Probiotics - Clinical Research & Resources

Researchers continue to study probiotics to support vaginal health as a means of fostering a vaginal environment dominated by beneficial lactobacillus and appropriate levels of lactic acid. Studies point to positive potential for specific probiotic strains to support vaginal health and maintenance. 

Influence of probiotic vaginal lactobacilli on in vitro adhesion of urogenital pathogens to vaginal epithelial cells

G. Za ́rate and M.E. Nader-Macias. Letters in Applied Microbiology (2006).

 

Probiotic supplementation with vaginal Lactobacillus rhamnosus BMX54 seems to be useful in hindering bacteria growth especially after antibiotic therapy; therefore this intervention may be considered a new prophylactic treatment for preventing recurrence of BV, in particular in high-risk patients.

 

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Restoring vaginal microbiota: biological control of bacterial vaginosis. A prospective case-control study using Lactobacillus rhamnosus BMX 54 as adjuvant treatment against bacterial vaginosis
Recine, N., Palma, E., Domenici, L., Giorgini, M., Imperiale, L., et al. Archives of Gynecology and Obstetrics (2016).

 

Probiotic supplementation with vaginal Lactobacillus rhamnosus BMX54 seems to be useful in hindering bacteria growth especially after antibiotic therapy; therefore this intervention may be considered a new prophylactic treatment for preventing recurrence of BV, in particular in high-risk patients.

 

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Topical vs. Oral Probiotics for Intimate Health
Valerie A. King, MD

 

Probiotics are the "good bacteria." They help support the healthy bacteria in a person's gut - as well as the healthy lactobacillus bacteria in the vagina. Good bacteria, such as the lactobacillus species in the vaginal area, protect you against yeast and other infections. One way in which the lactobacillus bacteria (i.e. L. Acidophilus, L. Casei, etc.) do this is by the production of lactic acid, which makes the vaginal environment more acidic. This keeps yeast and bad bacteria from growing. When you take certain antibiotics, have hormonal changes, or use harsh chemicals for intimate cleansing you lose this safeguard. This is when yeast and other opportunistic infections may occur. So what’s a girl to do? Consider adding a probiotic that’s formulated for vaginal health.

 

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Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women
Christina Gosmann, Melis N.Anahtar, Scott A. Handley, et al. Immunity (2017).

 

In a prospective cohort of young, healthy South African women, we found that individuals with diverse genital bacterial communities dominated by anaerobes other than Gardnerella were at over 4-fold higher risk of acquiring HIV and had increased numbers of activated mucosal CD4+ T cells compared to those with Lactobacillus crispatus-dominant communities. We identified specific bacterial taxa linked with reduced (L. crispatus) or elevated (Prevotella, Sneathia, and other anaerobes) inflammation and HIV infection and found that high-risk bacteria increased numbers of activated genital CD4+ T cells in a murine model. Our results suggest that highly prevalent genital bacteria increase HIV risk by inducing mucosal HIV target cells. These findings might be leveraged to reduce HIV acquisition in women living in sub-Saharan Africa.

 

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The role of lactobacilli and probiotics in maintaining vaginal health.
Sandra Borges, Joana Silva, and Paula Teixeira. Archives of Gynecology and Obstetrics (2014).

 

This review summarizes the role of lactic acid bacteria in preventing illness of the host, including bacterial vaginosis, yeast vaginitis, urinary tract infection and sexually transmitted diseases. The study determined that the administration of probiotics that colonize the vaginal tract can be important in maintaining a normal urogenital health and also to prevent or treat infections.

 

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Vaginal Lactobacillus Flora of Healthy Swedish Women
Alejandra Vásquez Tell Jakobsson, Siv Ahrné, Urban Forsum, and Göran Molin. Journal of Clinical Microbiology (2002).

 

Two hundred two isolates from the vaginal fluids of 23 Swedish women without bacterial vaginosis, as defined by the criteria of Nugent et al. (R. P. Nugent, M. A. Krohn, and S. L. Hillier, J. Clin. Microbiol. 29:297-301, 1991), were typed by randomly amplified polymorphic DNA (RAPD) analysis and identified to the species level by temporal temperature gradient gel electrophoresis, multiplex PCR, and 16S ribosomal DNA sequencing. The vaginal flora of most participants was dominated by a single RAPD type, but five of them harbored two RAPD types representing two different species or strains. The most frequently occurring species were Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii. L. iners has not previously been reported as one of the predominant Lactobacillus species in the vagina.

 

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Lactobacillus for preventing recurrent urinary tract infections in women: meta-analysis.
Peter M. Grin, Paulina M. Kowalewska, Waleed Alhazzan, and Alison E. Fox-Robichaud. The Canadian Journal of Urology International (2013).

 

Urinary tract infections (UTIs) are the most common infections affecting women, and often recur. Lactobacillus probiotics could potentially replace low dose, long term antibiotics as a safer prophylactic for recurrent UTI (rUTI). This systematic review and meta-analysis was performed to compile the results of existing randomized clinical trials (RCTs) to determine the efficacy of probiotic Lactobacillus species in preventing rUTI. This study concluded that Probiotic strains of Lactobacillus are safe and effective in preventing rUTI in adult women. However, more RCTs are required before a definitive recommendation can be made since the patient population contributing data to this meta-analysis was small.

 

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Probiotics for vulvovaginal candidiasis in non-pregnant women.
Juan Yu Xie, Dan Feng, Dong Mei Wei, Ling Mei, Hui Chen, Xun Wang, and Fang Fang. Cochrane Database of Systematic Reviews (2017).

 

Researchers at the Department of Obstetrics and Gynecology, People's Hospital of Deyang City, in Deyang, Sichuan, China, assessed the effectiveness and safety of probiotics for the treatment of vulvovaginal candidiasis in non-pregnant women. Vulvovaginal candidiasis (VVC) is estimated to be the second most common form of infection after bacterial vaginosis. The ability of probiotics in maintaining and recovering the normal vaginal microbiota, and their potential ability to resist Candidas give rise to the concept of using probiotics for the treatment of VVC. Low and very low quality evidence shows that, compared with conventional treatment, the use of probiotics as an adjuvant therapy could increases the rate of short-term clinical and mycological cure and decrease the relapse rate at one month. However, this did not translate into a higher frequency of long-term clinical or mycological cure. Probiotics use does not seem to increase the frequency of serious or non-serious adverse events. There is a need for well-designed RCTs with standardized methodologies, longer follow-up and larger sample size.

 

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Comparative Genomic and Phenotypic Analysis of the Vaginal Probiotic Lactobacillus rhamnosus GR-1
Mariya I. Petrova, Jean M. Macklaim, Sander Wuyts, Tine Verhoeven, Jos Vanderleyden, Gregory B. Gloor, Sarah Lebeer, and Gregor Reid. Frontiers in Microbiology (2018).

 

In this study, the complete genome sequence of the vaginal probiotic Lactobacillus rhamnosus GR-1 was determined and compared to other L. rhamnosus strains at genomic and phenotypic level. This study could thus provide a molecular framework for the selection of the optimal probiotic strain for each targeted niche and condition, though further substantiation of niche adaptation mechanisms of lactobacilli is warranted. Findings suggested that whilst L. rhamnosus is not a dominant species in the vagina of healthy women (Zhang et al., 2012), the selection of L. rhamnosus GR-1 as a probiotic, originally because of antagonism to uropathogens, is supported by the finding of a number of characteristics well-suited to vaginal persistence (Cadieux et al., 2002) and clinical effectiveness (Gardiner et al., 2002; Irvine et al., 2010). By identifying probiotic strain capabilities, it will one day be possible to improve the alignment of the best strain suited for a particular aberration in the vaginal niche.

 

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Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study.
R. Hemalatha, P. Mastromarino, B.A. Ramalaxmi, N.V. Balakrishna, and B. Sesikeran. European Journal of Clinical Microbiology & Infectious Diseases (2012).

 

The purpose of this study was to evaluate the effectiveness of lactobacilli on vaginal health and proinflammatory cytokines. Sixty-seven patients with bacterial vaginosis (BV), 50 with intermediate flora and 42 with normal vaginal flora were enrolled in this double-blind study. The subjects were randomized to receive probiotic lactobacilli vaginal tablets (L. brevis CD2, L. salivarius subsp. salicinius, L. plantarum) or the vaginal pH tablet (active comparator). The lactobacilli tablet was found to be better than the pH tablet in preventing BV in healthy subjects. A significant reduction in IL-1β and IL-6 vaginal cytokines was observed after treatment with lactobacilli, while the active comparator did not have any effect on local proinflammatory cytokines. Vaginal neutral sphingomyelinase activity was not modified in either group. Vaginal tablets containing lactobacilli can cure BV and reduce vaginal inflammatory response.

 

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