Seminars

Bacterial vaginosis (BV) frequently recurs despite antibiotics and probiotics, suggesting missing host regulators. A cellular automaton model shows that treatment outcomes depend on epithelial recovery dynamics rather than bacterial killing alone. Clinical glycomics and mechanistic assays identify cervicovaginal mucus as this control layer: mucin diversity tracks microbial diversity, suppresses pathogen toxicity and biofilms, and promotes commensal fitness. Host-directed modulation of mucus may reshape the ecosystem to stabilize health.