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pHyph, a novel antibiotic-free treatment for bacterial vaginosis, promotes Lactobacillus growth and reduces the abundance of pathogens in the vagina

Lahtinen, Emilia ; Hugerth, Luisa W. ; Edfeldt, Gabriella ; Säfholm, Annette LU ; Kornfält, Sten ; Engstrand, Lars ; Strevens, Helena LU and Schuppe-Koistinen, Ina (2025) In AJOG global reports 5(4).
Abstract

Background Bacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age worldwide, caused by dysbiosis of the vaginal microbiome. Despite its prevalence, the underlying molecular mechanisms remain poorly understood, making diagnosis and treatment challenging. Although antibiotics are the standard therapy, recurrence rates are high, up to 50% within 1 year, and repeated treatments contribute to the rise of antimicrobial resistance. There is an urgent need for alternative, sustainable, and microbiome-friendly treatment options. Objective To evaluate whether p Hyph, a novel antibiotic-free treatment, promotes a shift in the vaginal microbiome toward a health-associated composition in women with clinically... (More)

Background Bacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age worldwide, caused by dysbiosis of the vaginal microbiome. Despite its prevalence, the underlying molecular mechanisms remain poorly understood, making diagnosis and treatment challenging. Although antibiotics are the standard therapy, recurrence rates are high, up to 50% within 1 year, and repeated treatments contribute to the rise of antimicrobial resistance. There is an urgent need for alternative, sustainable, and microbiome-friendly treatment options. Objective To evaluate whether p Hyph, a novel antibiotic-free treatment, promotes a shift in the vaginal microbiome toward a health-associated composition in women with clinically diagnosed BV. Study design In a randomized, double-blind, placebo-controlled trial, vaginal swabs were collected from 152 women diagnosed with BV. Microbiome composition was assessed before and after a 6-day treatment with p Hyph or a placebo-like comparator, using qPCR targeting 25 bacterial, 2 viral, and 8 eukaryotic species. Results p Hyph significantly increased the abundance of Lactobacillus iners, Lactobacillus gasseri and Lactobacillus jensenii after treatment, while decreasing the abundance of BV-associated species, such as Gardnerella vaginalis , BVAB2, and Fannyhessea vaginae (Wilcoxon signed rank test, P<. 05). The growth-promoting effect on Lactobacillus was more pronounced in women who had detectable levels at baseline. Notably, a substantial number of participants in the p Hyph group (n=33) transitioned to a Lactobacillus -dominated community state type (CST), compared to none in the comparator group. Conclusions p Hyph supports BV resolution by promoting a Lactobacillus -dominated vaginal microbiome and reducing BV-associated species, offering a promising antibiotic-free alternative.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antibiotic-free treatment, bacterial vaginosis, dysbiosis, lactobacilli, qPCR, vaginal microbiome
in
AJOG global reports
volume
5
issue
4
article number
100566
publisher
Elsevier
external identifiers
  • pmid:41321665
  • scopus:105022727337
ISSN
2666-5778
DOI
10.1016/j.xagr.2025.100566
language
English
LU publication?
yes
additional info
Publisher Copyright: Copyright © 2025. Published by Elsevier Inc.
id
44d8723a-887a-4b98-80a4-6d5aa91fc35f
date added to LUP
2026-01-22 14:13:11
date last changed
2026-01-23 03:00:08
@article{44d8723a-887a-4b98-80a4-6d5aa91fc35f,
  abstract     = {{<p>Background Bacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age worldwide, caused by dysbiosis of the vaginal microbiome. Despite its prevalence, the underlying molecular mechanisms remain poorly understood, making diagnosis and treatment challenging. Although antibiotics are the standard therapy, recurrence rates are high, up to 50% within 1 year, and repeated treatments contribute to the rise of antimicrobial resistance. There is an urgent need for alternative, sustainable, and microbiome-friendly treatment options. Objective To evaluate whether p Hyph, a novel antibiotic-free treatment, promotes a shift in the vaginal microbiome toward a health-associated composition in women with clinically diagnosed BV. Study design In a randomized, double-blind, placebo-controlled trial, vaginal swabs were collected from 152 women diagnosed with BV. Microbiome composition was assessed before and after a 6-day treatment with p Hyph or a placebo-like comparator, using qPCR targeting 25 bacterial, 2 viral, and 8 eukaryotic species. Results p Hyph significantly increased the abundance of Lactobacillus iners, Lactobacillus gasseri and Lactobacillus jensenii after treatment, while decreasing the abundance of BV-associated species, such as Gardnerella vaginalis , BVAB2, and Fannyhessea vaginae (Wilcoxon signed rank test, P&lt;. 05). The growth-promoting effect on Lactobacillus was more pronounced in women who had detectable levels at baseline. Notably, a substantial number of participants in the p Hyph group (n=33) transitioned to a Lactobacillus -dominated community state type (CST), compared to none in the comparator group. Conclusions p Hyph supports BV resolution by promoting a Lactobacillus -dominated vaginal microbiome and reducing BV-associated species, offering a promising antibiotic-free alternative.</p>}},
  author       = {{Lahtinen, Emilia and Hugerth, Luisa W. and Edfeldt, Gabriella and Säfholm, Annette and Kornfält, Sten and Engstrand, Lars and Strevens, Helena and Schuppe-Koistinen, Ina}},
  issn         = {{2666-5778}},
  keywords     = {{antibiotic-free treatment; bacterial vaginosis; dysbiosis; lactobacilli; qPCR; vaginal microbiome}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{Elsevier}},
  series       = {{AJOG global reports}},
  title        = {{pHyph, a novel antibiotic-free treatment for bacterial vaginosis, promotes Lactobacillus growth and reduces the abundance of pathogens in the vagina}},
  url          = {{http://dx.doi.org/10.1016/j.xagr.2025.100566}},
  doi          = {{10.1016/j.xagr.2025.100566}},
  volume       = {{5}},
  year         = {{2025}},
}