Decoding vaginal microbiome: Harvard’s organ-on-a-chip advances antibiotic alternatives

12 Jan 2023 --- Industry is one step closer to decoding the vaginal microbiome and identifying treatments to keep it in balance. Thanks to the creation of the Vagina Chip at Harvard University, researchers now have an “intimate” view of how communities of bacteria interact on human vaginal cells in the preclinical phase.

The organ-on-a-chip technology is set to fast-track product development in the burgeoning women’s health sector. 

NutritionInsight speaks with Elodie Aragon, product manager responsible for the women’s health portfolio at Lallemand Health Solutions, who finds the technology “impressive and promising for the advancement of knowledge on the homeostasis of the vaginal microbiota.” 

“Understanding the vaginal microbiome in its homeostasis state will be key to discovering new ways of treating dysbiosis – an imbalance of the microbiome,” she says.

“Vaginal microflora imbalance is the most common reason for occasional vaginal discomfort in women aged 15 to 44,” she says. 

Among women who received a prescribed medical treatment for their intimate health discomforts, 47% were not fully satisfied with it, notes Lallemand.Building up bacteria, not breaking them down 
Dysbiosis can result in conditions such as vulvovaginal candidiasis (yeast infections), bacterial vaginosis (BV) and urinary tract infections. BV alone is estimated to cost upwards of US$4.8 billion to treat annually.  

Around 1.4 billion women worldwide experience these urogenital discomforts at least once in their life, underscores Aragon, but current treatments are falling short. 

BV, for example, is often treated with antibiotics. But the condition often recurs and can lead to more severe complications, including pelvic inflammatory disease and even infertility. 

“These intimate health discomforts significantly impact women’s quality of life. Moreover, among women who received a prescribed medical treatment for their intimate health discomforts, 47% were not fully satisfied with it,” she says. 

Therefore, many consumers are looking for alternative and natural solutions to balance their vaginal flora.

Opportunities in biotics 
Probiotics for women’s health is a considerable opportunity to expand brand portfolios, adds Aragon.  

“Globally, women have a good understanding of how supplements can naturally maintain and restore vaginal and digestive microflora. They know they can yield positive consequences for feminine health and well-being.”

The market for nutritional ingredients for women’s health is evolving into a more mature market, driven by consumers’ interest and research and development. 

An increasing number of supplements are being launched addressing vaginal health and microflora specifically, typically containing probiotics, cranberry and fibers, according to PharmaLinea.She notes that 26% of women probiotic consumers already use probiotics to support vaginal health. 

Increased consumer awareness can be seen through the emergence of at-home vaginal microbiome tests, inviting users to send in samples that can be cultured and analyzed. 

Companies like Daye and Juno claim to help women understand an array of risk factors based on their vaginal microbiome, from their likelihood of contracting an STI to how successful IVF might be for them. 

More specific solutions 
Women’s health has gained steady traction over the last years and, in some cases, exceeded growth projections. Aragon points out that the global women’s health and beauty supplements market was expected to reach US$49 billion by 2020 but reached US$53 billion in the end. 

“With an estimated CAGR of 4.9% from 2021 to 2028, it is a market that will continue to grow,” she highlights. 

Matevž Ambrožič, marketing and PR director at PharmaLinea, tells NutritionInsight that women’s health is diversifying into more specific products for certain health states.

“An increasing number of supplements are being launched addressing vaginal health and microflora specifically, typically containing probiotics, cranberry and fibers,” he says. 

At-home vaginal microbiome screening companies claim to help women understand an array of risk factors based on their test results.Ambrožič notes that the US is leading the category, citing the #1 probiotic brand according to ConsumerLab – Jarrow Formulas – as featuring a vaginal health prebiotic. 

“Additionally, the well-known brand Garden of Life launched a pre+pro+postbiotic in 2022, targeting vaginal pH, and European brands like Laboratoires Iprad (FRA) or Laborest (ITA) have launched products in the same segment.” 

Strains backed by science 
Healthy vaginal flora is composed of more than 90% Lactobacilli, explains Aragon. In times of occasional bacterial imbalance, probiotics can help rebalance the vaginal microflora and promote vaginal comfort. Lactobacilli probiotics help support the vaginal microflora and protect against some undesirable bacteria and fungi. 

But since the benefits of probiotics are strain-specific, Aragon says that clinical studies with significant results are crucial to showing which bacterial strains support vaginal balance. 

“Education is also important to ensure women pick the right solutions to tackle a specific issue.”

Lallemand Health Solutions’ L. plantarum Rosella has been studied in over 800 women in six clinical studies, including two by oral intake. The strain isolated from healthy vaginal flora demonstrates efficacy with a wide spectrum of benefits, from helping to maintain proper vaginal balance to being used for recurrent yeast infections, says Aragon. 

Clinical research helped Lallemand Health Solutions achieve several Canadian health claims for the strain, including:

• Source of probiotics
• Helps support female or vaginal health
• Helps support a healthy vaginal microflora
• Maintains a healthy vaginal microbiome

Maja Orešnik, science and research director at PharmaLinea, adds that major dietary ingredient manufacturers, such as Gnosis and Chr. Hansen, have invested in clinical research on their branded probiotics. 

In times of occasional bacterial imbalance, probiotics can help rebalance the vaginal microflora and promote vaginal comfort.Their research confirms the beneficial effect of the supplementation on vaginal health, including the management of BV, she says. 

Chr. Hansen has also been exploring solutions to help colonize neovaginas in transwomen using its Astarte probiotic, another emerging category.

Looking ahead in women’s health 
Aragon emphasizes that women’s health is a priority for Lallemand Health Solutions and its R&D team has many clinical studies investigating women’s health currently running.  

“In 2023, results of clinical trials conducted on healthy postmenopausal women, menopause-related symptoms, vaginal health and bone health should be revealed,” she says. 

“Given that probiotics have already been proven beneficial for pregnant women, further clinical trials are taking place to study their effects on healthy pregnant women in their last trimester and the effects on their newborn babies.” 

In other areas of women’s health, companies like Kerry have found that probiotics can aid in comfortable breastfeeding. Its LC40 probiotic, a strain isolated from human breast milk, has been clinically shown to help alleviate symptoms of mastitis, an infection that can result in premature cessation of breastfeeding. 

By Missy Green