A few years after the start of Isala, we launched VIAB2L, our daughter study in which vitamins play a central role. Here, we are investigating the effect of vitamin B2 (or riboflavin) on women’s health. To this end, we have been looking for 200 enthusiastic participants in the autumn of 2024. In the meantime, we wrote history together!
Vitamin B2 as a superhero
Every woman needs a certain amount of vitamin B2 every day. Deficiencies can consequently cause a lot of disadvantages. Generally, we talk about fatigue, anemia, impaired vision, and so on. But vitamin B2 also appears to be of great importance for women’s health. For instance, a good vitamin B2 status is important for reproduction, a healthy pregnancy, a balanced composition of breast milk, a good hormonal balance, and so on! Curious about the full list of benefits? Feel free to take a look at our summary article.
A recognizable name for a major study
Launching such a new Isala daughter study naturally began with choosing a suitable name. We opted for VIAB2L, an abbreviation of a long English study name that reads as follows: Vaginal and Intestinal Application of vitamin B2 produced by Lactobacilli and Supplementation. To summarize: with the VIAB2L study we investigate the intake of vitamin B2 produced by lactobacilli (our favorite good bacteria) or produced via a traditional process and examine their impact on vaginal and gut bacteria (among many other things!).
Capsules packed with vitamins
Without knowing which one, participants took one of the following capsules for 28 days:
- A capsule filled with our unique Isala bacterium, Limosilactobacillus reuteri AMBV339 (make sure to check our blog), which can produce large amounts of vitamin B2.
- A capsule filled with vitamin B2 traditionally made through a process that does not involve bacteria. You can compare this capsule to a vitamin B2 supplement found in the supermarket.
- A combination capsule containing both our vitamin B2-producing super bacterium and vitamin B2 as such. This way, we want to investigate whether both together are (even) better than when administered separately.
- A placebo capsule with a filling agent, for which we do not expect any effects, but this control capsule is crucial to properly understand the results of the study.
Study visits at the Isala lab
Thousands and thousands of samples were collected. Each participant followed a six-week study trajectory during which four types of samples were collected at five different timepoints (see figure). The four types of samples were vaginal swabs, stool samples, urine samples and blood samples, to give us a full picture of what is happening in the body before, during and after administering one of the capsule types. Finally, each participant completed a questionnaire at the five different timepoints to assess general health. Based on all the data collected, we are able to investigate the effect of vitamin B2 on women’s health.
An enthusiastic team of researchers
Behind every study is an enthusiastic team of researchers! Isabel Erreygers and Caroline Dricot are the PhD students leading this Isala daughter study under excellent guidance of Dr. Eline Cauwenberghs and Dr. Sarah Ahannach (present from the start of Isala). Of course, they can count on experienced Isala researchers such as Professor Sarah Lebeer (the one and only!) and Professor Veronique Verhoeven (Isala’s physician). They are supported by Camille Gepts, Tim Van Rillaer, Nele Van de Vliet, Reine Audenaert and Dr. Thies Gehrmann. Last but not least, our enthusiastic and indispensable study nurse Laurien De Schryver was responsible for daily contact with our participants. As usual at Isala: teamwork makes the dream work. We would also like to thank dsm-firmenich Switzerland Ltd for the fruitful collaboration.
Samples under the magnifying glass
As soon as we received the samples in the Isala lab, we have been busy processing them to be able to analyze different things. Specifically, we are mapping the vaginal and gut microbiome of our participants. We are also studying substances such as vitamin B2, fatty acids and elements of the immune system in the samples. For example, in the blood and urine samples, we are measuring the levels of vitamin B2 that the body does and does not absorb. By combining all the data with the information from the questionnaires, we hope to better understand the impact of vitamin B2 on women’s health. Of course, our participants will be the first to discover their personal results, and we will keep people up to date on new insights on this webpage.
Bacteria in the vagina
We analyzed the vaginal swabs that our participants collected at the start of the study, before they took their capsules home. This analysis revealed that each participant has her own unique vaginal microbiome profile. In order to present this large amount of information in a clear manner, we chose to focus on 12 important bacteria that we regularly found in the vaginal swabs. Each participant then discovers whether one of these bacteria was her dominant type at the start of the study. This means that this bacterium determined a quarter (or even more) of the composition of her vaginal microbiome at that moment. For a number of participants, none of these 12 bacteria accounted for a quarter of the microbiome. So they did not have a dominant type at that time, but, like the other participants, they also receive an overview of the different bacteria in their swab. Did you participate yourself and are you looking for your personal results? Then you can log in here!
The vaginal bacteria get a passport
Can we tell you a bit more about these 12 key vaginal bacteria listed below? Absolutely! We have created passports for all of them so that everyone can get to know the different types and their characteristics in more detail. Due to the enormous variety of bacteria, there is of course more to tell than just this selection of 12 bacteria. That is why there is also a category called “Other type of bacteria”.
- Lactobacillus crispatus
- Lactobacillus iners
- Lactobacillus jensenii
- Lactobacillus gasseri
- Lactobacillus mulieris
- Fannyhessea vaginae
- Gardnerella
- Prevotella
- Bifidobacterium
- Streptococcus
- Limosilactobacillus
- Anaerococcus
Bacteria in the gut
A new phase has started! We analyzed the stool samples that our participants collected at the start of the study, before they took their capsules home. This analysis showed that each participant also has their own unique gut microbiome. Thanks to the novel techniques we use in our vitamin study, we now have a detailed view of the different gut bacteria that were present at the start of the study, and there are quite a few. The gut microbiome is usually much more diverse than the vaginal microbiome. To present this pile of information in a clear way, we decided to take a step back and focus on bacterial genera. By way of comparison, a genus can be seen as the umbrella term “canines”, which includes the exact species such as a dog, a wolf or a coyote. So, at this stage, we are at the “canine” level, so to speak, in order to provide a good overview of the gut microbiome. We chose to focus on fifteen important genera of gut bacteria that we regularly found in the stool samples. Each participant discovered which of these fifteen genera were present in her stool sample at the start of the study and to what extent. Did you participate yourself and are you looking for your personal results? Then you can log in here!
The gut bacteria get a passport
Can we tell you more about these gut bacteria? Absolutely! We created a passport for the fifteen different genera of gut bacteria so that everyone can learn more about their characteristics. Due to the enormous diversity, there is of course much more to tell than just this selection of fifteen genera of gut bacteria. That is why there is also a category called “other type of bacteria” (link to passport).
- Agathobacter
- Akkermansia
- Alistipes
- Bacteroides
- Bifidobacterium
- Blautia
- Clostridium
- Collinsella
- Faecalibacterium
- Gemmiger
- Phocaeicola
- Prevotella
- Roseburia
- Ruminococcoides
- Vescimonas