Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Immunology Department, Weizmann Institute of Science, Rehovot, Israel.
Nat Med. 2019 Oct;25(10):1500-1504. doi: 10.1038/s41591-019-0600-6. Epub 2019 Oct 7.
We report the results of a first exploratory study testing the use of vaginal microbiome transplantation (VMT) from healthy donors as a therapeutic alternative for patients suffering from symptomatic, intractable and recurrent bacterial vaginosis (ClinicalTrials.gov NCT02236429 ). In our case series, five patients were treated, and in four of them VMT was associated with full long-term remission until the end of follow-up at 5-21 months after VMT, defined as marked improvement of symptoms, Amsel criteria, microscopic vaginal fluid appearance and reconstitution of a Lactobacillus-dominated vaginal microbiome. One patient presented with incomplete remission in clinical and laboratory features. No adverse effects were observed in any of the five women. Notably, remission in three patients necessitated repeated VMT, including a donor change in one patient, to elicit a long-standing clinical response. The therapeutic efficacy of VMT in women with intractable and recurrent bacterial vaginosis should be further determined in randomized, placebo-controlled clinical trials.
我们报告了一项首次探索性研究的结果，该研究测试了使用来自健康供体的阴道微生物组移植（VMT）作为患有症状性、难治性和复发性细菌性阴道病（ClinicalTrials.gov NCT02236429）患者的治疗替代方法。在我们的病例系列中，对五名患者进行了治疗，其中四名患者的 VMT 与完全长期缓解相关，直到 VMT 后 5-21 个月的随访结束，定义为症状、Amsel 标准、阴道液微观外观和乳酸杆菌主导的阴道微生物组的重建明显改善。一名患者的临床和实验室特征表现为不完全缓解。在这五名女性中，均未观察到不良反应。值得注意的是，三名患者的缓解需要重复进行 VMT，包括一名患者更换供体，以引起长期的临床反应。在随机、安慰剂对照临床试验中，应进一步确定 VMT 在治疗难治性和复发性细菌性阴道病女性中的疗效。
