Exploring the future possible directions for vaginal microbiome Research.

Speaking at the 7th Microbiome & Probiotics Business Collaboration Forum, Liisa Lehtoranta explored the future possible directions for vaginal microbiome research.

Complexity

The recent advances in molecular genomic technologies and bioinformatic tools have enabled researchers to deep dive into the vaginal ecosystem, while also revealing how complex it is. For example, research has shown that the composition of the vaginal microbiome is comprised of several microbiota. This complexity is underscored by the fact that the dominance of one microbiota over the other varies across different ethnic groups and the menstrual cycle. Additionally, not all non-lactobacillus dominated vaginal microbiota communities are direct implications of a disease and not all vaginal lactobacillus, are, necessarily, the most optimal for health. For example, lactobacillus iners, one of the most dominant species in the vaginal track, is frequently detected in both healthy women and women with bacterial vaginosis.

Viruses and Fungi

A new avenue of vaginal research is the role that viruses and fungi in the vaginal tract play in women’s health.

Viruses

Liisa referenced a recent study (Jakobsen et al 2020) which showed that the composition of viral communities varied between healthy women and between and women who had a BV infection. The study revealed that bacteriophages seemed to shape vaginal bacterial communities, by, for example, depleting commensal bacteria and promoting pathogenic bacterial colonization. This raises the hypothesis that phage therapy could target these vaginal pathogens to re-establish commensal bacterial populations.

Fungi

Candida albicans is the most abundant fungi in a healthy vaginal tract, but also the leading pathogen in vulvovaginal candidiasis. Again, Liisa looked at recent research (Gaziano et al 2020) which posited that vaginal bacteria may not be the best candidate to prevent candida infections. Instead, fungal probiotics could be more efficacious. For example, saccharomyces cerevisiae has been shown to restrict candida albicans pre-clinically and clinically. The potential is there to find more novel and more efficacious strains.

Vaginal microbiota transplantation the next frontier therapy for bacterial vaginosis infections

Liisa referenced a study (Lev-Sagie et al) of women who had intractable/difficult bacterial vaginosis, and who received vaginal microbiota transplantation from healthy women. After two years the study showed that most of the women reached long-term remission and the transplantation therapy was safe. There were no adverse effect effects.

Conclusion

In her concluding remarks, Liisa said that:

• the vaginal microbiota plays an important role in women’s health and the higher abundance of lactobacilli correlate positively with reproductive health and reduces infection risk
• specific probiotics, such as lactobacillus acidophilus, La 14, and lactobacillus rhamnosus HN 001 show potential in supporting healthy vaginal microbiota, as well as in BV and candida recovery
• molecular methods, as well as bioinformatic tools, expand our understanding of vaginal microbiota in health and in disease.

LIISA LEHTORANTA, R&D Manager, Nutrition & Biosciences, DuPont Vaginal Microbiota Management and Impact on Women’s Health.

Dr Liisa Lehtoranta and her team explore the health effects of probiotics, prebiotics, and other functional ingredients in preclinical and clinical settings. In her current role, she is also responsible for women’s health research platform. Dr Lehtoranta holds a PhD degree in Microbiology from the University of Helsinki. She has 10 years of experience in scientific research from academia and the industry with her main focus on probiotics and the effects on microbiota and health.