Vaginal microbiota modulation

“Vaginal microbiota modulation” refers to a collection of therapeutic approaches that seek to alter the composition and function of the vaginal microbial ecosystem, typically to reduce infection risk, promote mucosal health, and treat conditions such as bacterial vaginosis, vulvovaginal candidiasis, or recurrent urinary tract infection. Traditional approaches include the use of antibiotics and antifungals, although these can result in recurrence and resistance. Emerging therapies include probiotics (especially Lactobacillus species), Live Biotherapeutic Products composed of beneficial bacterial strains, acidifying agents, biofilm disruptors, phage therapy, and vaginal microbiota transplantation from healthy donors. While modulation of the vaginal microbiome is a promising field, especially for combating recalcitrant infections and dysbiosis, it is not a classical drug target or molecular entity, and thus is considered an intervention domain rather than a discrete biotarget. The risks and considerations for these therapies involve the safety of live microbial products, potential pathogen transmission, and the variable durability of the restored healthy state.

Other names

Vaginal microbiome modulationVaginal microbiota alterationMicrobiome-directed therapy (vaginal)

Inhibition or elimination of pathogenic/dysbiotic bacteria (antibiotics, phage therapy); Restoration or reinforcement of Lactobacillus-dominant community (probiotics, vaginal microbiota transplantation); Disruption of biofilms (biofilm-disrupting agents); Acidification of vaginal environment (acidifying agents, lactic acid production by probiotics); Suppression of specific bacterial metabolic pathways (e.g., cysteine uptake inhibitors to reduce Lactobacillus iners growth).