Department of Microbiology, Panjab University, Chandigarh, India.
Arch Microbiol. 2024 Jun 15;206(7):306. doi: 10.1007/s00203-024-04024-1.
In an age of cutting-edge sequencing methods and worldwide endeavors such as The Human Microbiome Project and MetaHIT, the human microbiome stands as a complex and diverse community of microorganisms. A central theme in current scientific inquiry revolves around reinstating a balanced microbial composition, referred to as "eubiosis," as a targeted approach for treating vast array of diseases. Vaginal Microbiota Transplantation (VMT), inspired by the success of fecal microbiota transplantation, emerges as an innovative therapy addressing vaginal dysbacteriosis by transferring the complete microbiota from a healthy donor. Antibiotics, while effective, pose challenges with adverse effects, high recurrence rates, and potential harm to beneficial Lactobacillus strains. Continued antibiotic usage also sparks worries regarding the development of resistant strains. Probiotics, though showing promise, exhibit inconsistency in treating multifactorial diseases, and concerns linger about their suitability for diverse genetic backgrounds. Given the recurrent challenges associated with antibiotic and probiotic treatments, VMT emerges as an imperative alternative, offering a unique and promising avenue for efficiently and reliably managing vaginal dysbiosis among a majority of women. This review critically evaluates findings from both animal and human studies, offering nuanced insights into the efficacy and challenges of VMT. An extensive analysis of clinical trials, provides a current overview of ongoing and completed trials, shedding light on the evolving clinical landscape and therapeutic potential of VMT. Delving into the origins, mechanisms, and optimized protocols of VMT, the review underscores the imperative for sustained research efforts to advance this groundbreaking gynecological therapy.
在当今测序方法日新月异、全球范围内如人类微生物组计划（Human Microbiome Project）和 MetaHIT 等项目如火如荼开展的时代，人类微生物组展现出其作为一个复杂多样的微生物群落的特性。当前科学研究的一个核心主题是重新建立平衡的微生物组成，即所谓的“共生”，将其作为治疗各种疾病的靶向方法。受粪便微生物群移植（Fecal Microbiota Transplantation，FMT）成功的启发，阴道微生物群移植（Vaginal Microbiota Transplantation，VMT）作为一种创新疗法应运而生，通过从健康供体转移完整的微生物群来治疗阴道菌群失调。尽管抗生素有效，但存在不良反应、高复发率以及对有益乳杆菌菌株潜在危害等挑战。持续使用抗生素也引发了对耐药菌株发展的担忧。益生菌虽然有一定的前景，但在治疗多因素疾病方面表现出不一致性，并且人们对其在不同遗传背景下的适用性仍存在疑虑。鉴于抗生素和益生菌治疗反复出现的挑战，VMT 作为一种必要的替代方法出现，为大多数女性高效可靠地管理阴道菌群失调提供了独特而有前途的途径。本综述批判性地评估了来自动物和人类研究的发现，深入探讨了 VMT 的疗效和挑战。对临床试验的广泛分析提供了正在进行和已完成试验的当前概述，揭示了 VMT 不断发展的临床前景和治疗潜力。通过深入探讨 VMT 的起源、机制和优化方案，该综述强调了持续研究努力的必要性，以推进这一具有开创性的妇科治疗方法。
