Researchers developing vaginal microbiota transplant to treat bacterial vaginosis.
According to the CDC, Bacterial Vaginosis (BV) is the most common vaginal infection in women aged between 15 and 44, affecting an estimated 21.2 million women nationwide. BV is associated with an increased risk of acquiring sexually transmitted infections and increased likelihood of having a preterm birth, however, it’s still under researched and difficult to treat. Now, a study from researchers at Johns Hopkins University develops an effective way to screen donors for the replacement of unhealthy vaginal microflora with a ready-to-use microbiome, called a vaginal microbiome transplantation (VMT). The team state VMT works by introducing good bacteria from a healthy woman’s vaginal mucus, which then take over and become dominant in the recipient’s microbiome, suppressing harmful bacteria. The opensource study is published in the journal Frontiers in Cellular and Infection Microbiology.
Previous studies show BV is treated using antibiotics which aren’t curative or restorative, and while antibiotics may treat the harmful bacteria, they don’t create a protective environment to prevent them from coming back. As a result up to 70% of women experience a recurrence of BV, with a raised risk of developing thrush due to the use of antibiotics. The vaginal microbiota in its healthiest state is dominated by one of only a few species of Lactobacillus. This means VMT has the potential to revolutionize the way in which conditions affecting the female reproductive tract are treated. Unfortunately, study of vaginal microbiota in preclinical animal models is limited by the fact dominance of the vaginal microbiota by Lactobacillus species is a uniquely human phenomenon. The current study develops a universal donor screening protocol intended to mitigate potential transmission of infectious pathogens, as well as collection, characterization, and testing procedures for donor VMT.
The current study designs a universal donor screening program, and tests it in 20 women. Participants, aged between 18 to 45, provided samples of their vaginal fluid, as well as blood and urine. They also completed a questionnaire on variables like their sexual history and whether they used vaginal products, as well as their general medical and travel history. Results show the team were able to analyze the make-up of bacteria in each woman to work out she if she would be suitable as a donor. Data findings show 35% of the women were eligible to be vaginal microbiota transplant donors in a future study.
The lab state, using this criteria, they will be able to eventually identify ‘super donors’, who have favourable lactobacillus-dominated microbiota, which tends to be higher in protective lactic acid content and lower pH. They go on to add that to become a donor, they suggest abstaining from sex for at least 30 days before giving a sample, with donors also screened for infections including HIV.
The team surmise they have characterized key properties of donor vaginal fluid and the corresponding composition of the vaginal microbiota to delineate criteria for inclusion/exclusion for VMT. For the future, the researchers state they anticipate that the framework described here will help accelerate clinical studies of VMT.