{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T03:24:06Z","timestamp":1787369046678,"version":"build-2736575974"},"reference-count":37,"publisher":"Walter de Gruyter GmbH","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Benef. Microbes"],"published-print":{"date-parts":[[2026,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Symptomatic vaginal and cervicovaginal conditions include bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and other sexually transmitted infection (STI)-related conditions with overlapping clinical features. Adjunctive probiotic therapies are increasingly explored to complement standard antimicrobial treatment. This randomised, double-blind, controlled trial examined clinical, microbiological, and immune marker patterns associated with the adjunctive use of vaginal-spray spore-forming probiotics (LiveSpo X-Secret;\n                    <jats:italic>Bacillus subtilis<\/jats:italic>\n                    ANA46,\n                    <jats:italic>Bacillus clausii<\/jats:italic>\n                    ANA39,\n                    <jats:italic>Heyndrickxia coagulans<\/jats:italic>\n                    ANA40; 1\u00a0\u00d7 10\n                    <jats:sup>9<\/jats:sup>\n                    cfu\/ml) in women with BV, VVC, and STI-related co-infections. A total of 120 symptomatic women were randomised (1:1; n\u00a0= 60 per group) to receive either physiological saline spray (Control) or probiotic spray (LiveSpo X-Secret) for 28 days, in addition to standard treatment. Outcomes included clinical signs and symptoms, pathogen positivity and relative load (real-time PCR), vaginal microbiota composition (16S rRNA sequencing), and IL-1\n                    <jats:italic>\u03b2<\/jats:italic>\n                    , IL-8, and secretory IgA (ELISA) at days 7 and 28 versus baseline. No adverse events were reported. Symptom improvement was observed from day 7. By day 28, the X-Secret group showed a substantial reduction in the proportion of patients with \u22653 symptoms\/signs (from 68.18% to 4.55%; OR\u00a0= 6.42,\n                    <jats:inline-formula\/>\n                    ). Multi-pathogen positivity decreased from 50 to 11.36%.\n                    <jats:italic>Gardnerella vaginalis<\/jats:italic>\n                    relative load decreased 275-fold more in the X-Secret group than in the Control group, calculated based on 2\n                    <jats:sup>\n                      <jats:italic>\u0394<\/jats:italic>\n                      Ct\n                    <\/jats:sup>\n                    (\n                    <jats:inline-formula\/>\n                    ). Stratified subsample microbiome analysis indicated increased lactobacilli dominance and reduced dysbiosis-associated genera (\n                    <jats:italic>Prevotella<\/jats:italic>\n                    ,\n                    <jats:italic>Gardnerella<\/jats:italic>\n                    ). IL-1\n                    <jats:italic>\u03b2<\/jats:italic>\n                    and IL-8 levels decreased by 62.98% (\n                    <jats:inline-formula\/>\n                    ) and 42.95% (\n                    <jats:inline-formula\/>\n                    ), respectively, while sIgA increased by 65.67% (\n                    <jats:inline-formula\/>\n                    ). In summary, this two-arm randomised study describes clinical, microbiological, and immune marker patterns associated with adjunctive vaginal-spray\n                    <jats:italic>Bacillus<\/jats:italic>\n                    spore probiotic versus saline spray, both in combination with standard treatment. While causal inferences cannot be drawn, these findings highlight the need for further aetiology-specific and longer-term studies.\n                  <\/jats:p>\n                  <jats:p>The trial was prospectively registered at ClinicalTrials.gov (NCT06165354).<\/jats:p>","DOI":"10.1163\/18762891-bja00131","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T03:04:01Z","timestamp":1787367841000},"page":"1-21","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, microbiological, and immune marker improvement with adjunctive vaginal-spray spore-forming probiotics in women with vaginal infections"],"prefix":"10.1163","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8737-5707","authenticated-orcid":true,"given":"H.T.","family":"Mai","sequence":"first","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7984-2045","authenticated-orcid":true,"given":"C.C.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.T.B.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5063-7851","authenticated-orcid":true,"given":"H.T.N.","family":"Vo","sequence":"additional","affiliation":[{"name":"Spobiotic Research Center, ANABIO R&D Ltd. Co., Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.T.","family":"Pham","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.L.","family":"Doan","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.T.","family":"Vu","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6976-5246","authenticated-orcid":true,"given":"M.D.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.T.B.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.T.K.","family":"Ta","sequence":"additional","affiliation":[{"name":"Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4590-4479","authenticated-orcid":true,"given":"A.H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Spobiotic Research Center, ANABIO R&D Ltd. Co., Hanoi, Vietnam"},{"name":"LiveSpo Pharma Ltd. Co., Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-2142","authenticated-orcid":true,"given":"T.D.","family":"Pham","sequence":"additional","affiliation":[{"name":"Faculty of Mathematics\u00a0\u2013 Mechanics\u00a0\u2013 Informatics, VNU University of Science, Vietnam National University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7654-0808","authenticated-orcid":true,"given":"V.C.","family":"Tran","sequence":"additional","affiliation":[{"name":"The National Center for Health Information, Vietnam Ministry of Health, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1215-6910","authenticated-orcid":true,"given":"A.T.V.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Spobiotic Research Center, ANABIO R&D Ltd. 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The Lancet Microbe 3: e435-e442. https:\/\/doi.org\/10.1016\/s2666-5247(22)00043-x"},{"key":"R000002","series-title":"Microbiome","first-page":"110","article-title":"Vaginal Lactobacillus crispatus persistence following application of a live biotherapeutic product: colonization phenotypes and genital immune impact","volume":"12","author":"Armstrong, E.","unstructured":"Armstrong, E., Hemmerling, A., Miller, S., Huibner, S., Kulikova, M., Crawford, E., Castan\u0303eda, G.R., Coburn, B., Cohen, C.R. and Kaul, R., 2024. Vaginal Lactobacillus crispatus persistence following application of a live biotherapeutic product: colonization phenotypes and genital immune impact. 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