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Intravaginal administration of gelatine capsules containing freeze-dried autochthonous lactobacilli: a double-blind, randomised clinical trial of safety

In: Beneficial Microbes
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P.R. De Gregorio Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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N.C. Maldonado Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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E. Vera Pingitore Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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M.C. Leccese Terraf Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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M.S. Juárez Tomás Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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C. Silva de Ruiz Facultad de Bioquímica, Química y Farmacia. Universidad Nacional de Tucumán, Ayacucho 471, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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V. Santos Facultad de Bioquímica, Química y Farmacia. Universidad Nacional de Tucumán, Ayacucho 471, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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B. Wiese Medizinische Hochschule Hannover, Institut für Allgemeinmedizin (OE 5440) AG Medizinische Statistik und IT-Infrastruktur Carl-Neuberg-Straβe 1, 30625 Hannover, Germany.

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E. Bru Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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M.C. Paiz Hospital de Clínicas Nicolás Avellaneda, Catamarca 2000, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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M.F. Reina Hospital de Clínicas Nicolás Avellaneda, Catamarca 2000, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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D.E. Schujman Hospital de Clínicas Nicolás Avellaneda, Catamarca 2000, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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M.E.F. Nader-Macías Centro de Referencia para Lactobacilos (CERELA)-CONICET, Chacabuco 145, 4000 San Miguel de Tucumán, Tucumán, Argentina.

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Vaginal lactobacilli (LAB) in probiotic formulas constitute a promising alternative for microbiome reconstitution and for the prevention and treatment of urogenital infections. A double-blind, randomised clinical trial was conducted to assess the safety of LAB-gelatine capsules vaginally administered to healthy sexually active women. Participants were randomised into three groups: intervention A: Lactobacillus reuteri CRL1324, Lactobacillus gasseri CRL1263 and CRL1307; intervention B: Lactobacillus rhamnosus CRL1332, L. gasseri CRL1256 and CRL1320; and intervention C: placebo. In a survey and clinical evaluation, participants received a blister with 7 capsules to be administered 1 per day. A second sampling and a new survey were conducted 3-10 days after completing application. Colposcopy was performed to assess adverse effects on vaginal-cervical mucosa. Vaginal swabs were taken for Gram staining to determine the Nugent score, and obtainment of viable-cell cultures to quantify cultivable lactic acid bacteria and pathogens. The main outcomes evaluated were overall satisfaction and secondary effects, including discomfort, urogenital infection, inflammatory response or other symptoms. No significant differences were found in Nugent score or in leukocyte numbers in vaginal samples either before or after the three interventions. However, a tendency to decrease in both the Nugent score and in leukocyte numbers was observed after interventions A and B, though not after C. A significant increase in cultivable lactobacilli was determined after LAB interventions. No severe adverse events were detected. LAB-containing capsules were well tolerated by subjects, so they could be proposed as an adequate alternative to restore vaginal lactobacilli in sexually active women.

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