Fig. 3

Increased immune activation and decreased keratinization and barrier pathways are associated with the neovagina. a Neovaginal samples have an overall unique host proteome signature compared to cis vaginal samples based on variation decomposition via principal coordinate analysis. b Hierarchical clustering of human proteins differentially abundant between neovaginas and cis vaginas (p < 0.05, Mann-Whitney U test). Neovaginas had increased signatures of immune activation and bacterial invasion and decreased barrier function and estrogen signaling pathways (q < 0.05, ConsensusPathDB). (LD = Lactobacillus dominant, nLD = non-Lactobacillus dominant, neovaginal S = sigmoid colon graft extension, neovaginal PI = penile inversion/scrotal graft only)