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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.
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Disbiose , Microbiota , Vagina , Vaginose Bacteriana , Feminino , Vaginose Bacteriana/microbiologia , Vaginose Bacteriana/terapia , Humanos , Disbiose/terapia , Disbiose/microbiologia , Vagina/microbiologia , Animais , Camundongos , Resultado do Tratamento , Ratos , LactobacillusRESUMO
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.
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Yanyangke mixture (YM) is composed of 12 kinds of traditional Chinese medicine (TCM) used for the treatment of patients with cough, dry throat and other diseases caused by acute or chronic pharyngitis or patients with difficulty in expectoration. With the wide application of YM in clinical practice, its quality control has attracted huge attention. Based on the multi-component characteristics of Chinese herbal medicines, it is pertinent to establish a quality evaluation system. A new idea is to adopt gas chromatography-mass spectrometry (GC-MS) chemical composition identification, GC-MS fingerprint, and GC content determination as a potential quality control index of the volatile oil in YM. In this study, the volatile oil of YM was extracted by steam distillation, and the chemical components of the volatile oil were analyzed by GC-MS, and 43 chemical components were identified. The fingerprint of the volatile oil from YM was established and the similarity evaluation was performed. Combined with chemometric methods, such as cluster analysis, principal component analysis and partial least squares analysis, the chemical composition differences of the volatile oil from different batches of YM were compared and the symbolic components affecting the quality of the volatile oil from different batches of YM were excavated. Finally, three components were selected as the potential active component markers of YM and the GC content determination method of these three components was established. A rapid, reasonable, and effective quality evaluation and control method of YM volatile oil was established, which provided a reference for further development and research on YM, as well as a new idea for research on other TCM prescriptions.
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The microbiomes of cesarean-born infants differ from vaginally delivered infants and are associated with increased disease risks. Vaginal microbiota transfer (VMT) to newborns may reverse C-section-related microbiome disturbances. Here, we evaluated the effect of VMT by exposing newborns to maternal vaginal fluids and assessing neurodevelopment, as well as the fecal microbiota and metabolome. Sixty-eight cesarean-delivered infants were randomly assigned a VMT or saline gauze intervention immediately after delivery in a triple-blind manner (ChiCTR2000031326). Adverse events were not significantly different between the two groups. Infant neurodevelopment, as measured by the Ages and Stages Questionnaire (ASQ-3) score at 6 months, was significantly higher with VMT than saline. VMT significantly accelerated gut microbiota maturation and regulated levels of certain fecal metabolites and metabolic functions, including carbohydrate, energy, and amino acid metabolisms, within 42 days after birth. Overall, VMT is likely safe and may partially normalize neurodevelopment and the fecal microbiome in cesarean-delivered infants.
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Microbioma Gastrointestinal , Microbiota , Feminino , Gravidez , Humanos , Lactente , Recém-Nascido , Parto Obstétrico , Cesárea/efeitos adversos , FezesRESUMO
Purpose: Previous studies reported a higher risk of food allergy for cesarean-born children than vaginal-born children. This study aims to systematically compare the prevalence of food allergy among cesarean-born and vaginal-born children aged 0-3 years. Methods: Three English and two Chinese databases were searched using terms related to food allergies and cesarean sections. Cohort studies that reported the prevalence of food allergy in cesarean-born and vaginal-born children aged 0-3 years were included. Two reviewers performed study selection, quality assessment, and data extraction. The pooled prevalence of food allergy in cesarean-born and vaginal-born children was compared by meta-analysis. Results: Nine eligible studies, with 9,650 cesarean-born children and 20,418 vaginal-born children aged 0-3 years, were included. Of them, 645 cesarean-born children and 991 vaginal-born children were identified as having food allergies. The pooled prevalence of food allergy was higher in cesarean-born children (7.8%) than in vaginal-born children (5.9%). Cesarean section was associated with an increased risk of food allergy [odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03-2.05] and cow's milk allergy (OR: 3.31; 95% CI: 1.98-5.53). Additionally, cesarean-born children with a parental history of allergy had an increased risk of food allergy (OR: 2.60; 95% CI: 1.28-5.27). Conclusion: This study suggests that cesarean sections was associated with an increased risk of food and cow's milk allergies in children aged 0-3 years. Cesarean-born children with a parental history of allergy demonstrated a higher risk for food allergy than did vaginal-born children. These results indicate that caregivers should be aware of the risks of food allergies in cesarean-born children, reducing the risk of potentially fatal allergic events. Further research is needed to identify the specific factors affecting food allergies in young children. Systematic Review Registration: http://www.crd.york.ac.uk/prospero, identifier: International Prospective Register of Systematic Reviews (NO. CRD42019140748).