Impact of a multi-strain L. crispatus-based vaginal synbiotic on the vaginal microbiome: a randomized placebo-controlled trial.

Jacques Ravel, Sheri Simmons, Eleni Greenwood Jaswa, Sara Gottfried, Miriam Greene, Susan Kellogg-Spadt, Dirk Gevers, Diane M Harper

Journal: NPJ biofilms and microbiomes 2025;11(1):158

PMID: 40783570

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Abstract

A clinical trial of a multi-strain vaginal synbiotic (NCT05659745, registered 12/19/2022 at clinicaltrials.gov) led to an optimal vaginal microbiome dominated by L. crispatus (CST I). The synbiotic led to a significant increase in L. crispatus compared to placebo (p < 0.05), and conversion to CST I was significantly higher with the vaginal synbiotic than with placebo (90 vs 11%; p < 0.002). Mechanistically, the synbiotic reduced Gardnerella vaginalis and Candida, clinically important microbes.

Address: Center for Advanced Microbiome Research and Innovation, Institute for Genome Sciences and Department of Microbiology & Immunology, University of Maryland, School of Medicine, Baltimore, MD, USA.; Seed Health, Venice, CA, USA.; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, USA.; Department of Integrative Medicine & Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, USA.; Department of Obstetrics & Gynecology, NYU Grossman School of Medicine, New York, NY, USA.; Department of Obstetrics & Gynecology, Drexel University College of Medicine, Philadelphia, PA, USA.; Seed Health, Venice, CA, USA. [email protected].; Departments of Family Medicine, Obstetrics & Gynecology, and Women's & Gender Studies, University of Michigan, Ann Arbor, MI, USA.

DOI: 10.1038/s41522-025-00788-6

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MeSH Terms: Female, Humans, Vagina, Synbiotics, Microbiota, Adult, Lactobacillus crispatus, Gardnerella vaginalis, Candida, Young Adult