Housekeeping! [a customarily intonated voice calls through a door]
How many of us are accustomed to taking for granted the bodies that transit our interior spaces, briskly cleaning up crumbs, hair, dust, waste and other debris generated through material existence? Housekeeping, it seems, is not just a small luxury afforded to those who employ others (typically women) willing to tidy up after them—whether that be at home or in a hotel. Housekeeping is also a somatic process embedded in our cellular activities. I want to share my discoveries around the microscopic activity within menstrual fluid and how the uterus and vagina are normally kept ‘clean’ by not only a community of microbes in mucus, but also by specialized human cells within this unique micro-ecology. I’m talking about phagocytes, whose performance I watched as it occurred within my own menstrual biomaterials last year.
A phagocyte is a, “type of [mammalian] cell that has the ability to ingest, and sometimes digest, foreign particles, such as bacteria, carbon, dust, or dye. It engulfs foreign bodies by extending its cytoplasm into pseudopods (cytoplasmic extensions like feet), surrounding the foreign particle and forming a vacuole [like an intracellular waste bin]. Poisons contained in the ingested bacteria cannot harm the phagocyte so long as the bacteria remain in the vacuole; phagocyte enzymes are secreted into the vacuole in which digestion takes place. In the blood, two types of white blood cells, neutrophilic leukocytes (microphages) and monocytes (macrophages), are phagocytic. Neutrophils are small, granular leukocytes that quickly appear at the site of a wound and ingest bacteria. Monocytes are larger, with a large, kidney-shaped nucleus; they appear about three days after infection and scavenge for bacteria, foreign particles, dead cellular material, and protozoa. Most phagocytic activity takes place outside the vascular system, among the cells.” (emphasis added)1
As part of a project funded by Canada Council for the Arts, I established a cell bank of primary menstrual-derived cells at a medical research facility in Montreal last year.2 Primary cells are those taken directly from a donor—in this case, me. The cells in the bank, which remain in cryopreservation at said facility, have not gone through a purification process yet. This process includes tagging them with antibodies, positive identification (as stem cells) through flow cytometry and then processing them through a cell sorting machine that selects each cell one-by-one using lasers and electrified plates. In this process, any cell not tagged with the right antibody gets discarded, resulting in a ‘purified’ (mono)culture. I completed this full process with my cells at the Harry Perkins Institute of Medical Research at UWA, but did not have a chance to get further than initial antibody staining and flow cytometry while in Montreal. The ‘impure’ (biodiverse) culture of cells I was working with in Montreal, however, revealed very interesting activity under the microscope. I had treated the cells in culture with the usual penicillin/ streptomycin antibiotic additives (though some protocols also suggest the inclusion of fungizone).34 Despite the antibiotics, some microbial species persisted in the culture, and observing how my (likely) neutrophils dealt with them and with inanimate cellular debris was fascinating to me.5 I’ve included a video below with further discussion, for my paid subscribers.
Previously, I completed a research project where I sequenced my own vaginal microbiome for a full menstrual cycle (one month).6 The analysis showed over 60 different types of microbes, most commensal (friendly, beneficial) and some pathogenic (potentially infectious), though the relative proportions of the populations indicated that the commensal species helped keep any pathogenic species in check. We all host pathogenic microbial visitors in various bodily niches—this only becomes a problem when those microbes meet with favourable conditions for proliferation and thus, infection. Recent (and scant) research shows that our immune systems work to prevent infections in tandem with commensal microbial populations in the endometrium.7
Phagocytes originate in blood as types of white blood cells (part of our immune response), through a process called hematopoiesis. It should be no surprise, then, that menstrual fluid is a hot broth of phagocytic activity that takes place in the endometrium and is thus expelled with it each month. Yet, I hadn’t known about this until I watched the cellular performance under the microscope and later figured out what was going on.
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