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Vaginale microbioomtransplantatie voor recidiverende bacteriële vaginose

23 september 2026 bijgewerkt door: Ahinoam Lev-Sagie, Hadassah Medical Organization

Vaginale microbioomtransplantatie voor recidiverende bacteriële vaginose-A Placebo, gerandomiseerde, gecontroleerde studie

Vaginal Microbiome Transplantation (VMT) may be beneficial in treating the most severe cases of recurrent and antibiotics-nonresponsive cases of BV.

We completed a preliminary study in which we treated patients with recurrent and antibiotics-non-responsive, intractable BV, with VMT from healthy donors [Lev-Sagie, Nature Medicine 2019]. Four VMT recipients in this preliminary study featured a significant improvement of both clinical symptoms and dysbiotic vaginal microbiome composition and function, which persisted over a long follow-up period, while one recipient featured a partial remission.

The proposed study is designed as a placebo, randomized controlled trial, and is aimed to further assess whether VMT may serve as a viable option in symptomatic, intractable BV. In the suggested study, we compare transplantation of: 1) vaginal fluid from healthy donors (VMT), and 2) saline and glycerol (placebo).

Studie Overzicht

Toestand

Actief, niet wervend

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Women diagnosed with symptomatic, recurrent BV, will be recruited. After assessment of inclusion and exclusion criteria and patient's consent to participate, patients will be assigned to receive transplantation of either VMT or a placebo. Patients will be blinded to the therapy given.

Following VMT, patients will be examined every 2 weeks for the first month, and then once every month, for additional 11 months after VMT. In case of BV recurrence, repeated transplantations will be done after antibiotics. Repeated VMTs can be done to a maximum of 6 sessions, before the procedure will be considered a failure.

Placebo recipients will be examined every 2 weeks for the first month, and then once every month for additional 3 months after placebo (total of 4 months). Patients may have up to 3 repeated placebo transplantations during the 4 months. At the 4 months post placebo timepoint, in case they are still symptomatic and fulfill inclusion criteria, patients who initially received placebo will be unblinded and offered a VMT. After VMT, they will be further followed for additional 12 months (every two weeks for the first month and then once a month for additional 11 months).

In each frontal appointment:

  1. Patients will be questioned regarding symptoms (discharge and odor) , adverse events (related and not related to the study), and compliance with the protocol.
  2. Will undergo examination which will include vaginal inspection, pH measurement, whiff test and microscopy.
  3. Samples will be taken.

During the follow-up phase, women who are clinically stable and asymptomatic will be given the option to collect a monthly vaginal sample at home, store it in their home freezer, and bring the collected samples to the clinic at three-month intervals when they arrive to their examination visit. These women will be contacted monthly and will be asked about their symptoms. If they report any change in their condition or recurrence of symptoms, they will be asked to attend the clinic for an examination.

In order to prevent transfer of pathogens, sperm, or antibiotic-resistant commensals we will establish a "vaginal fluid bank" in which samples from suitable donors will be kept for future use:

  • Donors will be screened using a questionnaire addressing risk factors for potentially transmissible infections, undergo screening for cervico-vaginal infections, cervical cytology screening, and serology analysis for transmittable infections.
  • The collected samples for VMT will be examined for bacteria,viruses and sperm.
  • Each sample will be sequenced to verify its composition (L. crisptus dominance).
  • Three months after collection of a sample, donors will undergo repeated serologic screening, to verify for the absence of sero-conversion prior to VMT.

In addition to the main cohort, we will conduct additional observational study;To assess the antimicrobial effects of lactobacilli on pathogenic bacteria, we will use 100 fresh samples from patients with BV or healthy controls. 100ul of These samples will be cultured to evaluate the influence of three antimicrobial molecules secreted by lactobacilli on both pathogenic bacteria and beneficial Lactobacilli in the vaginal microbiome. As a control, we will use lactic acid or boric acid. Samples will be analysed for the microbiome composition before culturting, after over-night culturing and after treatment with the antimicrobial molecules.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

30

Fase

  • Fase 2
  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Jerusalem, Israël, 9765422
        • Hadassah Medical Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 50 jaar (Volwassen)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Vrouw

Beschrijving

Inclusion Criteria:

  • Ages 18-50
  • Recurrent BV, defined as ≥4 symptomatic episodes of BV during the last year, who require maintenance antibiotic treatment (twice weekly) in order to remain symptom-free, or if they experienced recurrence of BV in ≤ 2 months following antibiotic treatment, with a documented history of recurrent BV in the last year.
  • Patients are otherwise healthy.
  • Contraception use

Exclusion Criteria:

  • Pregnancy or a planned pregnancy in the upcoming year
  • Infection with HIV.
  • Immunodeficiency status.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: VMT recipients

vaginal microbiome transplant from healthy donors

Before transplantation, patients will be treated with intravaginal antibiotics. A frozen specimen will be thawed at room temperature and will be placed in the patient's vagina.

Following VMT, patients will be evaluated every 14 days for the first month, then every month for additional 11 months.

Healthy donors vaginal fluid is introduced into recipients' vagina to replace their indigenous disease-associated microbiome

Placebo-vergelijker: Placebo

Saline with glycerol will be used as placebo.

Before transplantation, patients will be treated with intravaginal antibiotic. Following Placebo, patients will be evaluated every 14 days for the first month, then every month for additional 3 months (total of 4 months) After 4 months, patients who initially received placebo will be offered a VMT in case they are still symptomatic and fulfill inclusion criteria, in an open-label phase.

saline mixed with glycerol (10-20% total concentration).

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Clinical parameters- patient's complains
Tijdsspanne: Interim analysis at 4 months from initial intervention, and final analysis at 12 months.

participants report disappearance of discharge and odor.

Interim analysis at 4 months from initial intervention, and final analysis at 12 months.
Laboratory parameters- Amsel criteria
Tijdsspanne: Interim analysis at 4 months from initial intervention, and final analysis at 12 months.

Presence or absence of Amsel criteria (discharge, pH>4.5, positive whiff test and clue cells on microscopy).

Interim analysis at 4 months from initial intervention, and final analysis at 12 months.
Vaginal fluid microscopy
Tijdsspanne: Interim analysis at 4 months from initial intervention, and final analysis at 12 months.

Defined as normal (lactobacilli dominated), BV (coccid-bacillary dominated) or mixed.

Interim analysis at 4 months from initial intervention, and final analysis at 12 months.
Microbiome composition
Tijdsspanne: Interim analysis at 4 months from initial intervention, and final analysis at 12 months.

Characterization of the vaginal microbial community using shotgun analysis or 16S rRNA sequencing.

Interim analysis at 4 months from initial intervention, and final analysis at 12 months.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Onderzoekers

  • Hoofdonderzoeker: Ahinoam Lev-Sagie, Hadassah Medical Organization

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

20 augustus 2020

Primaire voltooiing (Geschat)

1 december 2026

Studie voltooiing (Geschat)

1 december 2026

Studieregistratiedata

Eerst ingediend

15 augustus 2020

Eerst ingediend dat voldeed aan de QC-criteria

17 augustus 2020

Eerst geplaatst (Werkelijk)

18 augustus 2020

Updates van studierecords

Laatste update geplaatst (Werkelijk)

28 september 2026

Laatste update ingediend die voldeed aan QC-criteria

23 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • HMO-19-691

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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