Prebiotic Maltose Gel Can Promote the Vaginal Microbiota From BV-Related Bacteria Dominant to Lactobacillus in Rhesus Macaque Original paper

What was studied?

This study examined the effects of prebiotic maltose gel on the vaginal microbiota in rhesus macaques, specifically its ability to promote the transition of the vaginal microbiota from a bacterial vaginosis (BV)-related bacteria-dominant state to a Lactobacillus-dominant state. The researchers tested whether maltose gel, as a non-antibiotic agent, could effectively encourage the proliferation of Lactobacillus species while suppressing the growth of BV-associated bacteria such as Fusobacterium, Parvimonas, and Mobiluncus.

Who was studied?

The study involved eighteen healthy female rhesus macaques, who were randomly divided into two groups. One group received the prebiotic maltose gel treatment, while the other received a placebo gel. The researchers collected vaginal microbiota samples at several time points during the treatment and after the gel withdrawal to observe changes in microbial composition.

What were the most important findings?

The results showed that maltose gel treatment significantly increased the abundance of Lactobacillus in the vaginal microbiota of rhesus macaques. Throughout the treatment, the Lactobacillus levels gradually increased, while the diversity and abundance of BV-associated bacteria, such as Fusobacterium, Parvimonas, Mobiluncus, and others, decreased. However, following the withdrawal of maltose gel, the Lactobacillus levels gradually decreased, although they remained higher than baseline levels at certain time points, indicating a lasting but moderate effect. This shift towards Lactobacillus dominance in the vaginal microbiota supports the potential of maltose gel as a prebiotic treatment for bacterial vaginosis (BV).

In terms of microbial diversity, the alpha diversity indices of the vaginal microbiota decreased significantly during treatment with maltose gel. The treatment caused a marked decrease in diversity, while the placebo group showed no significant changes. After drug withdrawal, the diversity of microbiota in both groups tended to increase, but the effects of maltose gel were more persistent in promoting Lactobacillus proliferation.

What are the implications of this study?

The study suggests that maltose gel may serve as a promising alternative to antibiotics in the treatment and prevention of bacterial vaginosis. Since BV is often recurrent despite antibiotic treatments, which can also disrupt beneficial Lactobacillus species, maltose gel offers a non-antibiotic strategy that can potentially maintain a healthy vaginal microbiota dominated by Lactobacillus. The prebiotic nature of maltose gel promotes the growth of Lactobacillus while reducing the harmful bacteria associated with BV, without inducing antibiotic resistance.

This study highlights the potential of developing prebiotics like maltose gel as adjunct therapies to traditional BV treatments, offering a more sustainable, long-term solution that supports the microbiome’s natural composition. However, further studies, including those in human populations, are necessary to assess the long-term effects and feasibility of such treatments.