号外:人类首次!5位妇女受阴道菌群移植,4位起效!
  • 招募5例27-47岁、症状明显的顽固性和复发性细菌性阴道病妇女;
  • 以克林霉素霜(3人)和甲硝唑凝胶(2人)先行处理,7天后分别植入来自3位健康女性的阴道菌群;
  • 2人经一次移植,2人经三次移植(其中1人最后一次更换供体)后取得了长期缓解,移植后5-21个月内未复发;
  • 具体表现为症状、Amsel诊断标准、显微阴道分泌物的明显改善,以及以乳酸杆菌为主的阴道菌群重构;
  • 1人的临床和实验室特征均未完全缓解,在5人中均未观察到明显不良反应。
主编推荐语
蓝灿辉 | 热心肠先生
我们关于粪菌移植(Fecal Microbiota Transplantation,FMT)的认识已经比较深入,在全世界范围内开展的 FMT 临床试验也非常多,并在复发性艰难梭菌感染、炎症性肠病以及一些肠外疾病中取得疗效。关于阴道菌群的研究不少,但是在原理上与 FMT 类似的阴道菌群移植临床研究一直未见报道。 来自以色列威兹曼研究所的 Eran Elinav 教授和合作者,今天在 Nature Medicine 上报道了他们完成的第一个在人身上做的阴道菌群移植研究,带来了让我们振奋的结果——5例顽固性和复发性细菌性阴道病患者,接受菌群移植后,4例获得长期缓解。当然,具体到每一个病例,在数百天的研究过程中,情况各不相同,特别是其中有2例,是在三次移植后得以缓解,其中还有1例中间更换了供体后才得以缓解。 这是一个探索性的研究,只有5个案例,却会给妇科阴道炎治疗带来完全不同的思路,很值得精细阅读本文。
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Nature Medicine [IF:30.641]

Vaginal microbiome transplantation in women with intractable bacterial vaginosis

在患有顽固性细菌性阴道病的妇女中的阴道菌群移植

10.1038/s41591-019-0600-6

10-07, Communication

Abstract & Authors:展开

Abstract:收起
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 5–21 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.

First Authors:
Ahinoam Lev-Sagie,Debra Goldman-Wohl

Correspondence Authors:
Ahinoam Lev-Sagie,Eran Elinav

All Authors:
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

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