Fengyuan Qi, Shangrong Fan, Chao Fang, Lan Ge, Jinli Lyu, Zhuoqi Huang, Shaowei Zhao, Yuanqiang Zou, Liting Huang, Xinyang Liu, Yiheng Liang, Yongke Zhang, Yiyi Zhong, Haifeng Zhang, Liang Xiao, Xiaowei Zhang
Journal: Frontiers in immunology 2023;14():1125239
PMID: 37575226
Bacterial vaginosis (BV) is a microecological disorder caused by decreased abundance of lactobacilli and an increased abundance of anaerobic bacteria, commonly affecting the female lower genital tract. The aim of this study was to evaluate the effectiveness of oral Chinese-origin probiotic strains (L. gasseri TM13 and L. crispatus LG55), with adjuvant primary treatment in treating Chinese BV patients, and investigate the dynamic of the intestine and vaginal microbiome using metagenomic sequencing. This study was a single-centre, prospective, parallel-group, randomized controlled clinical trial. Participants were randomly assigned to the control or probiotic group using a 1:1 ratio. Results showed that there was no significant difference in BV cure rates between the probiotic and control groups at day 14, day 30, and day 90. In addition, in the BV conversion population, the percentage of people in a transition state was lower in the probiotic group at all three time-points. Hence, oral administration of L. gasseri TM13 and L. crispatus LG55 is effective in restoring the vaginal health of patients recovered from BV. Authors conclude that an individualised intervention approach should be developed to restore the vaginal health of patients recovering from BV.
UNLABELLED
Bacterial vaginosis (BV) is a common infection of the lower genital tract with a vaginal microbiome dysbiosis caused by decreasing of lactobacilli. Previous studies suggested that supplementation with live may benefit the recovery of BV, however, the outcomes vary in people from different regions. Herein, we aim to evaluate the effectiveness of oral Chinese-origin with adjuvant metronidazole (MET) on treating Chinese BV patients. In total, 67 Chinese women with BV were enrolled in this parallel controlled trial and randomly assigned to two study groups: a control group treated with MET vaginal suppositories for 7 days and a probiotic group treated with oral TM13 and LG55 as an adjuvant to MET for 30 days. By comparing the participants with Nugent Scores ≥ 7 and < 7 on days 14, 30, and 90, we found that oral administration of probiotics did not improve BV cure rates (72.73% and 84.00% at day 14, 57.14% and 60.00% at day 30, 32.14% and 48.39% at day 90 for probiotic and control group respectively). However, the probiotics were effective in restoring vaginal health after cure by showing higher proportion of participants with Nugent Scores < 4 in the probiotic group compared to the control group (87.50% and 71.43% on day 14, 93.75% and 88.89% on day 30, and 77.78% and 66.67% on day 90). The relative abundance of the probiotic strains was significantly increased in the intestinal microbiome of the probiotic group compared to the control group at day 14, but no significance was detected after 30 and 90 days. Also, the probiotics were not detected in vaginal microbiome, suggesting that TM13 and LG55 mainly acted through the intestine. A higher abundance of at baseline was significantly associated with long-term cure failure of BV and greatly contributed to the enrichment of the lipid IVA synthesis pathway, which could aggravate inflammation response. To sum up, TM13 and LG55 can restore the vaginal health of patients recovering from BV, and individualized intervention mode should be developed to restore the vaginal health of patients recovering from BV.
CLINICAL TRIAL REGISTRATION
https://classic.clinicaltrials.gov/ct2/show/, identifier NCT04771728.
Copyright © 2023 Qi, Fan, Fang, Ge, Lyu, Huang, Zhao, Zou, Huang, Liu, Liang, Zhang, Zhong, Zhang, Xiao and Zhang.
© Copyright 2026, Nutrition Evidence
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