title: Individualized medicine and the microbiome in reproductive tract.
abstract: Humans have evolved along with the millions of microorganisms that populate their bodies. These microbes (10(14)) outnumber human cells by 10 to 1 and account for 3 × 10(6) genes, more than ten times the 25,000 human genes. This microbial metagenome acts as our "other genome" and like our own genes, is unique to the individual. Recent international efforts such as the Human Microbiome Project (HMP) and the MetaHIT Project have helped catalog these microbial genomes using culture-independent, high-throughput, next-generation sequencing. This manuscript will describe recent efforts to define microbial diversity in the female reproductive tract because of the impact that microbial function has on reproductive efficiency. In this review, we will discuss current evidence that microbial communities are critical for maintaining reproductive health and how perturbations of microbial community structures can impact reproductive health from the aspect of infection, reproductive cyclicity, pregnancy, and disease states. Investigations of the human microbiome are propelling interventional strategies from treating medical populations to treating individual patients. In particular, we highlight how understanding and defining microbial community structures in different disease and physiological states have lead to the discovery of biomarkers and, more importantly, the development and implementation of microbial intervention strategies (probiotics) into modern day medicine. Finally this review will conclude with a literature summary of the effectiveness of microbial intervention strategies that have been implemented in animal and human models of disease and the potential for integrating these microbial intervention strategies into standard clinical practice.
authors.affiliation: Department of Medical Microbiology, Immunology and Cell Biology, Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine Springfield, IL, USA.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Braundmeier
authors.affiliation: Department of Medical Microbiology, Immunology and Cell Biology, Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine Springfield, IL, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Lenz
authors.affiliation: Department of Cancer Biology, Mayo Clinic College of Medicine Jacksonville, FL, USA.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Inman
authors.affiliation: The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Division of Nutritional Sciences, University of Illinois Urbana, IL, USA ; Biomedical Engineering and Physiology, Mayo College Rochester, MN, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Chia
authors.affiliation: The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA ; Department of Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Patricio
authors.initials: P
authors.lastname: Jeraldo
authors.affiliation: The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Department of Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Marina R S
authors.initials: MR
authors.lastname: Walther-António
authors.affiliation: Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA.
authors.forename: Margret E
authors.initials: ME
authors.lastname: Berg Miller
authors.affiliation: Division of Nutritional Sciences, University of Illinois Urbana, IL, USA ; Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA.
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Mayo Clinic Rochester, MN, USA.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Creedon
authors.affiliation: The Center for Individualized Medicine, Mayo Clinic Rochester, MN, USA ; Department of Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Nelson
authors.affiliation: Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana, IL, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: White
keywords: Pregnancy; biomarkers; individualized medicine; microbiome; reproductive tract infections