Vaginal microbiome profiling is a powerful tool for identifying women at risk of recurrent infections and personalising probiotic recommendations accordingly, says a Swiss startup.
Yoni Solutions is a vaginal microbiome platform that sells a range of probiotic products alongside its screening kits. Its CEO, Dr Virginia Franco, was inspired to set up the company after she came across a “unique technology” while working on a clinical study investigating the link between the vaginal microbiome and recurrent vaginal infections.
“Thanks to this technology, we can better perform the discrimination between certain Lactobacillus strains [and] define the status of women in community state types of the vaginal microbiome,” she told Vitafoods Insights.
“With this we can better classify the status of their vaginal microbiomes... and better recommend food supplements, such as probiotics.”
A gynaecologist by training, Franco was inspired to set up Yoni Solutions in 2019 after she came across REM Analytics, the company behind a technology called advanced testing for genetic composition (ATGC).
ATGC is “based on cycling temperature capillary electrophoresis”, a technique “for separating DNA molecules based on their physical properties”, according to REM Analytics. When combined with bioinformatics and statistical modelling, it can be used to develop microbiome tests.
Yoni Solutions, which launched in 2021, now partners with REM Analytics. The startup claims to offer customers “a personalised approach to vaginal wellbeing, uniquely tailored to your microbiome profile”.
Customers send off an at-home screening kit for analysis and receive a microbiome profile report, as well as product recommendations based on which Lactobacillus strain is most beneficial for that individual.
How does Yoni Solutions go about defining different microbiome profiles?
While research on the subject is still emerging, most vaginal microbiomes fall into one of five categories, known as “community state types”. These are defined mostly by the species and number of Lactobacillus bacteria, which play a crucial role in a healthy vaginal microbiome.
Community state types can be useful when assessing an individual’s risk of developing infections. Types one, two, and five – dominated by Lactobacillus crispatus, Lactobacillus gasseri, and Lactobacillus jensenii, respectively – are associated with a lower risk of bacterial vaginosis, sexually transmitted infections, and urinary tract infections. All three are considered healthy vaginal community states, with type one deemed to be the healthiest.
Type three, dominated by Lactobacillus iners, is a grey zone. L. iners can exert a neutral or protective effect when found alongside other protective lactobacilli; however, if it is found in combination with disruptive bacteria, it can cause symptoms like itching and abnormal discharge.
Type four, a “very prevalent” profile, is characterised by a low abundance of Lactobacilli and a high diversity of “anaerobic bacteria that can play a disruptive role in the vaginal ecosystem”, said Franco. This, in turn, can make women more susceptible to recurrent infections.
What’s more, just like the gut microbiome, the vaginal microbiome varies between regions, time frames, and individual habits.
“What you eat, your hygiene, sexual intercourse, the place that you live, humidity levels – all of these can change the microbiome,” said Franco.
This is why she encourages customers to perform “two tests per year at least”. The company currently sells three probiotic products, covering most community state types – but in the future, Franco hopes to have “at least six lines on the shelf”, to allow the company to serve the full spectrum.
The consumer response has been good so far, Franco said, explaining that the company was “paying a lot of attention to the early adopters”, from whom it is requesting a lot of feedback.
Most of its clients are people with a history of recurrent infections, she said, which makes transparency all the more important.
“We just have to... [be] very clear about the fact that we are not a treatment. This is a food supplement,” she explained. “Whenever people have symptoms, they are encouraged to go to their gynaecologist, to pursue a treatment, to be examined. We do not substitute a gynaecologist at all.”
However, she hopes that Yoni products can act as a “preventive medicine, a more natural supplementation” that can potentially help to regulate women’s vaginal microbiome and thus reduce the recurrence of infections.
The microbiome report that customers receive, while designed to be user-friendly, is also intended to function as a complementary tool that people can then show to their healthcare provider. For instance, it includes references to the scientific literature to provide context for a user’s gynaecologist.
Franco recommends customers take their report to appointments, adding: “A lot of doctors love to see [the] microbiome profile description.”
Bringing the medical establishment along is key, she said.
“They have to like it,” she added. “We have doctors working with us in Switzerland and Italy – they have to like it, otherwise they just discourage the user, and they will not collaborate.”
