Research Group Microbial Communication, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.
Research Group Microbial Interactions and Processes, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany.
Microbiome. 2017 Sep 13;5(1):119. doi: 10.1186/s40168-017-0326-y.
Bacterial vaginosis (BV) is the most common vaginal syndrome among women in their reproductive years. It is associated with an increased risk of acquiring sexually transmitted infections and complications like preterm labor. BV is characterized by a high recurrence rate for which biofilms frequently found on vaginal epithelial cells may be a reason.
Here, we report a controlled randomized clinical trial that tested the safety and effectiveness of a newly developed pessary containing an amphoteric tenside (WO3191) to disrupt biofilms after metronidazole treatment of BV. Pessaries containing lactic acid were provided to the control group, and microbial community composition was determined via Illumina sequencing of the V1-V2 region of the 16S rRNA gene. The most common community state type (CST) in healthy women was characterized by Lactobacillus crispatus. In BV, diversity was high with communities dominated by either Lactobacillus iners, Prevotella bivia, Sneathia amnii, or Prevotella amnii. Women with BV and proven biofilms had an increased abundance of Sneathia sanguinegens and a decreased abundance of Gardnerella vaginalis. Following metronidazole treatment, clinical symptoms cleared, Nugent score shifted to Lactobacillus dominance, biofilms disappeared, and diversity (Shannon index) was reduced in most women. Most of the patients responding to therapy exhibited a L. iners CST. Treatment with WO 3191 reduced biofilms but did not prevent recurrence. Women with high diversity after antibiotic treatment were more likely to develop recurrence.
Stabilizing the low diversity healthy flora by promoting growth of health-associated Lactobacillus sp. such as L. crispatus may be beneficial for long-term female health.
ClinicalTrials.gov NCT02687789.
细菌性阴道病（BV）是育龄妇女中最常见的阴道综合征。它与获得性传播感染和早产等并发症的风险增加有关。BV 的特征是复发率高，阴道上皮细胞上经常发现生物膜可能是一个原因。
在这里，我们报告了一项对照随机临床试验，该试验测试了一种新开发的含有两性表面活性剂（WO3191）的阴道栓剂在治疗 BV 后破坏生物膜的安全性和有效性。对照组提供了含有乳酸的阴道栓剂，并通过 Illumina 对 16S rRNA 基因的 V1-V2 区进行测序来确定微生物群落组成。健康女性最常见的群落状态类型（CST）是乳酸杆菌crispatus。在 BV 中，多样性很高，社区主要由乳酸杆菌在内、普雷沃氏菌bivia、Sneathia amnii 或 Prevotella amnii 主导。患有 BV 且有生物膜证据的女性中，Sneathia sanguinegens 的丰度增加，Gardnerella vaginalis 的丰度降低。经过甲硝唑治疗后，临床症状消失，Nugent 评分转为乳酸杆菌优势，生物膜消失，大多数女性的多样性（Shannon 指数）降低。大多数对治疗有反应的患者表现出 L. iners CST。WO3191 的治疗减少了生物膜，但不能预防复发。抗生素治疗后多样性高的女性更有可能复发。
通过促进健康相关的乳酸杆菌（如 L. crispatus）的生长来稳定低多样性的健康菌群可能对女性的长期健康有益。
ClinicalTrials.gov NCT02687789。
