Postbiotic gel relieves clinical symptoms of bacterial vaginitis by regulating the vaginal microbiota

Vaginitis is the most common disease in gynecology. Vaginal dysbiosis is a main reason of bacteria vaginitis (BV), as the disrupted microecological environment facilitates the growth of various vaginal pathogens. The most dominant bacteria in the vaginal microbiota are lactic acid bacteria, which are important for maintaining vaginal health. At present, antibiotics and other drugs are often used in clinical treatment, but there are many adverse reactions and easy to relapse, and the intervention of probiotics can help restore vaginal microbiota and alleviate BV. This study is a human clinical trial of 50 patients with bacterial vaginitis (BV). The alleviation effect of applying a postbiotic gel for one week in BV was evaluated. Changes in patients’ clinical indicators of BV (properties of vaginal secretion) and the vaginal microbiota after using the postbiotic gel were monitored. Our results showed that apply the postbiotic gel improved the symptoms of BV, indicated by improvement in the abnormalities of patients’ vaginal secretions. After applying the gel, the relative abundance of vaginal lactobacilli increased compared to baseline. Significant negative correlations were found between lactobacilli and potential vaginal pathogens (including Gardnerella, Prevotella, and Atopobium), as well as the abnormalities of the vaginal secretion. Overall, our results showed that applying the postbiotic gel ameliorated BV, and the symptom improvement was accompanied by significant changes in the bacterial vaginal microbiota. Our study provides valuable clinical data in managing BV.

[1]  J. Ravel,et al.  Lactic acid from vaginal microbiota enhances cervicovaginal epithelial barrier integrity by promoting tight junction protein expression , 2022, Microbiome.

[2]  Kristin L Walter Premenopausal Vaginitis. , 2022, JAMA.

[3]  Heping Zhang,et al.  Probiotics synergized with conventional regimen in managing Parkinson’s disease , 2022, NPJ Parkinson's disease.

[4]  M. Cummings,et al.  Identification and characterization of novel endolysins targeting Gardnerella vaginalis biofilms to treat bacterial vaginosis , 2022, NPJ biofilms and microbiomes.

[5]  B. Xiao,et al.  Correlation Analysis of Vaginal Microbiome Changes and Bacterial Vaginosis Plus Vulvovaginal Candidiasis Mixed Vaginitis Prognosis , 2022, Frontiers in Cellular and Infection Microbiology.

[6]  J. Ravel,et al.  Towards a deeper understanding of the vaginal microbiota , 2022, Nature Microbiology.

[7]  E. Crawford,et al.  Metronidazole treatment rapidly reduces genital inflammation through effects on bacterial vaginosis–associated bacteria rather than lactobacilli , 2022, The Journal of clinical investigation.

[8]  A. Akobeng,et al.  Probiotics for treatment of chronic constipation in children. , 2021, The Cochrane database of systematic reviews.

[9]  P. Gajer,et al.  Insight into the ecology of vaginal bacteria through integrative analyses of metagenomic and metatranscriptomic data , 2021, bioRxiv.

[10]  C. Hill,et al.  The International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of postbiotics , 2021, Nature Reviews Gastroenterology & Hepatology.

[11]  Huixia Yang,et al.  Lactobacillus rhamnosus and Lactobacillus casei Affect Various Stages of Gardnerella Species Biofilm Formation , 2021, Frontiers in Cellular and Infection Microbiology.

[12]  Bu-Zhen Tan,et al.  Dysbiosis of rat vagina is efficiently rescued by the vaginal microbiota transplantation or probiotic combination: Vaginal microbiota transplantation rescues dysbiosis in rat vagina. , 2021, International journal of antimicrobial agents.

[13]  T. Dinan,et al.  Bifidobacterium longum counters the effects of obesity: Partial successful translation from rodent to human , 2020, EBioMedicine.

[14]  J. Thornton,et al.  A novel non-antimicrobial treatment of bacterial vaginosis: An open label two-private centre study. , 2020, European journal of obstetrics, gynecology, and reproductive biology.

[15]  R. Froissart,et al.  Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis , 2020, PLoS pathogens.

[16]  Gavin M Douglas,et al.  PICRUSt2 for prediction of metagenome functions , 2020, Nature Biotechnology.

[17]  Michael R. Wierzbicki,et al.  Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis. , 2020, The New England journal of medicine.

[18]  Quan Shuang,et al.  Evaluation of the Bacterial Diversity of Inner Mongolian Acidic Gruel Using Illumina MiSeq and PCR-DGGE , 2020, Current Microbiology.

[19]  Lulu Chen,et al.  Comparing dental plaque microbiome diversity of extrinsic black stain in the primary dentition using Illumina MiSeq sequencing technique , 2019, BMC oral health.

[20]  R. Mändar,et al.  Potential vaginal probiotics: safety, tolerability and preliminary effectiveness. , 2019, Beneficial microbes.

[21]  H. Bai,et al.  [Primary study on the relationship between high-risk HPV infection and vaginal cervical microbiota]. , 2018, Zhonghua fu chan ke za zhi.

[22]  Sonja Georgievska,et al.  fMLC: fast multi-level clustering and visualization of large molecular datasets , 2018, Bioinform..

[23]  F. De Seta,et al.  Study on the effects of an oral lactobacilli and lactoferrin complex in women with intermediate vaginal microbiota , 2018, Archives of Gynecology and Obstetrics.

[24]  A. Alekseyenko,et al.  Phylogenic inference using alignment-free methods for applications in microbial community surveys using 16s rRNA gene , 2017, PloS one.

[25]  M. Vaneechoutte,et al.  Bacterial biofilms in the vagina. , 2017, Research in microbiology.

[26]  Kelly Arnold,et al.  Microbiome Composition and Function Drives Wound-Healing Impairment in the Female Genital Tract , 2016, PLoS pathogens.

[27]  R. Fichorova,et al.  The Human Microbiome during Bacterial Vaginosis , 2016, Clinical Microbiology Reviews.

[28]  S. Nagai,et al.  Bioinformatic Amplicon Read Processing Strategies Strongly Affect Eukaryotic Diversity and the Taxonomic Composition of Communities , 2015, PloS one.

[29]  Robert G. Beiko,et al.  STAMP: statistical analysis of taxonomic and functional profiles , 2014, Bioinform..

[30]  M. Del Piano,et al.  Effectiveness of the Two Microorganisms Lactobacillus fermentum LF15 and Lactobacillus plantarum LP01, Formulated in Slow-release Vaginal Tablets, in Women Affected by Bacterial Vaginosis: A Pilot Study , 2014, Journal of clinical gastroenterology.

[31]  P. Teixeira,et al.  The role of lactobacilli and probiotics in maintaining vaginal health , 2014, Archives of Gynecology and Obstetrics.

[32]  L. Forney,et al.  Influence of Vaginal Bacteria and d- and l-Lactic Acid Isomers on Vaginal Extracellular Matrix Metalloproteinase Inducer: Implications for Protection against Upper Genital Tract Infections , 2013, mBio.

[33]  C. Påhlson,et al.  Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. , 2010, Microbes and infection.

[34]  William A. Walters,et al.  QIIME allows analysis of high-throughput community sequencing data , 2010, Nature Methods.

[35]  D. Raoult,et al.  Molecular quantification of Gardnerella vaginalis and Atopobium vaginae loads to predict bacterial vaginosis. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[36]  Jeanne M. Marrazzo,et al.  Diversity of Human Vaginal Bacterial Communities and Associations with Clinically Defined Bacterial Vaginosis , 2008, Applied and Environmental Microbiology.

[37]  Eoin L. Brodie,et al.  Greengenes, a Chimera-Checked 16S rRNA Gene Database and Workbench Compatible with ARB , 2006, Applied and Environmental Microbiology.

[38]  J. Marrazzo,et al.  Molecular identification of bacteria associated with bacterial vaginosis. , 2005, The New England journal of medicine.

[39]  Ross A. Overbeek,et al.  The Ribosomal Database Project (RDP) , 1996, Nucleic Acids Res..

[40]  M A Krohn,et al.  Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation , 1991, Journal of clinical microbiology.

[41]  K. Holmes,et al.  Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations , 1983 .