Transplantation of Vaginal Mikrobiome (DyscoverII)

Transplantation of Vaginal Mikrobiome - A Randomized, Double-blinded, Controlled Trial

Vaginal dysbiosis is a common condition among women. Vaginal dysbiosis covers imbalances in the vaginal flora, caused by the composition of microbes, bacteria, viruses and fungi. Dysbiosis occurs in about 16% of all women in Denmark. A large proportion of women who have vaginal dysbiosis do not experience any symptoms.

However, vaginal dysbiosis can present challenges in several contexts, including a higher tendency for bacterial infections in the female genitals, lower chances of pregnancy in women undergoing fertility treatment, just as it can predispose to premature birth.

This project is aimed at women aged 18-40, who wants to participate in a study to investigate whether, by transplanting vaginal secretion from one woman with a normal vaginal bacterial flora to another woman with an imbalance in the vaginal bacterial flora (called vaginal dysbiosis), can establish a normal vaginal bacterial flora in the recipient of the transplant.

The study will also explore weather genetic, immunological, hormonal, metabolic, health behaviors and clinical factors have significance on whether a normal vaginal flora is achieved after transplantation.

Study Overview

• Status: Completed
• Conditions: Transplantation; Vaginal Dysbiosis; Vaginal Microbiome
• Intervention / Treatment: Biological: Vaginal Microbiome Transplant; Biological: Vaginal Microbiome Transplant Placebo; Other: No intervention

Detailed Description

06.12.2021 - Amendment to protocol. A subgroup of 24 women included in the main study as recipients, were asked to participate in delivery of menstrual blood (2-3 times) and peripheral blood (2-3 times). This to analyse immunological cells via flowcytometry in women with vaginal dysbiosis and if there is a change after engraftment of the VMT product.

17.05.2022 - Amendment to protocol. Those/if any women who did not convert their vaginal microbiome is asked to participate in a substudy with 2 arms. Local pretreatment with antiseptic and saline water before VMT and local pretreatment with saline water before VMT.

26.09.2022 - Amendment to protocol. Study arm with only pretreatment of antiseptic was added to the amendment from the 17.05.2022.

• Study Type: Interventional
• Enrollment (Actual): 302
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Hvidovre
    • Copenhagen, Hvidovre, Denmark, 2650
      • Hvidovre Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 40 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

Donor:

• a woman between 18 and 40 years old;
• generally healthy and do not suffer from an immunological or other chronic diseases;
• have regular menstruation or do not menstruate due to birth control pills, gestagen pills (mini-pills), etonogestrel birth control implant or hormone IUD;
• not or do not have a desire to become pregnant within the next year;
• willing to be asked personal questions in the form of medical history, current use of medication, sexuality and sexual behavior;
• willing to refrain from vaginal intercourse unless a condom is used during certain periods of participation; and
• can read and understand information material in Danish or English.
• Accept not to use any intravaginal products such as tampons, menstrual cup, sex toys, vaginal cleaning products, spermicide products and vaginal lubrication.

Recipient:

• a woman between 18 and 40 years old;
• generally healthy and do not suffer from an immunological or other chronic diseases;
• have regular menstruation or do not menstruate due to birth control pills, gestagen pills (mini-pills), etonogestrel birth control implant or hormone IUD;
• not or do not have a desire to become pregnant within the next year;
• willing to be asked personal questions in the form of medical history, current use of medication, sexuality and sexual behavior;
• willing to refrain from vaginal intercourse unless a condom is used during certain periods of participation; and
• can read and understand information material in Danish or English.
• Accept not to use any intravaginal products such as tampons, menstrual cup, sex toys, vaginal cleaning products, spermicide products and vaginal lubrication.

Exclusion Criteria:

Donor:

• Being pregnant
• Any medical history of bacterial vaginosis, Trichomoniasis, Syphilis, HPV, herpes, intraabdominal infections, recurrent urine infections or Mycoplasma infections.
• Positive test result of HIV, Hepatitis A, B and C, Chlamydia, Gonorré, Mycoplasma, Trichonomas, HPV, herpes simplex and Streptococcus A, B, C and G.
• Currently pregnant or lactating.
• Any history of Gonorré and/or Chlamydia during the last year.
• Have been travelling or have had a sexual partner who has been travelling to countries with Ebola and/or Zika virus within the last year.
• Any other medical history, current use of medicine, travels or behavior which from a doctor's perspective is considered not suitable for being a donor.
• Hysterectomized
• Have participated in other medical studies within the last 30 days
• Removal of IUD, cervical cryotheraphy or cervical laser-treatment up until 3 months before screening.
• Any condition requiring the use of antibiotics in the investigation period
• Usage of long-acting hormonal therapy within the last 3 months prior to screening.
• Any social, medical or psychological condition including any history of drug and alcohol abuse, where it is evaluated that the participant cannot adhere to the protocol
• Unsatisfying examination and screening results evaluated by a doctor
• Any sexual habits, history or sexual partner, where the behavior can lead to an increased risk of sexual infections.
• Usage of medicine, recently vaccinated or other behavior which is considered to be a hinder for participation.

Recipient:

• Being pregnant
• Planning to become pregnant within the next 6 months
• Lactating
• Being less than 8 weeks post partum
• Known positive HIV/AIDS infection or other immune diseases
• Positive test result of HIV, Hepatitis A, B and C, Chlamydia, Gonorré, Mycoplasma, Trichonomas, positive urine hCG and HPV.
• Have participated in other medical studies within the last 30 days
• Removal of IUD, cervical cryotheraphy or cervical laser-treatment up until 3 months before screening.
• Any condition requiring the use of antibiotics in the investigation period
• Usage of long-acting hormonal therapy within the last 3 months prior to screening.
• Any social, medical or psychological condition including any history of drug and alcohol abuse, where it is evaluated that the participant cannot adhere to the protocol
• Unsatisfying examination and screening results evaluated by a doctor

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Vaginal Microbiome Transplant; Women are given the vaginal microbiome transplant at least one time and up to three times. If the woman receives the transplant more than once, it will be 28 days after the first transplant and again 28 days after the second transplant.	Biological: Vaginal Microbiome Transplant; Vaginal Microbiome Transplant is given at least once and up to three times. The transplant is admitted with a syringe
Placebo Comparator: Vaginal Microbiome Transplant Placebo; Women are given the vaginal microbiome transplant placebo at least one time and up to three times. If the woman receives the transplant more than once, it will be 28 days after the first transplant and again 28 days after the second transplant.	Biological: Vaginal Microbiome Transplant Placebo; Vaginal Microbiome Transplant Placebo is given at least once and up to three times. The transplant Placebo is admitted with a syringe
Experimental: Vaginal Microbiome Donors; Women allocated in the donor group will donate their vaginal secretion, which will be processed and analyzed throughy before it is used as a transplant. In total, the donors will each provide approximately 10 donations of vaginal secretion.	Other: No intervention; Donors have no intervention. This group deliver the transplant to arm 'Vaginal Microbiome Transplant'.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Engraftment of transplanted vaginal microbiome	The number of patients who shifts from having a vaginal dysbiosis to not having a vaginal dysbiosis 7 days after the transplant - up to 3 transplants.	63 days from transplantation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Engraftment of transplanted vaginal microbiome after one transplantation	The number of patients who shifts from having a vaginal dysbiosis to not having a vaginal dysbiosis 7 days after the transplant.	7 days from transplantation
Changes in the recipients vaginal bacterial composition	Changes in the recipients vaginal bacterial composition after and during the intervention time	63 days from transplantation

Collaborators and Investigators

• Sponsor: Copenhagen University Hospital, Hvidovre

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2021
• Primary Completion (Actual): January 1, 2023
• Study Completion (Actual): March 24, 2023

Study Registration Dates

• First Submitted: April 19, 2021
• First Submitted That Met QC Criteria: April 19, 2021
• First Posted (Actual): April 22, 2021

Study Record Updates

• Last Update Posted (Actual): March 27, 2023
• Last Update Submitted That Met QC Criteria: March 24, 2023
• Last Verified: March 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Dysbiosis
• Other Study ID Numbers: HH-Dyscover-2021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No