The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review.

OBJECTIVE: To comprehensively summarize the existing evidence on the effectiveness of vaginal microbiota transplantation (VMT) in treating vaginal dysbiosis (VD) and bacterial vaginosis (BV). METHODS: Following the PRISMA-ScR guidelines, a scoping review was conducted through October 10, 2023, using the databases PubMed, Embase, Scopus, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, SinoMed, Weipu (VIP), ClinicalTrials.gov and the Chinese clinical trial registry. RESULTS: A total of 12 studies were included, of which 7 were published (comprising 3 human and 4 animal studies), and 5 were ongoing registered trials (human). Of the published human studies involving 36 women, one focused on VD, and two investigated BV. These studies reported that VMT restored the Lactobacillus-dominated vaginal microbiota, alleviating symptoms. In animal studies with 145 female rats or mice, VMT was explored for one case of VD and three cases of BV, demonstrating a reduction in the expression of IL-1ß and TNF-α. Additionally, two of the animal studies also indicated an increase in the number of Lactobacilli following VMT. The ongoing registered trials involved 556 women, with two focusing on VD and three targeting BV. CONCLUSIONS: VMT shows promise in restoring the Lactobacillus-dominated vaginal microbiota among women with VD or BV. Moreover, animal studies have indicated an increase in the number of Lactobacilli and a decrease in the expression of IL-1ß and TNF-α following VMT. Ongoing registered trials are expected to provide comprehensive evidence regarding the efficacy of VMT.

Microbiota transplantation in restoring cesarean-related infant dysbiosis: a new frontier.

C-section is crucial in reducing maternal and neonatal mortality when medically indicated, but one of its side effects could be the disruption of vertical transmission of maternal-infant microbiota during delivery, potentially leading to gut dysbiosis and increased disease risks in C-section infants. To address such dysbiosis, it seems reasonable to supplement "what is missing" during C-section procedure. This idea has prompted several clinical trials, including proof-of-concept, investigating interventions like vaginal microbial seeding, oral administration of maternal vaginal microbes and even oral administration of maternal fecal materials. Hereby, we have summarized these trials to help understand the current state of these researches, highlighting the predominantly pilot nature of most of these studies and emphasizing the need for well-designed studies with larger sample to guide evidence-based medicine in the future.

C-section is associated with gut dysbiosis in CS infants and increased disease risks from childhood to adulthood.Apart from using traditional probiotics to restore CS-related dysbiosis, a new research direction is to investigate the potential of mimicking natural inoculation process would alleviate infant gut dysbiosis.Several small-scale studies have shown that transplanting maternal vaginal or even fecal microbiota might restore CS-related infant dysbiosis. Controversy remains regarding the clinical applicability, safety, efficacy and mechanisms of these approaches.

Association of maternal postpartum depression symptoms with infant neurodevelopment and gut microbiota.

Introduction: Understanding the mechanisms underlying maternal postpartum depression (PPD) and its effects on offspring development is crucial. However, research on the association between maternal PPD, gut microbiota, and offspring neurodevelopment remains limited. This study aimed to examine the association of maternal PPD symptoms with early gut microbiome, gut metabolome, and neurodevelopment in infants at 6 months. Methods: Maternal PPD symptoms were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at 42 days postpartum. Infants stool samples collected at 42 days after birth were analyzed using 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC-MS) detection. Infant neurodevelopment was measured at 6 months using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Correlations between gut microbiota, metabolites and neurodevelopment were identified through co-occurrence network analysis. Finally, mediation analyses were conducted to determine potential causal pathways. Results: A total of 101 mother-infant dyads were included in the final analysis. Infants born to mothers with PPD symptoms at 42 days postpartum had lower neurodevelopmental scores at 6 months. These infants also had increased alpha diversity of gut microbiota and were abundant in Veillonella and Finegoldia, while depleted abundance of Bifidobacterium, Dialister, Cronobacter and Megasphaera. Furthermore, alterations were observed in metabolite levels linked to the Alanine, aspartate, and glutamate metabolic pathway, primarily characterized by decreases in N-Acetyl-L-aspartic acid, L-Aspartic acid, and L-Asparagine. Co-occurrence network and mediation analyses revealed that N-Acetyl-L-aspartic acid and L-Aspartic acid levels mediated the relationship between maternal PPD symptoms and the development of infant problem-solving skills. Conclusions: Maternal PPD symptoms are associated with alterations in the gut microbiota and neurodevelopment in infants. This study provides new insights into potential early intervention for infants whose mother experienced PPD. Further research is warranted to elucidate the biological mechanisms underlying these associations.