# Association Between Gardnerella vaginalis Vaginolysin Level and Clinical Symptoms of Bacterial Vaginosis

## TL;DR

This study shows that high levels of a toxin from Gardnerella vaginalis are linked to severe symptoms of bacterial vaginosis.

## Contribution

The study reveals a nonlinear relationship between vaginolysin levels and symptom severity in bacterial vaginosis.

## Key findings

- Gardnerella vaginalis is present in healthy women but causes symptoms only at high vaginolysin levels.
- High vaginolysin levels correlate with increased inflammation and symptom severity in bacterial vaginosis.
- Low to moderate vaginolysin levels have minimal impact on clinical symptoms.

## Abstract

This study examined the role of vaginolysin (VLY), a virulence factor of the bacterium Gardnerella vaginalis (GV), in bacterial vaginosis (BV). In a group of 112 women with BV (diagnosis on the Nugent scale ≥7 points) and 122 control cases with normal microbiota, VLY levels, the state of the vaginal microecology (colposcopy, laboratory markers, pH), GV genotypes (clades 1–4), and clinical symptoms were assessed. It was found that GV also occurs in healthy women, but VLY levels are significantly higher in BV and correlate with inflammatory markers (e.g., leukocyte esterase) and symptom severity. However, the relationship is nonlinear: low and moderate VLY levels have little effect on symptoms, while high levels cause a sharp increase in symptoms. Thus, VLY is potentially important for the pathophysiology and clinical assessment of BV.