Bacterial vaginosis is typically treated with antibiotics, but relapse rates are high. When left untreated, bacterial vaginosis increases the risk of sexually transmitted infections and cervical cancer. In pregnant women, it can raise the risk of preterm birth or low birth weight.
Despite these risks, bacterial vaginosis — and the vagina itself — remains understudied.
“We don’t really understand how these processes are triggered by bacteria in the vagina or often even which bacteria are responsible,” said Amanda Lewis, a professor at the University of California, San Diego, who studies the vaginal microbiome. “As you might imagine, such a crude understanding of such an important physiological system makes for crude interventions or none at all.”
In 2019, Dr. Lev-Sagie and other researchers in Israel published the results of the world’s first vaginal microbiome transplants. They transferred bacteria-rich discharge from donors with healthy vaginas into the vaginas of five women who had struggled with recurring bacterial vaginosis. Screening the samples to make sure that they were safe and finding patients that were willing to participate was extremely difficult and took many years.
Other models, in animals or in the lab, are not effective environments in which to test the vaginal microbiome. While the vaginas of healthy humans are made up of around 70 percent Lactobacilli, in other mammals Lactobacilli rarely constitute more than 1 percent of the vaginal microbiome. And when vaginal cells are mixed with bacteria in a flat petri dish, bacteria quickly take over and kill the cells.
Similar drawbacks hamper the development of many drugs, which is why the organ chips are so promising, said Dr. Ingber, who holds a patent for the design of the silicone chip and founded a company that makes and tests them.
“There’s been a search for better in vitro models that really mimic the physiological complexity, the structural complexity of tissues,” he said. “And so that’s what we’ve done with organ chips.”