"Jespers","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1080\/00016340902852898","article-title":"The cervical mucus plug: Structured review of the literature","volume":"88","author":"Becher","year":"2009","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1146\/annurev.physiol.70.113006.100702","article-title":"Structure and function of the polymeric mucins in airways mucus","volume":"70","author":"Thornton","year":"2008","journal-title":"Annu Rev Physiol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1093\/oxfordjournals.molbev.a026400","article-title":"Evolution of the large secreted gel-forming mucins","volume":"17","author":"Desseyn","year":"2000","journal-title":"Mol. Biol. Evol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1095\/biolreprod56.4.999","article-title":"Mucin genes expressed by human female reproductive tract epithelia","volume":"56","author":"Gipson","year":"1997","journal-title":"Biol. Reprod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/01.pgp.0000225837.32719.c1","article-title":"Mucin genes (MUC2, MUC4, MUC5AC, and MUC6) detection in normal and pathological endometrial tissues","volume":"26","author":"Alameda","year":"2007","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/1743-422X-5-59","article-title":"The inhibition of the Human Immunodeficiency Virus type 1 activity by crude and purified human pregnancy plug mucus and mucins in an inhibition assay","volume":"5","author":"Habte","year":"2008","journal-title":"Virol. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.ympev.2009.03.035","article-title":"Mucin CYS domains are ancient and highly conserved modules that evolved in concert","volume":"52","author":"Desseyn","year":"2009","journal-title":"Mol. Phylogenet. Evol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.bbrc.2018.10.138","article-title":"Non-C-mannosylable mucin CYS domains hindered proper folding and secretion of mucin","volume":"506","author":"Gouyer","year":"2018","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/glycob\/cwh041","article-title":"C-Mannosylation of MUC5AC and MUC5B Cys subdomains","volume":"14","author":"Randell","year":"2004","journal-title":"Glycobiology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"G225","DOI":"10.1152\/ajpgi.00274.2015","article-title":"Biological modeling of mucus to modulate mucus barriers","volume":"310","author":"Desseyn","year":"2016","journal-title":"Am. J. Physiol.-Gastrointest. Liver Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.bbagen.2014.05.003","article-title":"Mucins: A biologically relevant glycan barrier in mucosal protection","volume":"1850","author":"Corfield","year":"2015","journal-title":"Biochim. Biophys. Acta-Gen. Subj."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1042\/BCJ20170853","article-title":"The sugar code: Letters and vocabulary, writers, editors and readers and biosignificance of functional glycan-lectin pairing","volume":"476","author":"Kaltner","year":"2019","journal-title":"Biochem. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"D1321","DOI":"10.2741\/Corfield","article-title":"Mucins in the gastrointestinal tract in health and disease","volume":"6","author":"Corfield","year":"2001","journal-title":"Front. Biosci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Corfield, A.P. (2018). The Interaction of the Gut Microbiota with the Mucus Barrier in Health and Disease in Human. Microorganisms, 6.","DOI":"10.3390\/microorganisms6030078"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Hoffmann, W. (2020). Trefoil Factor Family (TFF) Peptides and Their Diverse Molecular Functions in Mucus Barrier Protection and More: Changing the Paradigm. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21124535"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1515\/CCLM.2011.123","article-title":"Trefoil factor family peptides in human saliva and cyclical cervical mucus. Method evaluation and results on healthy individuals","volume":"49","author":"Samson","year":"2011","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s004410000297","article-title":"Synthesis and localization of the mucin-associated TFF-peptides in the human uterus","volume":"303","author":"Wiede","year":"2001","journal-title":"Cell Tissue Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"6961","DOI":"10.1073\/pnas.90.15.6961","article-title":"hP1.B, a human P-domain peptide homologous with rat intestinal trefoil factor, is expressed also in the ulcer-associated cell lineage and the uterus","volume":"90","author":"Hauser","year":"1993","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1038\/mi.2013.120","article-title":"IgG in cervicovaginal mucus traps HSV and prevents vaginal herpes infections","volume":"7","author":"Wang","year":"2014","journal-title":"Mucosal Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fahrbach, K.M., Malykhina, O., Stieh, D.J., and Hope, T.J. (2013). Differential binding of IgG and IgA to mucus of the female reproductive tract. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0076176"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1016\/j.bpj.2014.02.038","article-title":"Transient antibody-mucin interactions produce a dynamic molecular shield against viral invasion","volume":"106","author":"Chen","year":"2014","journal-title":"Biophys. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1093\/humupd\/dmu065","article-title":"Antimicrobial peptides in the female reproductive tract: A critical component of the mucosal immune barrier with physiological and clinical implications","volume":"21","author":"Yarbrough","year":"2015","journal-title":"Hum. Reprod. Update"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"376","DOI":"10.3389\/fimmu.2018.00376","article-title":"Role of Lactobacilli and Lactoferrin in the Mucosal Cervicovaginal Defense","volume":"9","author":"Valenti","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00404-005-0079-x","article-title":"Lifetime changes in the vulva and vagina","volume":"273","author":"Farage","year":"2006","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3872","DOI":"10.1096\/fj.07-8189com","article-title":"Globular structure of human ovulatory cervical mucus","volume":"21","author":"Brunelli","year":"2007","journal-title":"FASEB J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1074\/mcp.M600439-MCP200","article-title":"Large scale identification of proteins, mucins, and their O-glycosylation in the endocervical mucus during the menstrual cycle","volume":"6","author":"Thomsson","year":"2007","journal-title":"Mol. Cell. Proteomics"},{"key":"ref_32","first-page":"479","article-title":"Ultrastructure of the human periovulatory cervical mucus","volume":"54","author":"Ceric","year":"2005","journal-title":"J. Electron. Microsc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1039\/C5MB00071H","article-title":"Proteomic characterization of the qualitative and quantitative differences in cervical mucus composition during the menstrual cycle","volume":"11","author":"Grande","year":"2015","journal-title":"Mol. Biosyst."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1023\/A:1006543719401","article-title":"Analysis of pre-ovulatory changes in cervical mucus hydration and sperm penetrability","volume":"13","author":"Katz","year":"1997","journal-title":"Adv. Contracept. Off. J. Soc. Adv. Contracept."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1111\/j.1471-0528.1985.tb01457.x","article-title":"Quantitation of vaginal discharge in healthy volunteers","volume":"92","author":"Godley","year":"1985","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/0304-4165(80)90009-4","article-title":"Composition and functioin of human cervical mucus","volume":"630","author":"Wolf","year":"1980","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/S0015-0282(16)60492-2","article-title":"Histochemical changes in cervical mucus-secreting epithelium during the normal menstrual cycle","volume":"51","author":"Gilks","year":"1989","journal-title":"Fertil. Steril."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4733","DOI":"10.1016\/S0021-9258(18)61257-8","article-title":"Structural studies of sialylated oligosaccharides of human midcycle cervical mucin","volume":"262","author":"Yurewicz","year":"1987","journal-title":"J. Biol. Chem."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"D1245","DOI":"10.2741\/Gipson","article-title":"Mucins of the human endocervix","volume":"6","author":"Gipson","year":"2001","journal-title":"Front. Biosci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1095\/biolreprod60.1.58","article-title":"MUC4 and MUC5B transcripts are the prevalent mucin messenger ribonucleic acids of the human endocervix","volume":"60","author":"Gipson","year":"1999","journal-title":"Biol. Reprod."},{"key":"ref_41","first-page":"594","article-title":"The Amount of MUC5B mucin in cervical mucus peaks at midcycle","volume":"86","author":"Gipson","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1016\/S0002-9378(11)90559-6","article-title":"Human cervical mucus: Research update","volume":"165","author":"Katz","year":"1991","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1034\/j.1600-0412.2003.00041.x","article-title":"Involvement of the glycoproteic meshwork of cervical mucus in the mechanism of sperm orientation","volume":"82","year":"2003","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1073\/pnas.0911748107","article-title":"Nanoparticles reveal that human cervicovaginal mucus is riddled with pores larger than viruses","volume":"107","author":"Lai","year":"2010","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"4429","DOI":"10.1021\/bm401356q","article-title":"The microstructure and bulk rheology of human cervicovaginal mucus are remarkably resistant to changes in pH","volume":"14","author":"Wang","year":"2013","journal-title":"Biomacromolecules"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"8080","DOI":"10.1039\/C6NR09736G","article-title":"The particle in the spider\u2019s web: Transport through biological hydrogels","volume":"9","author":"Witten","year":"2017","journal-title":"Nanoscale"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.copbio.2018.03.010","article-title":"Selective permeability of mucus barriers","volume":"52","author":"Witten","year":"2018","journal-title":"Curr. Opin. Biotechnol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/S0006-3495(94)80802-1","article-title":"Antibody diffusion in human cervical mucus","volume":"66","author":"Saltzman","year":"1994","journal-title":"Biophys. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1086\/418170","article-title":"Menstruation as a defense against pathogens transported by sperm","volume":"68","author":"Profet","year":"1993","journal-title":"Q. Rev. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1006\/cimm.1994.1154","article-title":"Leukocytes migrate through three-dimensional gels of midcycle cervical mucus","volume":"156","author":"Parkhurst","year":"1994","journal-title":"Cell. Immunol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jri.2011.01.005","article-title":"Innate and adaptive immunity at mucosal surfaces of the female reproductive tract: Stratification and integration of immune protection against the transmission of sexually transmitted infections","volume":"88","author":"Hickey","year":"2011","journal-title":"J. Reprod. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Critchfield, A.S., Yao, G., Jaishankar, A., Friedlander, R.S., Lieleg, O., Doyle, P.S., McKinley, G., House, M., and Ribbeck, K. (2013). Cervical mucus properties stratify risk for preterm birth. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0069528"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"10302","DOI":"10.1038\/s41598-017-08057-z","article-title":"Probing the potential of mucus permeability to signify preterm birth risk","volume":"7","author":"Wagner","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1056\/NEJM200005183422007","article-title":"Intrauterine infection and preterm delivery","volume":"342","author":"Goldenberg","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/aogs.12296","article-title":"The cervical mucus plug inhibits, but does not block, the passage of ascending bacteria from the vagina during pregnancy","volume":"93","author":"Hansen","year":"2014","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1530\/REP-16-0396","article-title":"Characterization of the cervical mucus plug in mares","volume":"153","author":"Loux","year":"2017","journal-title":"Reprod. Camb. Engl."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Palombi, C., Paolucci, M., Stradaioli, G., Corubolo, M., Pascolo, P.B., and Monaci, M. (2013). Evaluation of remote monitoring of parturition in dairy cattle as a new tool for calving management. BMC Vet. Res., 9.","DOI":"10.1186\/1746-6148-9-191"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/0007-1935(91)90085-2","article-title":"Mechanical properties of the ovine cervix during pregnancy, labour and immediately after parturition","volume":"147","author":"Owiny","year":"1991","journal-title":"Br. Vet. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/BF01730575","article-title":"Comparative anatomy and histology of the cervix uteri in non-human primates","volume":"13","author":"Hafez","year":"1972","journal-title":"Primates"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/j.theriogenology.2010.05.004","article-title":"Changes in the histomorphology of the canine cervix through the oestrous cycle","volume":"74","author":"Schmidt","year":"2010","journal-title":"Theriogenology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1111\/j.2042-7158.1987.tb03153.x","article-title":"The effects of bromhexine hydrochloride and S-carboxymethyl-L-cysteine on guinea-pig uterine microflora","volume":"39","author":"Malhi","year":"1987","journal-title":"J. Pharm. Pharmacol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1038\/s41467-019-14089-y","article-title":"Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice","volume":"11","author":"Pavlidis","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.reprotox.2015.10.018","article-title":"Assessment of cervical passage of vital dyes in pregnant, nonpregnant, and mated rats and mice","volume":"59","author":"Thompson","year":"2016","journal-title":"Reprod. Toxicol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/aogs.13038","article-title":"Trefoil factor peptide 3 is positively correlated with the viscoelastic properties of the cervical mucus plug","volume":"96","author":"Bastholm","year":"2017","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1067\/mob.2002.123034","article-title":"Antimicrobial factors in the cervical mucus plug","volume":"187","author":"Hein","year":"2002","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Frew, L., Makieva, S., McKinlay, A.T.M., McHugh, B.J., Doust, A., Norman, J.E., Davidson, D.J., and Stock, S.J. (2014). Human cathelicidin production by the cervix. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0103434"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1093\/infdis\/jiy076","article-title":"Human Cervical Mucus Plugs Exhibit Insufficiencies in Antimicrobial Activity Towards Group B Streptococcus","volume":"217","author":"Vornhagen","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/j.0001-6349.2005.00525.x","article-title":"Immunoglobulin levels and phagocytes in the cervical mucus plug at term of pregnancy","volume":"84","author":"Hein","year":"2005","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"(2012). Human Microbiome Project Consortium Structure, function and diversity of the healthy human microbiome. Nature, 486, 207\u2013214.","DOI":"10.1038\/nature11234"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.3389\/fmicb.2016.01936","article-title":"Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?","volume":"7","author":"Miller","year":"2016","journal-title":"Front. Microbiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"132ra52","DOI":"10.1126\/scitranslmed.3003605","article-title":"Temporal dynamics of the human vaginal microbiota","volume":"4","author":"Gajer","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/2049-2618-2-4","article-title":"The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women","volume":"2","author":"Romero","year":"2014","journal-title":"Microbiome"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40168-016-0223-9","article-title":"The interaction between vaginal microbiota, cervical length, and vaginal progesterone treatment for preterm birth risk","volume":"5","author":"Kindinger","year":"2017","journal-title":"Microbiome"},{"key":"ref_75","first-page":"404","article-title":"Qualitative and quantitative differences in normal vaginal flora of conventionally reared mice, rats, hamsters, rabbits, and dogs","volume":"53","author":"Noguchi","year":"2003","journal-title":"Comp. Med."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Vrbanac, A., Riestra, A.M., Coady, A., Knight, R., Nizet, V., and Patras, K.A. (2018). The murine vaginal microbiota and its perturbation by the human pathogen group B Streptococcus. BMC Microbiol., 18.","DOI":"10.1186\/s12866-018-1341-2"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1574-6968.1994.tb07316.x","article-title":"Cell surface appendages of lactobacilli","volume":"124","author":"McGroarty","year":"1994","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1080\/1040841X.2017.1306688","article-title":"Defence factors of vaginal lactobacilli","volume":"44","author":"Kovachev","year":"2018","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.resmic.2017.04.001","article-title":"The role of lactic acid production by probiotic Lactobacillus species in vaginal health","volume":"168","author":"Tachedjian","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"O\u2019Hanlon, D.E., Moench, T.R., and Cone, R.A. (2013). Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0080074"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.resmic.2017.07.004","article-title":"Eve\u2019s garden: Myths, legends and secrets unmasked","volume":"168","author":"Crucitti","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1093\/jac\/dkt156","article-title":"Vaginal concentrations of lactic acid potently inactivate HIV","volume":"68","author":"Aldunate","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_83","first-page":"19","article-title":"Inhibition of herpes simplex virus type 2 by vaginal lactobacilli","volume":"60","author":"Conti","year":"2009","journal-title":"J. Physiol. Pharmacol. Off. J. Pol. Physiol. Soc."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1038\/mi.2017.27","article-title":"Vaginal lactic acid elicits an anti-inflammatory response from human cervicovaginal epithelial cells and inhibits production of pro-inflammatory mediators associated with HIV acquisition","volume":"10","author":"Hearps","year":"2017","journal-title":"Mucosal Immunol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1128\/JCM.42.2.713-717.2004","article-title":"Identification and H(2)O(2) production of vaginal lactobacilli from pregnant women at high risk of preterm birth and relation with outcome","volume":"42","author":"Wilks","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"O\u2019Hanlon, D.E., Moench, T.R., and Cone, R.A. (2011). In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide. BMC Infect. Dis., 11.","DOI":"10.1186\/1471-2334-11-200"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40168-018-0418-3","article-title":"The implausible \u201cin vivo\u201d role of hydrogen peroxide as an antimicrobial factor produced by vaginal microbiota","volume":"6","author":"Tachedjian","year":"2018","journal-title":"Microbiome"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ejogrb.2014.09.018","article-title":"Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: A retrospective comparative study","volume":"182","author":"Parazzini","year":"2014","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1093\/cid\/cir183","article-title":"Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection","volume":"52","author":"Stapleton","year":"2011","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.carbpol.2015.10.035","article-title":"Association of Lactobacillus crispatus with fructo-oligosaccharides and ascorbic acid in hydroxypropyl methylcellulose vaginal insert","volume":"136","author":"Vitali","year":"2016","journal-title":"Carbohydr. Polym."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"e01084-15","DOI":"10.1128\/mBio.01084-15","article-title":"Enhanced Trapping of HIV-1 by Human Cervicovaginal Mucus Is Associated with Lactobacillus crispatus-Dominant Microbiota","volume":"6","author":"Nunn","year":"2015","journal-title":"mBio"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e01548-19","DOI":"10.1128\/mBio.01548-19","article-title":"The Cervicovaginal Microbiota-Host Interaction Modulates Chlamydia trachomatis Infection","volume":"10","author":"Edwards","year":"2019","journal-title":"mBio"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/S0006-3495(99)77288-7","article-title":"pH-dependent conformational change of gastric mucin leads to sol-gel transition","volume":"76","author":"Cao","year":"1999","journal-title":"Biophys. J."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"11196","DOI":"10.1128\/JVI.01899-08","article-title":"Human immunodeficiency virus type 1 is trapped by acidic but not by neutralized human cervicovaginal mucus","volume":"83","author":"Lai","year":"2009","journal-title":"J. Virol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"276ra27","DOI":"10.1126\/scitranslmed.3010525","article-title":"Oxidation increases mucin polymer cross-links to stiffen airway mucus gels","volume":"7","author":"Yuan","year":"2015","journal-title":"Sci. Transl. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/j.1574-6968.2011.02495.x","article-title":"Characterization of the adherence properties of human Lactobacilli strains to be used as vaginal probiotics","volume":"328","author":"Urdaci","year":"2012","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1111\/jam.12642","article-title":"Phenotypic surface properties (aggregation, adhesion and biofilm formation) and presence of related genes in beneficial vaginal lactobacilli","volume":"117","author":"Mendoza","year":"2014","journal-title":"J. Appl. Microbiol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e00800-19","DOI":"10.1128\/AEM.00800-19","article-title":"Putative Adhesion Factors in Vaginal Lactobacillus gasseri DSM 14869: Functional Characterization","volume":"85","author":"Zeng","year":"2019","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1128\/IAI.66.5.1985-1989.1998","article-title":"Adherence of human vaginal lactobacilli to vaginal epithelial cells and interaction with uropathogens","volume":"66","author":"Boris","year":"1998","journal-title":"Infect. Immun."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"613","DOI":"10.3390\/nu3050613","article-title":"Lactobacillus adhesion to mucus","volume":"3","author":"Miller","year":"2011","journal-title":"Nutrients"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1258\/095646207780749583","article-title":"Bacterial vaginal flora in relation to changing oestrogen levels","volume":"18","author":"Wilson","year":"2007","journal-title":"Int. J. STD AIDS"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1080\/01443615.2017.1395398","article-title":"To \u201cdouche\u201d or not to \u201cdouche\u201d: Hygiene habits may have detrimental effects on vaginal microbiota","volume":"38","author":"Aslan","year":"2018","journal-title":"J. Obstet. Gynaecol. J. Inst. Obstet. Gynaecol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1097\/OLQ.0b013e3181ca3cac","article-title":"Prevalence and risks for bacterial vaginosis in women who have sex with women","volume":"37","author":"Marrazzo","year":"2010","journal-title":"Sex. Transm. Dis."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1093\/infdis\/jiw121","article-title":"Pathogenesis of Bacterial Vaginosis: Discussion of Current Hypotheses","volume":"214","author":"Muzny","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S0924-8579(00)00350-2","article-title":"Recurrent urinary tract infection in women","volume":"17","author":"Hooton","year":"2001","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.resmic.2015.10.006","article-title":"A DNA tool for early detection of vaginal dysbiosis in African women","volume":"167","author":"Jespers","year":"2016","journal-title":"Res. Microbiol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.1056\/NEJMra1808418","article-title":"Bacterial Vaginosis and Desquamative Inflammatory Vaginitis","volume":"379","author":"Paavonen","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/j.tim.2019.07.006","article-title":"Host-Pathogen Interactions during Female Genital Tract Infections","volume":"27","author":"Pekmezovic","year":"2019","journal-title":"Trends Microbiol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/0002-9343(83)91112-9","article-title":"Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations","volume":"74","author":"Amsel","year":"1983","journal-title":"Am. J. Med."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.resmic.2017.02.001","article-title":"Bacterial biofilms in the vagina","volume":"168","author":"Hardy","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Hoang, T., Toler, E., DeLong, K., Mafunda, N.A., Bloom, S.M., Zierden, H.C., Moench, T.R., Coleman, J.S., Hanes, J., and Kwon, D.S. (2020). The cervicovaginal mucus barrier to HIV-1 is diminished in bacterial vaginosis. PLoS Pathog., 16.","DOI":"10.1371\/journal.ppat.1008236"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1128\/jcm.27.2.251-256.1989","article-title":"Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis","volume":"27","author":"Eschenbach","year":"1989","journal-title":"J. Clin. Microbiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/00007435-200303000-00016","article-title":"Glycosidase and proteinase activity of anaerobic gram-negative bacteria isolated from women with bacterial vaginosis","volume":"30","author":"Olmsted","year":"2003","journal-title":"Sex. Transm. Dis."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Moncla, B.J., Chappell, C.A., Debo, B.M., and Meyn, L.A. (2016). The Effects of Hormones and Vaginal Microflora on the Glycome of the Female Genital Tract: Cervical-Vaginal Fluid. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158687"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"5504","DOI":"10.1128\/JCM.43.11.5504-5508.2005","article-title":"A novel bacterial mucinase, glycosulfatase, is associated with bacterial vaginosis","volume":"43","author":"Roberton","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"12067","DOI":"10.1074\/jbc.M113.453654","article-title":"Degradation, foraging, and depletion of mucus sialoglycans by the vagina-adapted Actinobacterium Gardnerella vaginalis","volume":"288","author":"Lewis","year":"2013","journal-title":"J. Biol. Chem."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"2648","DOI":"10.1093\/jac\/dkt244","article-title":"Proteome profiles of vaginal fluids from women affected by bacterial vaginosis and healthy controls: Outcomes of rifaximin treatment","volume":"68","author":"Cruciani","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"11640","DOI":"10.1038\/srep11640","article-title":"Using an in-vitro biofilm model to assess the virulence potential of bacterial vaginosis or non-bacterial vaginosis Gardnerella vaginalis isolates","volume":"5","author":"Castro","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1086\/314505","article-title":"Impairment of the mucosal immune system: IgA and IgM cleavage detected in vaginal washings of a subgroup of patients with bacterial vaginosis","volume":"178","author":"Cauci","year":"1998","journal-title":"J. Infect. Dis."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1038\/s41598-018-20649-x","article-title":"In vivo microbiome and associated immune markers: New insights into the pathogenesis of vaginal dysbiosis","volume":"8","author":"Campisciano","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/QAI.0b013e318189a7ca","article-title":"Bacterial vaginosis in HIV-infected women induces reversible alterations in the cervical immune environment","volume":"49","author":"Rebbapragada","year":"2008","journal-title":"J. Acquir. Immune Defic. Syndr. 1999"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1089\/aid.2015.0006","article-title":"Bacterial Vaginosis and Subclinical Markers of Genital Tract Inflammation and Mucosal Immunity","volume":"31","author":"Thurman","year":"2015","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/QCO.0000000000000620","article-title":"Host-vaginal microbiota interactions in the pathogenesis of bacterial vaginosis","volume":"33","author":"Muzny","year":"2020","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0002-9378(98)70430-2","article-title":"Immunoglobulin A response against Gardnerella vaginalis hemolysin and sialidase activity in bacterial vaginosis","volume":"178","author":"Cauci","year":"1998","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and causes of preterm birth","volume":"371","author":"Goldenberg","year":"2008","journal-title":"Lancet"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1007\/s00404-014-3367-5","article-title":"Would it be too late? A retrospective case-control analysis to evaluate maternal-fetal outcomes in advanced maternal age","volume":"290","author":"Ciancimino","year":"2014","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1126\/science.1251816","article-title":"Preterm labor: One syndrome, many causes","volume":"345","author":"Romero","year":"2014","journal-title":"Science"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1086\/521628","article-title":"Cytokines, pregnancy, and bacterial vaginosis: Comparison of levels of cervical cytokines in pregnant and nonpregnant women with bacterial vaginosis","volume":"196","author":"Beigi","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"132.e1","DOI":"10.1016\/j.ajog.2007.05.035","article-title":"Among pregnant women with bacterial vaginosis, the hydrolytic enzymes sialidase and prolidase are positively associated with interleukin-1beta","volume":"198","author":"Cauci","year":"2008","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_131","first-page":"701","article-title":"IL-1beta, IL-6, TNFalpha, fetal fibronectin, and endotoxin in the lower genital tract of pregnant women with bacterial vaginosis","volume":"77","author":"Hosseini","year":"1998","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/0090-6980(92)90082-5","article-title":"Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis","volume":"43","author":"Brandberg","year":"1992","journal-title":"Prostaglandins"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/0002-9378(93)90274-M","article-title":"Endotoxin and interleukin-1 alpha in the cervical mucus and vaginal fluid of pregnant women with bacterial vaginosis","volume":"169","author":"Thomsen","year":"1993","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1089\/jwh.2018.7383","article-title":"Characterization and Treatment of Recurrent Bacterial Vaginosis","volume":"28","author":"Faught","year":"2019","journal-title":"J. Womens Health"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1086\/503780","article-title":"High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence","volume":"193","author":"Bradshaw","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.3389\/fmicb.2015.01528","article-title":"Bacterial Vaginosis Biofilms: Challenges to Current Therapies and Emerging Solutions","volume":"6","author":"Machado","year":"2016","journal-title":"Front. Microbiol."},{"key":"ref_137","first-page":"657","article-title":"Probiotics for the treatment of women with bacterial vaginosis","volume":"13","author":"Falagas","year":"2007","journal-title":"Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"ref_138","unstructured":"(2012). Comparative Anatomy and Histology, Elsevier."},{"key":"ref_139","doi-asserted-by":"crossref","unstructured":"Byers, S.L., Wiles, M.V., Dunn, S.L., and Taft, R.A. (2012). Mouse estrous cycle identification tool and images. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0035538"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1093\/infdis\/136.2.271","article-title":"Quantitative bacteriology of the vaginal flora","volume":"136","author":"Bartlett","year":"1977","journal-title":"J. Infect. Dis."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1099\/jmm.0.012583-0","article-title":"Vaginal colonization and activity of the probiotic bacterium Lactobacillus fermentum L23 in a murine model of vaginal tract infection","volume":"59","author":"Pascual","year":"2010","journal-title":"J. Med. Microbiol."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1128\/iai.60.6.2375-2379.1992","article-title":"Mouse intravaginal infection with Trichomonas vaginalis and role of Lactobacillus acidophilus in sustaining infection","volume":"60","author":"McGrory","year":"1992","journal-title":"Infect. Immun."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4103\/0971-5916.162127","article-title":"Evaluation of profertility effect of probiotic Lactobacillus plantarum 2621 in a murine model","volume":"142","author":"Bhandari","year":"2015","journal-title":"Indian J. Med. Res."},{"key":"ref_144","doi-asserted-by":"crossref","unstructured":"Barfod, K.K., Roggenbuck, M., Hansen, L.H., Schj\u00f8rring, S., Larsen, S.T., S\u00f8rensen, S.J., and Krogfelt, K.A. (2013). The murine lung microbiome in relation to the intestinal and vaginal bacterial communities. BMC Microbiol., 13.","DOI":"10.1186\/1471-2180-13-303"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0165-0378(97)00081-8","article-title":"Immunity to vaginal infection by herpes simplex virus type 2 in adult mice: Characterization of the immunoglobulins in vaginal mucus","volume":"38","author":"Parr","year":"1998","journal-title":"J. Reprod. Immunol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"e44591","DOI":"10.1038\/srep44591","article-title":"In vivo imaging of the Muc5b gel-forming mucin","volume":"7","author":"Portal","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1513\/AnnalsATS.201802-085AW","article-title":"Transgenic Mouse Reporter to Study Muc5b In Vivo","volume":"15","author":"Desseyn","year":"2018","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1126\/science.1069094","article-title":"Colorectal cancer in mice genetically deficient in the mucin Muc2","volume":"295","author":"Velcich","year":"2002","journal-title":"Science"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1038\/nature12807","article-title":"Muc5b is required for airway defence","volume":"505","author":"Roy","year":"2014","journal-title":"Nature"},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s00418-019-01785-5","article-title":"Muc5b is mainly expressed and sialylated in the nasal olfactory epithelium whereas Muc5ac is exclusively expressed and fucosylated in the nasal respiratory epithelium","volume":"152","author":"Amini","year":"2019","journal-title":"Histochem. Cell Biol."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"bio046359","DOI":"10.1242\/bio.046359","article-title":"Muc5b-deficient mice develop early histological lung abnormalities","volume":"8","author":"Valque","year":"2019","journal-title":"Biol. Open"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1084\/jem.20102057","article-title":"Muc5ac: A critical component mediating the rejection of enteric nematodes","volume":"208","author":"Hasnain","year":"2011","journal-title":"J. Exp. Med."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"9577","DOI":"10.1038\/srep09577","article-title":"Delivery of a mucin domain enriched in cysteine residues strengthens the intestinal mucous barrier","volume":"5","author":"Gouyer","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"16993","DOI":"10.1038\/s41598-019-53547-x","article-title":"Mucin CYS domain stiffens the mucus gel hindering bacteria and spermatozoa","volume":"9","author":"Demouveaux","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"1800897","DOI":"10.1080\/19490976.2020.1800897","article-title":"Impact and consequences of intensive chemotherapy on intestinal barrier and microbiota in acute myeloid leukemia: The role of mucosal strengthening","volume":"12","author":"Hueso","year":"2020","journal-title":"Gut Microbes"},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1093\/glycob\/cwq134","article-title":"High-sensitivity O-glycomic analysis of mice deficient in core 2 {beta}1,6-N-acetylglucosaminyltransferases","volume":"21","author":"Ismail","year":"2011","journal-title":"Glycobiology"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"3770","DOI":"10.1128\/MCB.00204-09","article-title":"Glycosyltransferase function in core 2-type protein O glycosylation","volume":"29","author":"Stone","year":"2009","journal-title":"Mol. Cell. Biol."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/BF02602853","article-title":"Neisseria gonorrhoeae: Acquisition of auxotrophy in the mouse","volume":"1","author":"Kenyon","year":"1978","journal-title":"Curr. Microbiol."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/0002-9378(76)90888-7","article-title":"An experimental model for disseminated herpesvirus infection of the neonate","volume":"125","author":"Amstey","year":"1976","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1093\/infdis\/135.5.837","article-title":"Infection and fertilization of mice after artificial insemination with a mixture of sperm and murine cytomegalovirus","volume":"135","author":"Young","year":"1977","journal-title":"J. Infect. Dis."},{"key":"ref_161","doi-asserted-by":"crossref","unstructured":"Hu, J., Cladel, N.M., Budgeon, L.R., Balogh, K.K., and Christensen, N.D. (2017). The Mouse Papillomavirus Infection Model. Viruses, 9.","DOI":"10.3390\/v9090246"},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1093\/jnci\/94.21.1604","article-title":"Herpes simplex virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical cancer","volume":"94","author":"Smith","year":"2002","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_163","doi-asserted-by":"crossref","unstructured":"Olmsted, S.S., Khanna, K.V., Ng, E.M., Whitten, S.T., Johnson, O.N., Markham, R.B., Cone, R.A., and Moench, T.R. (2005). Low pH immobilizes and kills human leukocytes and prevents transmission of cell-associated HIV in a mouse model. BMC Infect. Dis., 5.","DOI":"10.1186\/1471-2334-5-79"},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.intimp.2018.09.043","article-title":"The antiviral activity of arbidol hydrochloride against herpes simplex virus type II (HSV-2) in a mouse model of vaginitis","volume":"68","author":"Du","year":"2019","journal-title":"Int. Immunopharmacol."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1038\/s41467-018-07993-2","article-title":"Interferon lambda protects the female reproductive tract against Zika virus infection","volume":"10","author":"Caine","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_166","doi-asserted-by":"crossref","unstructured":"Almeida, A.B., Ara\u00fajo, P.F., Bernal, F.M., and Rosa, A. (2019). de C.; Valente, S.A.; Teixeira, A.R.L. Sexual Transmission of American Trypanosomes from Males and Females to Naive Mates. J. Vis. Exp. JoVE.","DOI":"10.3791\/57985"},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.peptides.2018.12.004","article-title":"Epinecidin-1: A marine fish antimicrobial peptide with therapeutic potential against Trichomonas vaginalis infection in mice","volume":"112","author":"Huang","year":"2019","journal-title":"Peptides"},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"e00834-18","DOI":"10.1128\/IAI.00834-18","article-title":"Characterization of the Horizontal and Vertical Sexual Transmission of Chlamydia Genital Infections in a New Mouse Model","volume":"87","author":"Pal","year":"2019","journal-title":"Infect. Immun."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1146\/annurev-micro-090816-093530","article-title":"Neisseria gonorrhoeae: Drug Resistance, Mouse Models, and Vaccine Development","volume":"71","author":"Rice","year":"2017","journal-title":"Annu. Rev. Microbiol."},{"key":"ref_170","doi-asserted-by":"crossref","unstructured":"Liao, H., Liu, S., Wang, H., Su, H., and Liu, Z. (2019). Enhanced antifungal activity of bovine lactoferrin-producing probiotic Lactobacillus casei in the murine model of vulvovaginal candidiasis. BMC Microbiol., 19.","DOI":"10.1186\/s12866-018-1370-x"},{"key":"ref_171","doi-asserted-by":"crossref","unstructured":"Gilbert, N.M., Lewis, W.G., and Lewis, A.L. (2013). Clinical features of bacterial vaginosis in a murine model of vaginal infection with Gardnerella vaginalis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0059539"},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1093\/infdis\/jiy704","article-title":"Gardnerella vaginalis and Prevotella bivia Trigger Distinct and Overlapping Phenotypes in a Mouse Model of Bacterial Vaginosis","volume":"220","author":"Gilbert","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"934","DOI":"10.4049\/jimmunol.1300661","article-title":"Viral infection of the pregnant cervix predisposes to ascending bacterial infection","volume":"191","author":"Racicot","year":"2013","journal-title":"J. Immunol."},{"key":"ref_174","first-page":"922","article-title":"Mouse models of preterm birth: Suggested assessment and reporting guidelines","volume":"99","author":"McCarthy","year":"2018","journal-title":"Biol. Reprod."},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"5481","DOI":"10.1172\/JCI78765","article-title":"Hyaluronan in cervical epithelia protects against infection-mediated preterm birth","volume":"124","author":"Akgul","year":"2014","journal-title":"J. Clin. Investig."},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1016\/j.ajpath.2018.06.016","article-title":"Ascending Vaginal Infection Using Bioluminescent Bacteria Evokes Intrauterine Inflammation, Preterm Birth, and Neonatal Brain Injury in Pregnant Mice","volume":"188","author":"Suff","year":"2018","journal-title":"Am. J. Pathol."},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/0002-9378(94)90040-X","article-title":"Transvaginal ultrasonographic evaluation of the cervix before labor: Presence of cervical wedging is associated with shorter duration of induced labor","volume":"171","author":"Boozarjomehri","year":"1994","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1093\/humrep\/dew123","article-title":"Prevalence of infertility and help seeking among 15,000 women and men","volume":"31","author":"Datta","year":"2016","journal-title":"Hum. Reprod. Oxf. Engl."},{"key":"ref_179","unstructured":"Strauss, J.F., and Barbieri, R.L. (2019). Chapter 22\u2014Female Infertility. Yen and Jaffe\u2019s Reproductive Endocrinology, Elsevier. [8th ed.]."},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.addr.2017.12.002","article-title":"Technological strategies to estimate and control diffusive passage times through the mucus barrier in mucosal drug delivery","volume":"124","author":"Newby","year":"2018","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"138ra79","DOI":"10.1126\/scitranslmed.3003453","article-title":"Mucus-penetrating nanoparticles for vaginal drug delivery protect against herpes simplex virus","volume":"4","author":"Ensign","year":"2012","journal-title":"Sci. Transl. Med."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/21\/21\/8266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:29:17Z","timestamp":1760178557000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/21\/21\/8266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,4]]},"references-count":181,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["ijms21218266"],"URL":"https:\/\/doi.org\/10.3390\/ijms21218266","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,4]]}}}