Effect of probiotics on vaginal health in pregnancy. EFFPRO, a randomized controlled trial

Gille, Christian; Böer, B; Marschal, Matthias; Urschitz, Michael S.; Heinecke, Volker; Hund, Verena; Speidel, Sarah; Tarnow, Inge; Mylonas, Ioannis; Franz, Axel; Engel, Corinna; Poets, Christian F.

doi:10.1016/j.ajog.2016.06.021

Cited by 68 publications

(48 citation statements)

References 33 publications

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“…BV is an inflammatory vaginal disease caused by a disturbance of the vaginal microbiota, including a decrease in the number of beneficial bacteria, such as lactobacilli, and an increase in the number of harmful bacteria, such as GV and AV [4,10,21]. BV increases the risk of infection by sexually transmitted pathogens, such as HIV-1, and carries a risk of early delivery in pregnant women [22].…”

Section: Discussionmentioning

confidence: 99%

“…Although antibacterial drugs, such as clindamycin and metronidazole, are commonly used for BV treatment, probiotics are frequently recommended due to infection recurrence and drug resistance [7,8]. Unlike anti-bacterial drugs, microbiota-friendly probiotics may attenuate vaginosis by killing or out competing pathogens in the vagina [9,10,23]. …”

Section: Discussionmentioning

confidence: 99%

“…Although antimicrobial drugs, such as clindamycin and metronidazole, are recommended for the treatment of BV, the use of these drugs is limited due to their side effects such as drug resistance and superinfection [7,8]. Therefore, probiotics are frequently used to treat BV [9,10]. …”

Section: Introductionmentioning

confidence: 99%

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Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 Attenuate Gardnerella vaginalis-Infected Bacterial Vaginosis in Mice

Jang

Jeong

Choi³

et al. 2017

Nutrients

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Oral administration of a probiotic mixture (PM; Respecta®) consisting of Lactobacillus rhamnosus HN001 (L1), Lactobacillus acidophilus La-14 (L2), and lactoferrin RCXTM results in colonization of these probiotics in the vagina of healthy women. Therefore, we examined whether vaginal colonization of the PM ingredients L1 and L2 could attenuate bacterial vaginosis (BV). BV was induced in mice via β-estradiol-3-benzoate-induced immunosuppression and intravaginal inoculation with Gardnerella vaginalis (GV). Inflammatory markers were analyzed using enzyme-linked immunosorbent assay, immunoblotting, quantitative polymerase chain reaction, and flow cytometry. Oral or intravaginal administration of PM resulted in colonization of L1 and L2 in the vagina. Oral or intravaginal administration of L1, L2, or PM significantly inhibited GV-induced epithelial cell disruption, myeloperoxidase activity, NF-κB activation, and IL-1β and TNF-α expression (p < 0.05). Administration of these probiotics also inhibited IL-17 and RORγt expression but increased IL-10 and Foxp3 expression. Of these probiotics, L2 most effectively attenuated GV-induced BV, followed by L1 and PM. Oral administration was more effective against GV-induced BV than intravaginal administration. L1 and L2 also significantly inhibited the adherence of GV to HeLa cells (a human cervical cancer cell line) and GV growth in vitro. In addition, L1 and L2 inhibited lipopolysaccharide-induced NF-κB activation in macrophages and the differentiation of splenocytes into Th17 cells in vitro, but increased their differentiation into Treg cells. Our study suggests that L1, L2, and PM attenuated GV-induced vaginosis by regulating both vaginal and systemic innate and adaptive immune responses rather than direct competition or killing of GV in the vagina.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 Attenuate Gardnerella vaginalis-Infected Bacterial Vaginosis in Mice

Jang

Jeong

Choi³

et al. 2017

Nutrients

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“…A cohort study in Norway demonstrated an association between high intake of probiotic dairy products and reduced risk of spontaneous preterm delivery (Table 2) [30]. A more recent study showed no significant difference in the vaginal microbiota after eight weeks of probiotics, starting at the end of the first trimester [31]; however, the incidence of bacterial vaginosis was low (2.8%) in the treatment group.…”

Section: Probiotic Administration In Pregnancymentioning

confidence: 99%

Prenatal and postnatal administration of prebiotics and probiotics

Sohn

Underwood

2017

Seminars in Fetal and Neonatal Medicine

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SUMMARY Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates. Administration of enteral prebiotics, probiotics, and synbiotics during pregnancy, lactation, and postnatal life appears to be a safe and feasible method to alter the maternal and neonatal microbiome, thus improving pregnancy and neonatal outcomes.

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“…Evidence suggests that restoration of the vaginal microbiota and/or modulation of the local mucosal immune response can be achieved via supplementation with probiotics, which can be administered orally as a probiotic food supplement, intra-vaginally as vaginal suppositories, or applied topically as a gel (Gille et al 2016;Stapleton et al 2011;Zeng et al 2010). Bertuccini et al (2017) evaluated the effects of L. rhamnosus HN001 and L. acidophilus GLA-14 on bacterial vaginal pathogens (G. vaginalis and A. vaginae) and aerobic vaginitis (AV) (S. aureus and E. coli).…”

Section: Probiotics and Prebiotics On The Health Of The Female Urogenmentioning

confidence: 99%

Probiotics and prebiotics potential for the care of skin, female urogenital tract, and respiratory tract

et al. 2019

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The prebiotics and probiotics market is constantly growing due to the positive effects of its consumption on human health, which extends beyond the digestive system. In addition, the synbiotic products market is also expanding due to the synergistic effects between pre-and probiotics that provide additional benefits to consumers. Pre-and probiotics are being evaluated for their effectiveness to treat and prevent infectious diseases in other parts of the human body where microbial communities exist. This review examines the scientific data related to the effects of pre-and probiotics on the treatment of diseases occurring in the skin, female urogenital tract, and respiratory tract. The evidence suggests that probiotics consumption can decrease the presence of eczema in children when their mothers have consumed probiotics during pregnancy and lactation. In women, probiotics consumption can effectively prevent recurrent urinary tract infections. The consumption of synbiotic products can reduce respiratory tract infections and their duration and severity. However, the outcomes of the meta-analyses are still limited and not sufficiently conclusive to support the use of probiotics to treat infectious diseases. This is largely a result of the limited number of studies, lack of standardization of the studies, and inconsistencies between the reported results. Therefore, it is advisable that future studies consider these shortcomings and include the evaluation of the combined use of pre-and probiotics.

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Effect of probiotics on vaginal health in pregnancy. EFFPRO, a randomized controlled trial

Abstract: Oral probiotics may be suitable for implementation in antenatal care but, as administered here, had no effect on vaginal health during mid gestation. Other application routes or probiotic preparations may be more effective in supporting vaginal microbiota during pregnancy.

Cited by 68 publications

References 33 publications

Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 Attenuate Gardnerella vaginalis-Infected Bacterial Vaginosis in Mice

Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 Attenuate Gardnerella vaginalis-Infected Bacterial Vaginosis in Mice

Prenatal and postnatal administration of prebiotics and probiotics

Probiotics and prebiotics potential for the care of skin, female urogenital tract, and respiratory tract

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