Research press release


Nature Medicine

Medical research: Vaginal bacteria transplant may help women with recurrent vaginosis



E Elinavたちは、細菌性膣症を繰り返し発症したことがあり、抗生物質には反応しなかった女性5人を選んで、腟内微生物相(マイクロバイオーム)の移植を行った。膣液のドナーには厳しいスクリーニングを行って、感染の可能性を排除し、また膣液の提供の前は性行為を控えるように依頼した。移植後、著者たちの観察によれば副作用は見られず、移植を受けた5人のうちの4人では、移植後5~21か月間にわたって症状の著しい改善が見られた。5人目の患者は、病状は改善したものの不十分だった。また、臨床症状の改善が見られた4人の患者の腟内微生物相には、Lactobacillus属の微生物が多くなっていることが分かった。この属の微生物は、健康な腟内微生物相環境に関連していることが、これまでの研究で明らかになっている。


The transplantation of vaginal fluid containing healthy microbes is associated with the clinical improvement of bacterial vaginosis in four out of five women who had previously not responded to antibiotic treatment. The findings are reported in an exploratory study published in Nature Medicine.

Bacterial vaginosis is a common condition in which there is a change in the natural balance of microbes in the vagina. In most cases, this change does not require treatment or can be resolved with antibiotic treatment. However, in a subset of women it can cause extreme discomfort, become disruptive to the woman’s life and increase her chances of acquiring sexually transmitted diseases or developing other genitourinary problems.

Eran Elinav and colleagues selected five patients who had a history of recurrent bacterial vaginosis symptoms and had not responded to antibiotics to receive the vaginal microbiome transplant. The vaginal fluid donors went through a rigorous screening process to exclude the presence of potential infections and were counseled to abstain from sexual activity prior to the donation of vaginal fluid. After the transplant, the authors observed no adverse effects, and four of the five patients treated showed a marked improvement of symptoms 5- 21 months after transplantation; the fifth showed incomplete remission. The team also found that the vaginal microbiomes of the four patients who showed clinical improvement were enriched with Lactobacillus microbes. These microbes have been associated with a healthy vaginal microbiome environment in previous studies.

Although all patients in this small study benefited from the microbiome therapy to some extent, the authors conclude that randomized placebo-controlled trials are required to test the therapeutic efficacy of vaginal microbiome transplant.

doi: 10.1038/s41591-019-0600-6


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