Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Ragon Institute of MIT, MGH and Harvard, Cambridge, MA, USA.
Sci Rep. 2022 Oct 26;12(1):17948. doi: 10.1038/s41598-022-22873-y.
Bacterial vaginosis (BV), the overgrowth of diverse anaerobic bacteria in the vagina, is the most common cause of vaginal symptoms worldwide. BV frequently recurs after antibiotic therapy, and the best probiotic treatments only result in transient changes from BV-associated states to "optimal" communities dominated by a single species of Lactobacillus. Therefore, additional treatment strategies are needed to durably alter vaginal microbiota composition for patients with BV. Vaginal microbiota transplantation (VMT), the transfer of vaginal fluid from a healthy person with an optimal vaginal microbiota to a recipient with BV, has been proposed as one such alternative. However, VMT carries potential risks, necessitating strict safety precautions. Here, we present an FDA-approved donor screening protocol and detailed methodology for donation collection, storage, screening, and analysis of VMT material. We find that Lactobacillus viability is maintained for over six months in donated material stored at - 80 °C without glycerol or other cryoprotectants. We further show that species-specific quantitative PCR for L. crispatus and L. iners can be used as a rapid initial screening strategy to identify potential donors with optimal vaginal microbiomes. Together, this work lays the foundation for designing safe, reproducible trials of VMT as a treatment for BV.
细菌性阴道病（BV），即阴道内多种厌氧菌过度生长，是全球最常见的阴道症状病因。BV 在抗生素治疗后常复发，而最佳的益生菌治疗仅导致与 BV 相关的状态向“最佳”单一乳杆菌物种主导的群落的短暂变化。因此，需要额外的治疗策略来持久改变 BV 患者的阴道微生物群落组成。阴道微生物群移植（VMT），即从具有最佳阴道微生物群的健康人向患有 BV 的受赠者转移阴道液，已被提议作为一种替代方法。然而，VMT 存在潜在风险，需要严格的安全预防措施。在这里，我们提出了一个 FDA 批准的供体筛选方案，并详细介绍了捐赠收集、储存、筛选和 VMT 材料分析的方法。我们发现，在没有甘油或其他冷冻保护剂的情况下，捐赠材料在 -80°C 下储存超过六个月，乳酸杆菌的活力得以维持。我们进一步表明，用于 L. crispatus 和 L. iners 的种特异性定量 PCR 可以用作快速初始筛选策略，以识别具有最佳阴道微生物组的潜在供体。总之，这项工作为设计安全、可重复的 VMT 试验作为 BV 治疗方法奠定了基础。
