Vincent Center for Reproductive Biology
Mitchell Lab: Caroline Mitchell, MD, MPH
Vincent Center for Reproductive Biology
Thier Building, Floor 9
55 Fruit Street
Boston,
MA
02114
Phone: 617-724-6047
Explore This Lab
Overview
The primary goal of research in the Mitchell Lab is to increase our understanding of the role of the vaginal microbiome in reproductive health in order to drive novel interventions to improve women’s health. Our work includes clinical studies, translational analyses and experiments at the bench to identify key pathways in host-microbe interactions, and ways to intervene to promote vaginal health. Humans are the only species with a Lactobacillus-dominant vaginal microbiota, thus all of our work involves human samples or human cell lines.
Our Current Projects
MOTIF (Modifying Organisms Transvaginally in Females)
This is an NIH-funded, randomized trial of vaginal microbiome transplant (VMT) to prevent recurrent bacterial vaginosis. In this study, people with a history of recurrent BV are given antibiotic treatment and then randomized to either transplant of Lactobacillus rich vaginal fluid (which is pre-tested to ensure no infections) or sterile water placebo. This study will help us identify what features of healthy vaginal fluid can transfer protection from BV and will allow development of new preventive therapies. This study is part of a close collaboration between the Mitchell Lab and the Kwon Lab at the Ragon Institute of MGH, MIT and Harvard.
Interested in being a healthy donor? LEARN MORE
Interested in being part of the VMT trial? LEARN MORE
THRIVE
In this study, we are looking into what allows HPV (human papillomavirus, #1 cause of cervical cancer) to either clear on its own or persist without progression to cervical cancer. This research can hopefully help to create a therapeutic vaccine for HR-HPV types, many of which are not targeted by available vaccines (Gardasil).
VIBRANT
We're conducting a clinical trial to assess the safety, tolerability, and effectiveness of a vaginally inserted live biotherapeutic product containing multiple strains of Lactobacillus crispatus to prevent recurrent bacterial vaginosis.
RituxiVag
This is an NIH-funded study of women receiving rituximab (a medication that decreases B-cells in the bloodstream) for treatment of autoimmune disorders. The study arose from clinical observations in patients shared between Dr. Mitchell and Dr. John Niles of the Vasculitis and Glomerulonephritis Center. Our goal is to identify the impact of B-cells on the vaginal microbiome and vaginal immunity. This will help us better understand vaginal immunity overall.
V2
Patients seen in the MGH Gynecology clinic, and in Dr. Mitchell’s vulvovaginitis clinic have the opportunity to contribute to an observational cohort study collecting vaginal samples from a wide range of women to improve our understanding of the basic biology of the human vaginal mucosa and microbiota. Samples from this study have already helped us examine links between symptoms, microbiome and inflammatory markers.
Who We Are
Caroline Mitchell, MD, MPH
Caroline Mitchell, MD, MPH, is a faculty member in the Vincent Center for Reproductive Biology at Massachusetts General Hospital in Boston, an Associate Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and the Director of the Vulvovaginal Disorders Program at Massachusetts General Hospital. Dr. Mitchell received her undergraduate degree from Harvard College with a concentration in Women’s Studies, then spent 2 years in the Peace Corps in Southern Africa as a high school science teacher. She completed her medical school at Harvard, and her OB/Gyn residency training and an MPH at the University of Washington in Seattle. She spent 7 years on faculty at the UW before returning to Boston and MGH in 2014.
Dr. Mitchell's research focuses on the role of the vaginal microbiome in women’s sexual and reproductive health. Clinically, she sees patients with complex vulvovaginal disorders, and recurrent vaginal infections. She has received funding from the NIH, the Doris Duke Foundation, the Bill & Melinda Gates Foundation, the American Association of Obstetricians & Gynecologists Fund, the MGH Claflin Award, and is a member of the Vaginal Microbiome Research Consortium.
Meet Our Team
Ofri Bar, MD
Research Fellow
Ofri is a joint PhD student in Caroline Mitchell’s lab and Moran Yassour’s lab (The Hebrew University of Jerusalem in Israel). Ofri is interested in studying the mother-to-child transmission of bacteria and how it affects the establishment of the infant gut microbiome in early life.
Prior to beginning PhD research, Ofri completed an MD degree at The Hebrew University. Ofri’s long-term goal is to continue medical practice and training with clinical research, and bring them together.
In Ofri’s free time, she enjoys running, yoga, hiking in nature with her family and messy baking with her son.
Agnes Bergerat-Thompson, PhD
Senior Research Technologist
Agnes joined the Mitchell Lab in August 2016 to investigate the female reproductive tract microbiome. Her work focuses on developing in vitro models to study the host flora-interaction. She is also studying the mucosal immune system of patients with dysbiotic flora using flow cytometry.
Briah Cooley
Clinical Research Coordinator I
Briah is a Clinical Research Coordinator in the Mitchell Lab and recently graduated from Macalester College in May 2021 with a BA in Biology. She plans to attend medical school and study obstetrics and gynecology. She is extremely interested in prevention of mother-to-child transmission of HIV (PMTCT) and the development of an HIV vaccine. Briah is interested in studying the vaginal microbiome because it is still an understudied area, and is interested in possible vaginal microbiome differences linked to race and ethnicity.
Wafae El-Arar
Research Technician
Wafae El-arar is originally from Morocco and has lived in the Boston area for 19 years. She is a Research Technician in the Mitchell Lab and recently graduated from Stonehill College in May 2021 with a BS in Biology. Wafae is interested in women's health especially because it is an area that is overlooked in healthcare. She hopes that her contributions would make an impact for women around the world.
Philipp Foessleitner, MD, BSc
Research Fellow
Dr. Foessleitner completed his MD degree and residency training in Obstetrics and Gynecology at the Medical University of Vienna/Vienna General Hospital, Austria. Subsequently, he has been working as an attending doctor at the same institution, specializing in high-risk obstetric care, obstetrics, and vulvovaginal infections. His research focuses on the vaginal microbiome, vaginal infections, and the prevention of preterm birth. He has co-authored over 25 publications in international (top-)journals and received multiple research awards.
Philipp has recently entered the Mitchell Lab as a visiting post-doctoral research fellow. In this role, he will focus on microbiome research and will be joining the MOTIF and KINETICS study teams.
Miles Goldenberg
Research Technician
Miles joined the Mitchell Lab as Research Technician in July 2023. He received his B.S. in Ecology & Evolutionary Biology from Yale University where he completed a senior thesis on antibiotic resistance in pathogenic Vibrio bacteria. In the Mitchell Lab, he is interested in using wet lab work and computational methods to study how the microbiome can be harnessed to treat and prevent disease. In his free time, he enjoys curating his Spotify playlists, reading, and playing tennis.
Anam Khan, MD MSCR
Clinical Research Coordinator
Anam is a medical graduate from India who completed her master’s in clinical research from Icahn School of Medicine at Mount Sinai, New York. Her experience working at a maternity center exposed her to the stark research disparities in women's health. Anam currently works at the Mitchell lab as a Clinical Research Coordinator and hopes to make a meaningful impact advocating for diverse female representation in research studies and encouraging community participation. In her free time, as a Boston newcomer, Anam looks forward to exploring New England over the next few years."
Nomfuneko Mafunda, MPH
Clinical Research Project Manager
Nomfuneko earned her MPH in Social and Behavioral Sciences, with concentrations in Maternal and Child Health and Public Health Leadership from Harvard T.H. Chan School of Public Health. She also holds a BA in Chemistry from Smith College. Her interests are women’s health, improving social and structural determinants of health and health inequities. Her work in the Mitchell lab focuses on managing our clinical studies and coordinating with collaborators both nationally and internationally. In her free time, Nomfuneko enjoys cooking especially trying new recipes and has recently started experimenting with baking.
Alumni
- Helai Hesham
- Laura Yockey
- Namit Choksi
- Marcus Ortega
- Alissa Mitchell
- Kristin Hung
- Youngwu Kim
- Stelios vagios
- Xavier Westergard
- Vi Duong
News Coverage and Publications
News
First Vaginal Bacteria Transplants in the US to Begin at Massachusetts General Hospital - WGBH
Selected Publications
Truong S, Foley OW, Fallah P, Trujillo Lalla A, Osterbur-Badhey M, Boatin A, Mitchell C, Bryant AS, Molina RL. Transcending Language Barriers in Obstetrics and Gynecology: A Critical Dimension for Health Equity. Obstetrics and Gynecology. 2023 Oct 1;142(4):809-817. PMID 37678884
Jenkins DJ, Woolston BM, Hood-Pishchany MI, Pelayo P, Konopaski AN, Peters MQ, France MT, Ravel J, Mitchell CM, Rakoff-Nahoum S, Whidbey C, Balskus EP. Bacterial amylases enable glycogen degradation by the vaginal microbiome. Nature Microbiology. 2023 Sep;8(9):1641-1652. 2023 Aug 10. Online ahead of print. PMID 37563289.
Mitchell CM, Larson JC, Reed SD, Guthrie KA. The complexity of GSM: number, severity and frequency of vulvovaginal discomfort symptoms in women enrolled in a randomized trial evaluating treatment for GSM. Menopause. 2023 Jul 4. EPub ahead of print. PMID 37402281.
Bar O, Sudhof LS, Yockey LJ, Bergerat A, Morial N, Andrews E, Ananthakrishnan AN, Xavier RJ, Yassour M*, Mitchell CM*. Comparison of vaginal microbiota between women with inflammatory bowel disease and healthy controls. PLoS One. 2023 Nov 29;18(11). PMID 38019873
Kim Y, Bergerat A, Mitchell C. Vaginal and urinary evaluation of lactobacilli quantification by qPCR: identifying factors that influence urinary detection and the quantity of Lactobacillus. PLoS One. 2023 Apr 14;18(4):e0283215 PMID 37058538
Vatanen T, Jabbar KS, Ruohtula T, Honkanen J, Avila-Pacheco J, Siljander H, Stražar M, Oikarinen S, Hyöty H, Ilonen J, Mitchell CM, Yassour M, Virtanen SM, Clish CB, Plichta DR, Vlamakis H, Knip M, Xavier RJ. Mobile genetic elements from the maternal microbiome shape infant gut microbial assembly and metabolism. Cell. 2022 Dec 22;185(26):4921-4936. PMID 36563663
Yockey L, Hussein F, Bergerat A, Reissis A, Worrall D, Xu J, Gomez I, Bloom SM, Mafunda NA, Kwon DS, Mitchell CM. Screening and Characterization of Vaginal Fluid Donations for Vaginal Microbiota Transplantation. Scientific Reports. 2022 Oct 26;12(1):17948. doi: 10.1038/s41598-022-22873-y. PMID 36289360
Mitchell CM, Larson JC, Crandall CJ, Bhasin S, LaCroix AZ, Ensrud KE, Guthrie KA, Reed SD. Association of vaginal estradiol tablet with serum estrogens in postmenopausal women: secondary analysis of a randomized clinical trial. JAMA Network Open. 2022; 5(11):e2241743. doi: 10.1001/jamanetworkopen.2022.41743. PMID 36374501
Lagon E, Mitchell C, Bryant AC, Bibbo C. The Inequity Inbox: a model for addressing bias in the clinical environment. Am J Obstet Gynecol MFM. 2022 May 20;4(5):100666. Online ahead of print. doi: 10.1016/j.ajogmf.2022.100666. PMID 35605933
Ensrud K, Larson J, Guthrie K, Crandall C, LaCroix A, Reed S, Bhasin S, Mitchell C, Joffe H. Changes in serum endogenous estrogen concentrations are mediators of the effect of low dose oral estradiol on vasomotor symptoms. Menopause. 29(9):1014-1020, September 2022. PMID 35969887.
Bull ME, Mitchell C, Soria J, Styrchak S, Williams-Wietzikoski C, Legard J, McKernan-Mullin J, Kraft K, Onchiri F, Stern J, Holte S, Ryan KJ, Acosta EP, La Rosa A, Coombs RW, Ticona E, Frenkel LM. Monotypic low-level HIV viremias during antiretroviral therapy are associated with disproportionate production of X4 virions and systemic immune activation. AIDS. 2018 Jul 17;32(11):1389-1401. doi: 10.1097/QAD.0000000000001824.PMID:29683841
Anahtar MN, Gootenberg DB, Mitchell CM, Kwon DS. Cervicovaginal Microbiota and Reproductive Health: The Virtue of Simplicity. Cell Host Microbe. 2018 Feb 14;23(2):159-168. doi: 10.1016/j.chom. 2018.01.013. Review.PMID:29447695
Mitchell CM, Reed SD, Diem S, Larson JC, Newton KM, Ensrud KE, LaCroix AZ, Caan B, Guthrie KA. Efficacy of Vaginal Estradiol or Vaginal Moisturizer vs Placebo for Treating Postmenopausal Vulvovaginal Symptoms: A Randomized Clinical Trial. JAMA Intern Med. 2018 May 1;178(5):681-690. doi: 10.1001/jamainternmed.2018.0116. PMID:29554173
Zhao N, Zhan X, Guthrie KA, Mitchell CM, Larson J. Generalized Hotelling's test for paired compositional data with application to human microbiome studies. Genet Epidemiol. 2018 Jul;42(5):459-469. doi: 10.1002/gepi.22127. Epub 2018 May 7.PMID:29737047
Diem SJ, Guthrie KA, Mitchell CM, Reed SD, Larson JC, Ensrud KE, LaCroix AZ. Effects of vaginal estradiol tablets and moisturizer on menopause-specific quality of life and mood in healthy postmenopausal women with vaginal symptoms: a randomized clinical trial. Menopause. 2018 Oct;25(10):1086-1093. doi: 10.1097/GME.0000000000001131. PMID:29738424
Mitchell CM, Reed SD, Guthrie KA. Good Clinical Practice in Diagnosis of Vulvovaginal Symptoms-Reply. JAMA Intern Med. 2018 Aug 1;178(8):1136-1137. doi: 10.1001/jamainternmed.2018.2856. No abstract available. PMID:30083740
Mitchell CM, Reed SD, Guthrie KA. Time to advocate for better science, and better treatments for women. Menopause. 2018 Oct;25(10):1065-1068. doi: 10.1097/GME.0000000000001175. No abstract available. PMID:30085982
Murphy K, Mitchell CM. The interplay of host immunity and environment on risk for bacterial vaginosis and associated reproductive health outcomes. Journal of Infectious Diseases. 2016 Aug 15;214 Suppl 1:S29-35.
Herbst-Kralovetz M, Pyles R, Ratner A, Sycuro L, Mitchell CM. New Systems for Studying Intercellular Interactions in Bacterial Vaginosis. Journal of Infectious Diseases. 2016 Aug 15;214 Suppl 1:S6-S13
Ticona E, Bull M, Soria J, Tapia K, Legard J, Styrchak S, Williams C, Mitchell CM, La Rosa A, Coombs R, Frenkel L. Biomarkers of inflammation in HIV-infected Peruvian men and women before and during suppressive anti-retroviral therapy (ART). 2015 Aug 24;29(13):1617-22