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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Cell. Infect. Microbiol. | doi: 10.3389/fcimb.2019.00306

Conceptual Design of a Universal Donor Screening Approach for Vaginal Microbiota Transplant

Kevin DeLong1,  Sabrine Bensouda1,  Fareeha Zulfiqar1,  Hannah C. Zierden1, Thuy M. Hoang1, Alison G. Abraham1, Jenell S. Coleman1, Richard A. Cone1, Patti E. Gravitt2,  Craig W. Hendrix1, Edward J. Fuchs1, Charlotte A. Gaydos1, Ethel D. Weld1 and  Laura M. Ensign1*
  • 1Johns Hopkins University, United States
  • 2George Washington University, United States

The success of fecal microbiota transplant (FMT) in treating recurrent Clostridioides difficile
infection has led to growing excitement about the potential of using transplanted human material as a therapy for a wide range of diseases and conditions related to microbial dysbiosis. We anticipate that the next frontier of microbiota transplantation will be vaginal microbiota transplant (VMT). The composition of the vaginal microbiota has broad impact on sexual and reproductive health. The vaginal microbiota in the “optimal” state are one of the simplest communities, dominated by one of only a few species of Lactobacillus. Diversity in the microbiota and the concomitant depletion of lactobacilli, a condition referred to as bacterial vaginosis (BV), is associated with a wide range of deleterious effects, including increased risk of acquiring sexually transmitted infections and increased likelihood of having a preterm birth. However, we have very few treatment options available, and none of them curative or restorative, for “resetting” the vaginal microbiota to a more protective state. In order to test the hypothesis that VMT may be a more effective treatment option, we must first determine how to screen donors to find those with minimal risk of pathogen transmission and “optimal” vaginal microbiota for transplant. Here, we describe a universal donor screening approach that was implemented in a small pilot study of 20 women. We further characterized key physicochemical properties of donor cervicovaginal secretions (CVS) and the corresponding composition of the vaginal microbiota to delineate criteria for inclusion/exclusion. We anticipate that the framework described here will help accelerate clinical studies of VMT.

Keywords: Fecal microbiota transplant (FMT), Bacterial vaginosis (BV), Lactobaciilus, Sexually tranmistted infections, Cervicovaginal secretions

Received: 16 May 2019; Accepted: 09 Aug 2019.

Edited by:

Gilda Tachedjian, Burnet Institute, Australia

Reviewed by:

Rita Verhelst, Hogeschool Gent, Belgium
Tania Crucitti, Centre Pasteur du Cameroun, Cameroon  

Copyright: © 2019 DeLong, Bensouda, Zulfiqar, Zierden, Hoang, Abraham, Coleman, Cone, Gravitt, Hendrix, Fuchs, Gaydos, Weld and Ensign. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Laura M. Ensign, Johns Hopkins University, Baltimore, 21218, Maryland, United States, lensign@jhmi.edu