In addition to acting as a physical barrier to infections, vaginal epithelial cells generate an innate immune response to non-optimal bacteria associated with BV by producing inflammatory cytokines and anti-microbial products, such as defensins and lysozymes [44, 78], while a microbiome dominated by L. crispatus that is considered optimal reduces the pro-inflammatory response as shown, for example, in cervicovaginal cell cultures stimulated with various TLR agonists [3, 43]. Here, LYZ is linked to infection.