Correction of vaginal microbiocenosis in bacterial vaginosis. Promising areas

Grechkanev G.O.; Strelets I.O.; Nikishov N.N.; Sinitsyna E.V.; Nikishova A.N.

doi:https://doi.org/10.17116/rosakush20252504144

Рекомендуем статьи по данной теме:

Бактериальный вагиноз: современные представления. Клиническая дерматология и венерология. 2025;(3):261-268

Лактобактерии и бактериальный вагиноз. Типирование видов и анализ уровней содержания в микробиоме. Молекулярная генетика, микробиология и вирусология. 2025;(2):43-50

Резюме / Abstract:

В обзоре литературы на основе анализа отечественных и зарубежных источников последних лет дано представление об альтернативном патогенетическом лечении актуальной патологии — бактериального вагиноза — при помощи трансплантации вагинальной микробиоты от здоровых доноров. Представлен критический взгляд на традиционные способы восстановления микробиоты влагалища с использованием пробиотиков. Описаны как преимущества, так и объективные сложности реализации трансплантационных методик — технические, юридические, этические.

Ключевые слова / Keywords:

микробиота влагалища

бактериальный вагиноз

трансплантация вагинальной микробиоты здоровых доноров

Авторы / Authors:

Гречканев Г.О.

ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России

ORCID: 0000-0003-0021-030X

Стрелец И.О.

ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России

ORCID: 0000-0002-2346-2131

Никишов Н.Н.

ФГАОУ ВО «Балтийский федеральный университет им. Иммануила Канта», Минобрнауки России

ORCID: 0000-0002-8404-016X

Синицина Е.В.

ФГБОУ ВО «Санкт-Петербургский государственный университет» Минобрнауки России

ORCID: 0009-0003-2342-2169

Никишова А.Н.

Медицинский институт ФГАОУ ВО «Балтийский федеральный университет им. Иммануила Канта» Минобрнауки России

ORCID: 0009-0005-5872-2553

Дата поступления:

19.08.2024

Дата принятия в печать:

11.09.2024

Закрыть метаданные

Литература / References:

Coudray MS, Madhivanan P. Bacterial vaginosis — A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020; 245:143-148. https://doi.org/10.1016/j.ejogrb.2019.12.035
Chow K, Wooten D, Annepally S, Burke L, Edi R, Morris SR. Impact of (recurrent) bacterial vaginosis on quality of life and the need for accessible alternative treatments. BMC Womens Health. 2023;23:1:112. https://doi.org/10.1186/s12905-023-02236-z
Cerca N. Addressing the challenges with bacterial vaginosis pharmacotherapy. Expert Opin Pharmacother. 2023;24:1:11-13. https://doi.org/10.1080/14656566.2022.2082285
Sobel JD, Vempati YS. Bacterial vaginosis and vulvovaginal candidiasis pathophysiologic interrelationship. Microorganisms. 2024; 12:1:108. https://doi.org/10.3390/microorganisms12010108
Хрипунова А.Д. Бактериальный вагиноз у беременных как одна из причин невынашивания. Вестник науки. 2022;5:50:134-140.
Ильина И.Ю., Доброхотова Ю.Э. Бактериальный вагиноз. Возможные пути решения проблемы. РМЖ. 2020;28:11:75-78.
Bhakta V, Aslam S, Aljaghwani A. Bacterial vaginosis in pregnancy: prevalence and outcomes in a tertiary care hospital. Afr J Reprod Health. 2021;25:1:49-55.
Ravel J, Moreno I, Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am J Obstet Gynecol. 2021;224:3:251-257. https://doi.org/10.1016/j.ajog.2020.10.019
Тевлин К.П., Ханалиев Б.В., Тевлина Е.В. Бактериальный вагиноз и инфекция нижних мочевыводящих путей у женщин. Клинический случай. Гинекология. 2022;24:2:140-143. https://doi.org/10.26442/20795696.2022.2.201411
Кравченко Е.Н., Куклина Л.В. Папилломавирусная инфекция и бактериальный вагиноз: иммуномодулирующая терапия у беременных. Вопросы гинекологии, акушерства и перинатологии. 2018;17:6:33-38. https://doi.org/10.20953/1726-1678-2018-6-33-38
Coudray M, Kiplagat S. Bacterial vaginosis and the risk of human papillomavirus and cervical cancer. Am J Obstet Gynecol. 2019;221:2:171-172. https://doi.org/10.1016/j.ajog.2019.05.016
Кузнецова И.В., Землина Н.С. Выбор тактики ведения пациенток с вагинальными инфекциями в неоднозначных клинических ситуациях. Женская клиника. 2023;2:37-51.
Кузнецова И.В., Бурчаков Д.И. Нерешенные вопросы и проблемы терапии бактериального вагиноза. Женская клиника. 2023;3:38-50.
Белая Ю.М., Зароченцева Н.В. Рецидивирующий бактериальный вагиноз. Вопросы практической кольпоскопии. Генитальные инфекции. 2022;4:36-40. https://doi.org/10.46393/27826392_2022_4_36
Safwat F, Safwat S, Daka N, Sivanathan N, Lazarevic M. Recurrent bacterial vaginosis: A Case report and review of management. Cureus. 2023;15:4:e37348. https://doi.org/10.7759/cureus.37348
Thomas-White K, Navarro P, Wever F, King L, Dillard LR, Krapf J. Psychosocial impact of recurrent urogenital infections: a review. Womens Health (Lond). 2023;19:17455057231216537. https://doi.org/10.1177/17455057231216537
de Andrade Ramos B, Kanninen TT, Sisti G, Witkin SS. Microorganisms in the female genital tract during pregnancy: tolerance versus pathogenesis. Am J Reprod Immunol. 2015;73:5:383-389. https://doi.org/10.1111/aji.12326
Ayinde O, Ross JD. The association between symptom or microscopy based diagnosis of bacterial vaginosis (BV) and response to treatment in women with recurrent BV. Int J STD AIDS. 2023;34:9:608-616. https://doi.org/10.1177/09564624231158056
Sousa LGV, Pereira SA, Cerca N. Fighting polymicrobial biofilms in bacterial vaginosis. Microb Biotechnol. 2023;16:7:1423-1437. https://doi.org/10.1111/1751-7915.14261
Кира Е.Ф., Расторгуева Л.И., Халтурина Ю.В., Пушкина В.В. Инфекции влагалища. Двухэтапный метод лечения. Акушерство и гинекология. 2020;4:201-208.
Радзинский В.Е., Манухин И.Б., Ордиянц И.М., Балан В.Е., Тихомирова Е.В., Сахаутдинова И.В., Зулкарнеева Э.М. Эффективность восстановления вагинальной микробиоты после противомикробной терапии бактериального вагиноза и вульвовагинального кандидоза у беременных (по результатам многоцентрового проспективного неинтервенционного сравнительного исследования). РМЖ. Мать и дитя. 2021;4:3:192-200. https://doi.org/10.32364/2618-8430-2021-4-3-192-200
Кузнецова И.В., Бебнева Т.Н. Аспекты терапии бактериального вагиноза в реальной клинической практике. Женская клиника. 2021;2:71-79.
Shi LH, Balakrishnan K, Thiagarajah K, Mohd Ismail NI, Yin OS. Beneficial properties of probiotics. Trop Life Sci Res. 2016; 27:2:73-90. https://doi.org/10.21315/tlsr2016.27.2.6
Basavaprabhu HN, Sonu KS, Prabha R. Mechanistic insights into the action of probiotics against bacterial vaginosis and its mediated preterm birth: An overview. Microb Pathog. 2020;141:104029. https://doi.org/10.1016/j.micpath.2020.104029
Miquel S, Verlaguet J, Garcin S, Bertran T, Evrard B, Forestier C, Vareille-Delarbre M. Lacticaseibacillus rhamnosus Lcr35 stimulates epithelial vaginal defenses upon Gardnerella vaginalis Infection. Infect Immun. 2022;90:9:e0030922. https://doi.org/10.1128/iai.00309-22
Jang SE, Jeong JJ, Choi SY, Kim H, Han MJ, Kim DH. Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 attenuate gardnerella vaginalis-infected bacterial vaginosis in mice. Nutrients. 2017;9:6:531. https://doi.org/10.3390/nu9060531
Kim DE, Kim JK, Han SK, Jang SE, Han MJ, Kim DH. Lactobacillus plantarum NK3 and Bifidobacterium longum NK49 alleviate bacterial vaginosis and osteoporosis in mice by suppressing NF-κB-Linked TNF-α expression. J Med Food. 2019;22:10:1022-1031. https://doi.org/10.1089/jmf.2019.4419
Mändar R, Sõerunurk G, Štšepetova J, Smidt I, Rööp T, Kõljalg S, Saare M, Ausmees K, Le DD, Jaagura M, Piiskop S, Tamm H, & Salumets A. Impact of Lactobacillus crispatus-containing oral and vaginal probiotics on vaginal health: a randomised double-blind placebo controlled clinical trial. Benef Microbes. 2023;14:2:143-152. https://doi.org/10.3920/BM2022.0091
Park SH, Lee ES, Park ST, Jeong SY, Yun Y, Kim Y, Jeong Y, Kang CH, & Choi HJ. Efficacy and Safety of MED-01 probiotics on vaginal health: A 12-Week, multicenter, randomized, double-blind, placebo-controlled clinical trial. Nutrients. 2023;15:2:331. https://doi.org/10.3390/nu15020331
Rostok M, Hütt P, Rööp T, Smidt I, Štšepetova J, Salumets A, Mändar R. Potential vaginal probiotics: safety, tolerability and preliminary effectiveness. Benef Microbes. 2019;10:4:385-393. https://doi.org/10.3920/BM2016.0123
Yang S, Reid G, Challis JRG, Gloor GB, Asztalos E, Money D, Seney S, & Bocking AD. Effect of oral probiotic lactobacillus rhamnosus GR-1 and lactobacillus reuteri RC-14 on the vaginal microbiota, cytokines and chemokines in pregnant women. Nutrients. 2020;12:2:368. https://doi.org/10.3390/nu12020368
Jepsen IE, Saxtorph MH, Englund ALM, Petersen KB, Wissing MLM, Hviid TVF, & Macklon N. Probiotic treatment with specific lactobacilli does not improve an unfavorable vaginal microbiota prior to fertility treatment-A randomized, double-blinded, placebo-controlled trial. Front Endocrinol. 2022;13:1057022. https://doi.org/10.3389/fendo.2022.1057022
Li P, Wei K, He X, Zhang L, Liu Z, Wei J, Chen X, Wei H, Chen T. Vaginal probiotic Lactobacillus crispatus seems to inhibit sperm activity and subsequently reduces pregnancies in rat. Front Cell Dev Biol. 2021;9:705690. https://doi.org/10.3389/fcell.2021.705690
Zuñiga Vinueza AM. Probiotics for the prevention of vaginal infections: A Systematic review. Cureus. 2024;16:7:e64473. https://doi.org/10.7759/cureus.64473
Bohbot JM, Daraï E, Bretelle F, Brami G, Daniel C, Cardot JM. Efficacy and safety of vaginally administered lyophilized Lactobacillus crispatus IP 174178 in the prevention of bacterial vaginosis recurrence. J Gynecol Obstet Hum Reprod. 2018;47:2:81-86. https://doi.org/10.1016/j.jogoh.2017.11.005
Кира Е.Ф., Припутневич Т.В., Муравьева В.В., Халтурина Ю.В. Трансплантация вагинальной микробиоты. Акушерство и гинекология. 2023;10:39-46. https://doi.org/10.18565/aig.2023.142
Benech N, Sokol H. Fecal microbiota transplantation in gastrointestinal disorders: time for precision medicine. Genome Med. 2020;12:1:58. https://doi.org/10.1186/s13073-020-00757-y
Liu SX, Li YH, Dai WK, Li XS, Qiu CZ, Ruan ML, Zou B, Dong C, Liu YH, He JY, Huang ZH, Shu SN. Fecal microbiota transplantation induces remission of infantile allergic colitis through gut microbiota re-establishment. World J Gastroenterol. 2017;23: 48:8570-8581. https://doi.org/10.3748/wjg.v23.i48.8570
Meng Y, Sun J, Zhang G. Fecal microbiota transplantation holds the secret to youth. Mech Ageing Dev. 2023;212:111823. https://doi.org/10.1016/j.mad.2023.111823
Aron-Wisnewsky J, Clément K, Nieuwdorp M. Fecal microbiota transplantation: a future therapeutic option for obesitydiabetes. Curr Diab Reports. 2019;19:1-9. https://doi.org/10.1007/s11892-019-1180-z
Vaughn BP, Rank KM, Khoruts A. Fecal microbiota transplantation: current status in treatment of GI and liver disease. Clin Gastroenterol Hepatol. 2019;17:2:353-361. https://doi.org/10.1016/j.cgh.2018.07.026
Shasthry SM. Fecal microbiota transplantation in alcohol related liver diseases. Clin Mol Hepatol. 2020;26:3:294-301. https://doi.org/10.3350/cmh.2020.0057
Kaakoush NO. Fecal transplants as a microbiome-based therapeutic. Curr Opinion Microbiol. 2020;56:16-23. https://doi.org/10.1016/j.mib.2020.05.008
Kaźmierczak-Siedlecka K, Daca A, Fic M, van de Wetering T, Folwarski M, Makarewicz W. Therapeutic methods of gut microbiota modification in colorectal cancer management — fecal microbiota transplantation, prebiotics, probiotics, and synbiotics. Gut Microbes. 2020;11:6:1518-1530. https://doi.org/10.1080/19490976.2020.1764309
DeLong K, Zulfiqar F, Hoffmann DE, Tarzian AJ, Ensign LM. Vaginal microbiota transplantation: The Next frontier. J Law Med Ethics. 2019;47:4:555-567. https://doi.org/10.1177/1073110519897731
Ma D, Chen Y, Chen T. Vaginal microbiota transplantation for the treatment of bacterial vaginosis: a conceptual analysis. FEMS Microbiol Lett. 2019;366:4:fnz025. https://doi.org/10.1093/femsle/fnz025
Lev-Sagie A, Goldman-Wohl D, Cohen Y, Dori-Bachash M, Leshem A, Mor U, Strahilevitz J, Moses AE, Shapiro H, Yagel S, Elinav E. Vaginal microbiome transplantation in women with intractable bacterial vaginosis. Nat Med. 2019;25:10:1500-1504. https://doi.org/10.1038/s41591-019-0600-6
Meng Y, Sun J, Zhang G. Vaginal microbiota transplantation is a truly opulent and promising edge: fully grasp its potential. Front Cell Infect Microbiol. 2024;14:1280636. https://doi.org/10.3389/fcimb.2024.1280636
Gardner HL, Dukes CD. Haemophilus vaginalis vaginitis: a newly defined specific infection previously classified non-specific vaginitis. Am J Obstet Gynecol. 1955;69:5:962-976.
Swidsinski S, Moll WM, Swidsinski A. Bacterial vaginosis-vaginal polymicrobial biofilms and dysbiosis. Dtsch Arztebl Int. 2023; 120:20:347-354. https://doi.org/10.3238/arztebl.m2023.0090
Joseph RJ, Ser HL, Kuai YH, Tan LT, Arasoo VJT, Letchumanan V, Wang L, Pusparajah P, Goh BH, Ab Mutalib NS, Chan KG, Lee LH. Finding a balance in the vaginal microbiome: How do we treat and prevent the occurrence of bacterial vaginosis? Antibiotics (Basel). 2021;10:6:719. https://doi.org/10.3390/antibiotics10060719
Vieira-Baptista P, De Seta F, Verstraelen H, Ventolini G, Lonnee-Hoffmann R, Lev-Sagie A. The vaginal microbiome: V. Therapeutic modalities of vaginal microbiome engineering and research challenges. J Low Genit Tract Dis. 2022;26:1:99-104. https://doi.org/10.1097/LGT.0000000000000647
Li Y, Zhu W, Jiang Y, Lessing DJ, Chu W. Synthetic bacterial consortia transplantation for the treatment of Gardnerella vaginalis-induced bacterial vaginosis in mice. Microbiome. 2023;11:1:54. https://doi.org/10.1186/s40168-023-01497-y
Chen T, Xia C, Hu H, Wang H, Tan B, Tian P, Zhao X, Wang L, Han Y, Deng KY, Wei H, Xin HB. Dysbiosis of the rat vagina is efficiently rescued by vaginal microbiota transplantation or probiotic combination. Int J Antimicrob Agents. 2021;57:3:106277. https://doi.org/10.1016/j.ijantimicag.2021.106277
Chen P, Chen P, Guo Y, Fang C, Li T. Interaction between chronic endometritis caused endometrial microbiota disorder and endometrial immune environment change in recurrent implantation failure. Front Immunol. 2021;12:748447. https://doi.org/10.3389/fimmu.2021.748447
Lu F, Wei J, Zhong Y, Feng Y, Ma B, Xiong Y, Wei K, Tan B, Chen T. Antibiotic therapy and vaginal microbiota transplantation reduce endometriosis disease progression in female mice via NF-κB signaling pathway. Front Med (Lausanne). 2022;9:831115. https://doi.org/10.3389/fmed.2022.831115
Dominguez-Bello MG, De Jesus-Laboy KM, Shen N, Cox LM, Amir A, Gonzalez A, Bokulich NA, Song SJ, Hoashi M, Rivera-Vinas JI, Mendez K, Knight R, Clemente JC. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nat Med. 2016;22:3:250-253. https://doi.org/10.1038/nm.4039
Butler ÉM, Chiavaroli V, Derraik JGB, Grigg CP, Wilson BC, Walker N, O’Sullivan JM, Cutfield WS. Maternal bacteria to correct abnormal gut microbiota in babies born by C-section. Medicine (Baltimore). 2020;99:30:e21315. https://doi.org/10.1097/MD.0000000000021315
Wilson BC, Butler ÉM, Grigg CP, Derraik JGB, Chiavaroli V, Walker N, Thampi S., Creagh C, Reynolds AJ, Vatanen T, O’Sullivan JM, Cutfield WS. Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial. EBioMedicine. 2021;69:103443. https://doi.org/10.1016/j.ebiom.2021.103443
Mueller NT, Differding MK, Sun H, Wang J, Levy S, Deopujari V, Appel LJ, Blaser MJ, Kundu T, Shah AA, Dominguez Bello MG, Hourigan SK. Maternal bacterial engraftment in multiple body sites of Cesarean section born neonates after vaginal seeding-a randomized controlled trial. mBio. 2023;14:3:e0049123. https://doi.org/10.1128/mbio.00491-23
Wrønding T, Vomstein K, Bosma EF, Mortensen B, Westh H, Heintz JE, Mollerup S, Petersen AM, Ensign LM, DeLong K, van Hylckama Vlieg JET, Thomsen AB, Nielsen HS. Antibiotic-free vaginal microbiota transplant with donor engraftment, dysbiosis resolution and live birth after recurrent pregnancy loss: a proof of concept case study. EClinicalMedicine. 2023;61:102070. https://doi.org/10.1016/j.eclinm.2023.102070
Luo H, Zhou C, Zhou L, He Y, Xie RH. The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review. Arch Gynecol Obstet. 2024;310:2:643-653. https://doi.org/10.1007/s00404-024-07611-1
DeLong K, Bensouda S, Zulfiqar F, Zierden HC, Hoang TM, Abraham AG, Coleman JS, Cone RA, Gravitt PE, Hendrix CW, Fuchs EJ, Gaydos CA, Weld ED, Ensign LM. Conceptual design of a universal donor screening approach for vaginal microbiota transplant. Front Cell Infect Microbiol. 2019;9:306. https://doi.org/10.3389/fcimb.2019.00306
Yockey LJ, Hussain FA, Bergerat A, Reissis A, Worrall D, Xu J, Gomez I, Bloom SM, Mafunda NA, Kelly J, Kwon DS, Mitchell CM. Screening and characterization of vaginal fluid donations for vaginal microbiota transplantation. Sci Rep. 2022;12:1:17948. https://doi.org/10.1038/s41598-022-22873-y
Hoffmann DE, Palumbo FB, Ravel J, Rowthorn V, von Rosenvinge E. A proposed definition of microbiota transplantation for regulatory purposes. Gut Microbes. 2017;8:3:208-213. https://doi.org/10.1080/19490976.2017.1293223
Wei K, Chen T. Vaginal microbiota transplantation for treatment of bacterial vaginosis: a review. Sheng Wu Gong Cheng Xue Bao. 2021;37:11:3820-3827. (In Chinese). https://doi.org/10.13345/j.cjb.210163
Zhang F, Cui B, He X, Nie Y, Wu K, Fan D. FMT-standardization Study Group. Microbiota transplantation: concept, methodology and strategy for its modernization. Protein Cell. 2018;9:5:462-473. https://doi.org/10.1007/s13238-018-0541-8
Quaranta G, Ianiro G, De Maio F, Guarnaccia A, Fancello G, Agrillo C, Iannarelli F, Bibbo S, Amedei A, Sanguinetti M, Cammarota G, Masucci L. «Bacterial Consortium»: A Potential evolution of fecal microbiota transplantation for the treatment of Clostridioides difficile infection. Biomed Res Int. 2022:5787373. https://doi.org/10.1155/2022/5787373
Louie T, Golan Y, Khanna S, Bobilev D, Erpelding N, Fratazzi C, Carini M, Menon R, Ruisi M, Norman JM, Faith JJ, Olle B, Li M, Silber JL, Pardi DS. VE303, a defined bacterial consortium, for prevention of recurrent clostridioides difficile infection: A Randomized clinical trial. JAMA. 2023;329:16:1356-1366. https://doi.org/10.1001/jama.2023.4314
Brown SE, Tuddenham S, Shardell MD, Klebanoff MA, Ghanem KG, Brotman RM. Bacterial vaginosis and spontaneous clearance of Chlamydia trachomatis in the longitudinal study of vaginal flora. J Infect Dis. 2023;228:6:783-791. https://doi.org/10.1093/infdis/jiad142
Tomás M, Palmeira-de-Oliveira A, Simões S, Martinez-de-Oliveira J, Palmeira-de-Oliveira R. Bacterial vaginosis: Standard treatments and alternative strategies. Int J Pharm. 2020;587:119659. https://doi.org/10.1016/j.ijpharm.2020.119659
Martinelli S, Nannini G, Cianchi F, Staderini F, Coratti F, Amedei A. Microbiota transplant and gynecological disorders: The Bridge between present and future treatments. Microorganisms. 2023;11:10:2407. https://doi.org/10.3390/microorganisms11102407