阴道微生物组移植或可治疗顽固性细菌阴道炎
本期文章：《自然—医学》：Online/在线发表
以色列威兹曼科学研究所Eran Elinav和哈达萨希伯来大学医学中心Ahinoam Lev-Sagie等研究人员合作，对患有顽固性细菌阴道炎的女性进行了阴道微生物组移植治疗试验。相关论文2019年10月7日在线发表在《自然—医学》上。
研究人员报告了一项首次探索性研究的结果，该研究测试了使用健康供体的阴道微生物组移植（VMT）作为患有症状性、顽固型和复发型细菌阴道炎的患者的治疗替代方案。在研究的病例系列中，研究人员治疗了5例患者，其中4例VMT与长期完全缓解相关，这一直延续到VMT术后5-21个月随访结束，这由症状、Amsel标准、镜检明显改善乳杆菌为主的阴道微生物组阴道液外观和重构所定义。一名患者的临床和实验室特征未完全缓解。在这五名妇女中没有观察到不良反应。
值得注意的是，三名患者的缓解需要重复VMT，包括一名患者的供体改变，以引起长期的临床反应。VMT在顽固型和复发型细菌阴道炎女性中的治疗效果应在随机、安慰剂对照的临床试验中进一步确定。
附：英文原文
Title: Vaginal microbiome transplantation in women with intractable bacterial vaginosis
Author: Ahinoam Lev-Sagie, Debra Goldman-Wohl, Yotam Cohen, Mally Dori-Bachash, Avner Leshem, Uria Mor, Jacob Strahilevitz, Allon E. Moses, Hagit Shapiro, Simcha Yagel, Eran Elinav
Issue&Volume: 2019-10-07
Abstract: 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 521 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. This first-in-human study assessed the feasibility of vaginal microbiome transplantation from healthy donors as a therapeutic alternative for patients suffering from symptomatic, intractable and recurrent bacterial vaginosis.
DOI: 10.1038/s41591-019-0600-6
Source:https://www.nature.com/articles/s41591-019-0600-6
期刊信息
Nature Medicine：《自然—医学》，创刊于1995年。隶属于施普林格·自然出版集团，最新IF：30.641
官方网址：https://www.nature.com/nm/
投稿链接：https://mts-nmed.nature.com/cgi-bin/main.plex
