Lactobacillus crispatus probiotics may support vaginal health: RCT

Formulations of Lactobacillus crispatus strains may be effective against bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC), according to a new study published in Beneficial Microbes.

The randomized double-blind placebo controlled clinical trial revealed that novel probiotic L. crispatus strains were effective in relieving the signs and symptoms of BV and VVC when consumed orally or administered vaginally.

The study included 89 women with BV and 93 with VVC randomly assigned to receive placebo or probiotic capsules containing two (DSM32717 and DSM32720, in case of BV) or three (DSM32720, DSM32718 and DSM32716, in case of VVC) Lactobacillus crispatus strains for three months.

“… compared with other species of Lactobacilli, strains of L. crispatus provide the best balance of beneficial species-specific properties to sustain vaginal eubiosis with respect to the production of H2O2, bacteriocins and lactic acid, including the most beneficial ratio of the l- and d-isomers, and the protonated form of lactic acid,” explained researchers based in Estonia, led by Dr Reet Mändar from the University of Tartu.

“Therefore, the future vaginal probiotic research should be centred around L. crispatus.”

Vaginal microbiome

Over 250 species of bacteria have been detected in the vagina using genomic sequencing. The healthy female microbiome is dominated by Lactobacilli. The most prevalent vaginal Lactobacilli include homofermentative species Lactobacillus crispatus, Lactobacillus iners, Lactobacillus gasseri and Lactobacillus jensenii.

Lactobacillus maintains the stability of the vaginal microenvironment, by inhibiting the growth of pathogenic microorganisms and maintaining a low vaginal pH. Disturbance of the vaginal microbiome can lead to bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC). The use of probiotic Lactobacilli vaginally and orally has shown great promise in helping to restore and maintain a healthy vagina.

Most probiotics contain multiple Lactobacilli species; this randomized double-blind placebo controlled clinical trial used strains of Lactobacillus crispatus, only. The aim of the study was to evaluate the impact of Lactobacillus crispatus probiotics on bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) patients.

Key findings

The three-month study found “remarkable” clinical and microbiological improvement was observed during the first 4 weeks of the trial, said the researchers.

The trial also showed how targeted specific probiotic strains used orally or vaginally, short term, can be used for the development of live biotherapeutic strategies. Currently, there are patents on all four of the Lactobacillus crispatus strains. The patents are held by the Competence Centre on Health Technologies (CCHT).

Dr Mändar and her co-workers noted that while most probiotics for women’s health have focused on BV patients, VVD has been much less studied. VVC is characterized by significant increases in yeast in the vagina, and significantly lower abundance of Lactobacillus. The new study indicated that the specific L. crispatus strains may decrease discharge and itching/irritation.

“If we summarised the scores of these two parameters, we could see statistically significant decrease of complaints in both administration mode groups. Hence, the numerous women with recurrent VVC may benefit from this formulation,” they stated.

CCHT

CCHT is a biotechnology company established in 2009, that during 2009-2014 was known as the Competence Centre on Reproductive Medicine and Biology. Until 2014, the research in CCHT was focused on novel approaches for human infertility diagnostics and treatment, and human and animal assisted reproductive technologies. Two new development areas were added, personal medicine and drug development and the company name changed to Tervisetehnoloogiate Arenduskeskus AS.

A spokesperson for CCHT told NutraIngredients-USA that they do not yet have the commercial partner(s). "Some companies have shown their interest but so far we are just negotiating.

"We are looking for the possibility to become the supplier for the supplement manufacturers," they added

Source: Beneficial Microbes
Published online ahead of print, doi: 10.3920/BM2022.0091
“Impact of Lactobacillus crispatus-containing oral and vaginal probiotics on vaginal health: a randomised double-blind placebo controlled clinical trial”
Authors: R. Mändar, et al.