A new sequencing-based women’s health assay combining self-sampling, HPV detection and genotyping, STI detection, and vaginal microbiome analysis

Bik, E. M.; Bird, S. W.; Bustamante, J. P.; Leon, L. E.; Nieto, P. A.; Addae, K.; Alegria-Mera, V.; Bravo, C.; Bravo, D.; Cardenas, J. P.; Caughey, A.; Covarrubias, P. C.; Perez-Donoso, J.; Gass, G.; Gupta, S. L.; Harman, K.; Hongo, D. M. B.; Jimenez, J. C.; Kraal, L.; Melis-Arcos, F.; Morales, E. H.; Morton, A.; Navas, C. F.; Nunez, H.; Olivares, E.; Ordenes-Aenishanslins, N.; Ossandon, F. J.; Phan, R.; Pino, R.; Soto-Liebe, K.; Varas, I.; Walton, N. A.; Vera-Wolf, P.; Almonacid, D. E.; Goddard, A. D.; Ugalde, J. A.; Richman, J.; Apte, Z. S.

doi:10.1101/217216

Home/Archive/bioRxiv

bioRxiv · 10.1101/217216

A new sequencing-based women’s health assay combining self-sampling, HPV detection and genotyping, STI detection, and vaginal microbiome analysis

View original source ↗Export metadata ↓

Abstract

The composition of the vaginal microbiome, including both the presence of pathogens involved in sexually transmitted infections (STI) as well as commensal microbiota, has been shown to have important associations for a womans reproductive and general health. Currently, healthcare providers cannot offer comprehensive vaginal microbiome screening, but are limited to the detection of individual pathogens, such as high-risk human papillomavirus (hrHPV), the predominant cause of cervical cancer. There is no single test on the market that combines HPV, STI, and microbiome screening. Here, we describe a novel inclusive womens health assay that combines self-sampling with sequencing-based HPV detection and genotyping, vaginal microbiome analysis, and STI-associated pathogen detection. The assay includes genotyping and detection of 14 hrHPV types, 5 low-risk HPV types (lrHPV), as well as the relative abundance of 32 bacterial taxa of clinical importance, including Lactobacillus, Sneathia, Gardnerella, and 4 pathogens involved in STI, with high sensitivity, specificity, and reproducibility. For each of these taxa, healthy ranges were determined in a group of 50 self-reported healthy women. The hrHPV portion of the test was evaluated against the Digene High-Risk HPV HC2 DNA test with vaginal samples obtained from 185 women. Results were concordant for 181/185 of the samples (overall agreement of 97.83%, Cohens kappa = 0.93), with sensitivity and specificity values of 94.74% and 98.64%, respectively. Two discrepancies were caused by the Digene assays known cross-reactivity with low-risk HPV types, while two additional samples were found to contain hrHPV not detected by Digene. This novel assay could be used to complement conventional cervical cancer screening, because its self-sampling format can expand access among women who would otherwise not participate, and because of its additional information about the composition of the vaginal microbiome and the presence of pathogens.

Source connections

Published article ↗

Explore related subjects

microbiology Preprint

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Bik, E. M., Bird, S. W., Bustamante, J. P., Leon, L. E., Nieto, P. A., Addae, K., Alegria-Mera, V., Bravo, C., Bravo, D., Cardenas, J. P., Caughey, A., Covarrubias, P. C., Perez-Donoso, J., Gass, G., Gupta, S. L., Harman, K., Hongo, D. M. B., Jimenez, J. C., Kraal, L., Melis-Arcos, F., Morales, E. H., Morton, A., Navas, C. F., Nunez, H., Olivares, E., Ordenes-Aenishanslins, N., Ossandon, F. J., Phan, R., Pino, R., Soto-Liebe, K., Varas, I., Walton, N. A., Vera-Wolf, P., Almonacid, D. E., Goddard, A. D., Ugalde, J. A., Richman, J., Apte, Z. S.. 2017-11-13. A new sequencing-based women’s health assay combining self-sampling, HPV detection and genotyping, STI detection, and vaginal microbiome analysis. https://doi.org/10.1101/217216

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2026

Lipid nanoparticle-encapsulated mRNA encoding CagW, a conserved component of the Helicobacter pylori type IV secretion system, protects mice against H. pylori challenge

Background: Roughly one person in two carries Helicobacter pylori, a pathogen classified by the World Health Organization as a group I carcinogen, and the steady loss of antibiotic efficacy has made prophylaxis an urgent rather than an optional goal. No mRNA vaccine against this organism has yet been tested in the clinic, and CagW, a conserved inner-membrane subunit of the H. pylori type IV secretion system (T4SS), has never been evaluated as an mRNA-encoded antigen. Methods: A codon-optimised construct carrying a signal peptide, the CagW coding sequence and a human IgG Fc tag was synthesised, transcribed into mRNA, encapsulated in lipid nanoparticles (LNPs) and shown to direct antigen expression in HEK293T cells. C57BL/6 mice received three intramuscular doses of CagW-Fc mRNA-LNPs (5 ug mRNA each) at 14-day intervals; animals given alum alone, luciferase mRNA-LNPs or CagW protein adsorbed to alum served as comparators. Humoral readouts (IgG, IgG1, IgG2a, IgM, IgA and secretory IgA), lymphocyte proliferation, CD4+/CD8+ subsets, intracellular IFN-{gamma}, IL-4 and IL-17A and circulating cytokines were quantified before challenge, and protection was assessed after live challenge. Results: The formulation (93.2 nm; PDI 0.13; approximately 90% encapsulation) produced CagW-specific protein in vitro. Vaccination raised high-titre CagW-specific IgG (maximal on day 42), IgM and mucosal sIgA, and drove Th1/Th2-type cellular activation (IL-2, IL-4, IL-12, IFN-{gamma} and IL-17A). After challenge, immunised animals carried markedly fewer gastric bacteria and showed lower urease activity than controls. Conclusions: CagW-Fc mRNA-LNPs are therefore a credible mRNA vaccine platform for H. pylori and warrant further preclinical development.

microbiology↗

bioRxiv2026

Experimental evolution reveals temporally opposing roles for Csu pili during Acinetobacter baumannii respiratory infection

Multidrug-resistant (MDR) Acinetobacter baumannii is an opportunistic pathogen responsible for a wide range of infections, including ventilator-associated pneumonia, bloodstream infections, and urinary tract infections. Most studies investigating A. baumannii pulmonary pathogenesis rely on acute pneumonia models that use high bacterial inocula and do not recapitulate the prolonged infections observed in some patients. Recently, our laboratory developed a murine model of chronic pulmonary infection that enabled the identification of virulence factors specifically required for long-term lung persistence. To investigate how A. baumannii adapts during chronic pulmonary infection, we performed an experimental evolution study using this model. This approach revealed an unexpected role for the archaic chaperone-usher (Csu) pili in A. baumannii pathogenesis. At early time points, Csu expression reduced bacterial burdens in both acute and chronic pneumonia models, an effect associated with enhanced host inflammatory responses. In contrast, at later stages of chronic infection, Csu promoted bacterial persistence, potentially by facilitating adhesion to pulmonary epithelial cells. These opposing effects were conserved across two distinct A. baumannii clinical isolates. We also found that Csu contributes to bacterial colonization in a catheter-associated urinary tract infection (CAUTI) model in a strain-dependent manner. Together, these findings reveal an infection-stage-dependent role for Csu in A. baumannii pathogenesis, demonstrating that a bacterial surface structure can impair early colonization while promoting long-term persistence.

microbiology↗

bioRxiv2026

A Vma13-targeted thiadiazole-succinimide disrupts V-ATPase dependent arginine-polyamine homeostasis to block Candida albicans escape from macrophages

Invasive candidiasis caused by Candida albicans is a life-threatening nosocomial infection with limited therapies and high morbidity and mortality among immunocompromised patients. Within host phagocytes, C. albicans catabolizes arginine to produce ammonia and fuels polyamine biosynthesis, which correlates with phagosomal alkalinization and yeast-to-hypha morphogenesis, facilitating macrophage escape and systemic dissemination. However, new antifungal strategies blocking this fungal escape remain scarce. Here, we characterize the thiadiazole-succinimide derivative ETSI, an arginine-dependent antifungal small molecule with minimal direct growth inhibition under arginine-free conditions yet robust anti-C. albicans activity in arginine-rich microenvironments mimicking the macrophage intracellular niche. Mechanistically, ETSI targets the vacuolar Vma13 to inhibit vacuolar H-ATPase (V-ATPase), dissipating vacuolar proton (H+) gradients and leading to cytoplasmic H+ retention. The accumulated cytoplasmic H+ traps intracellular ammonia and blocks its external release, while impaired vacuolar metabolite sequestration further triggers cytotoxic accumulation of arginine and polyamine metabolites. This dual metabolic perturbation suppresses phagosomal alkalinization, retains C. albicans in yeast form and blocks macrophage escape. ETSI is the first small molecule blocking C. albicans escape via disrupted Vma13/V-ATPase dependent arginine-polyamine homeostasis. This work identifies an intracellular metabolic vulnerability and establishes a niche-targeted antifungal strategy distinct from classic growth-suppressive drugs for treating invasive candidiasis.

microbiology↗