## 3 Results
### Colonization of GMNL Lactobacillus Strains among Participants of VGA-1 or VGA-2 Group
These data suggest that the ameliorative effect of VGA-1 or VGA-2 consumption in BV could be mediated by their anti-inflammatory activity. Changes in Vaginal Lactobacillus Species Composition in BV Patients after VGA-1 or VGA-2 Consumption  
The decreased lactic acid or H\({}_{2}\)O\({}_{2}\)-produced _Lactobacillus_ species in vagina was considered to be one of the mechanisms for BV [10]. To understand the alternations of vaginal _Lactobacillus_ species composition among BV patients after VGA-1 or VGA-2 consumption, DNA was extracted from vaginal swabs at weeks 2 and 4, and the qPCR method was applied to quantify the changes in _Lactobacillus_ species. As shown in Table 4, _L. rhamnus_ significantly increased by 2.2 \(\pm\) 1.1-fold in the VGA-1 group (\(p\) = 0.0014), whereas _L. crispatus_ significantly increased by 2.2 \(\pm\) 1.1-fold in the VGA-2 group (\(p\) = 0.0397) at week 2. Significantly increased levels of _L. gasseri_ and _L. jensenii_ were observed in the VGA-1 consumption group (Table 4, 72.1 \(\pm\) 39.5-fold for _L. gasseri_, \(p\) = 0.0426; 1.2 \(\pm\) 0.3-fold for _L. jensenii_, \(p\) = 0.0426) at week 4. A significantly increased level of _L. iners_ was found in the week-4 samples of the VGA-1 and VGA-2 consumption groups (Table 4, 43.8 \(\pm\) 40.5-fold and \(p\) = 0.0041 in VGA-1 group; 1.8 \(\pm\) 0.4-fold and \(p\) = 0.0388 in VGA-2 group). In addition, we observed a negative correlation between the _Lactobacillus_ species and the Nugent scores of the VGA-1 or VGA-2 consumption group. In the VGA-1 group, the change of the Nugent score was significantly and negatively associated with the level of _L. rhamnus_, _L. acidophilus_, or _L. gasseri_ (Figure S6). A significant negative correlation between the Nugent score change and _L. gasseri_ was observed in the VGA-2 consumption group (Figure S6). These data suggest that the ameliorative effects of VGA-1 or VGA-2 consumption in BV patients could be associated with increased vaginal _Lactobacillus_ species. Figure 7: Inflammatory cytokines of vagina after VGA-1/VGA-2 treatment. The fold change (2\({}^{-\Delta\Delta\text{Ct}}\)) from baseline of inflammatory cytokines from vaginal specimens. Asterisks (*) represent statistical significance between baseline and week 4 (* \(p\) < 0.05; ** \(p\) < 0.01), which were calculated by the Wilcoxon signed-rank test. \begin{table}
\begin{tabular}{l c c c c c c c c c c c} \multicolumn{1}{c}{} & \multicolumn{4}{c}{**VGA-1, \(n=18\)**} & \multicolumn{4}{c}{**VGA-2, \(n=19\)**} \\ \multicolumn{1}{c}{} & \multicolumn{4}{c}{**2W**} & \multicolumn{4}{c}{**4W**} & \multicolumn{4}{c}{**4W**} \\ \hline \multicolumn{1}{c}{2–aA} & Mean \(\pm\) SE & \(p\)-value (\({}^{\star}\)) & Mean \(\pm\) SE & \(p\)-value (\({}^{\star}\)) & \(p\)-value (\({}^{\star}\)) & Mean \(\pm\) SE & \(p\)-value (\({}^{\star}\)) & Mean \(\pm\) SE & \(p\)-value (\({}^{\star}\)) & \(p\)-value (\({}^{\star}\)) \\ \multicolumn{1}{c}{_Lockwellii_} & \(24.7\pm 1.51\) & \(0.1845\) & \(12.6\pm 5.1\) & \(0.5094\) & \(0.9771\) & \(1.2\pm 0.3\) & \(0.7435\) & \(1.0\pm 0.1\) & \(0.7504\) & \(0.4084\) \\ \multicolumn{1}{c}{_L. plantarum_} & \(13.5\pm 10.6\) & \(0.9851\) & \(2.8\pm 0.8\) & \(0.1845\) & \(0.5087\) & \(3.3\pm 1.2\) & \(0.2886\) & \(5.5\pm 1.9\) & \(0.5053\) & \(0.7774\) \\ \multicolumn{1}{c}{_L. harmares_} & \(22.2\pm 1.1\) & \(0.0014\) & \(10.2\pm 8.6\) & \(0.5128\) & \(0.8457\) & \(1.3\pm 0.2\) & \(0.1771\) & \(2.5\pm 0.9\) & \(0.5057\) & \(0.8308\) \\ \multicolumn{1}{c}{_L. catdrophits_} & \(205.0\pm 191.2\) & \(0.5079\) & \(29.1\pm 26.2\) & \(0.5128\) & \(0.8892\) & \(1.1\pm 0.2\) & \(0.1763\) & \(1.5\pm 0.3\) & \(0.1768\) & \(0.5452\) \\ \multicolumn{1}{c}{_L. crisprus_} & \(106.4\pm 97.9\) & \(0.1845\) & \(16.5\pm 13.9\) & \(0.1845\) & \(0.9778\) & \(2.2\pm 1.1\) & \(0.0397^{*}\) & \(1.2\pm 0.2\) & \(0.5002\) & \(0.5959\) \\ \multicolumn{1}{c}{_L. classeri_} & \(250.1\pm 22.3\) & \(>0.9999\) & \(72.1\pm 39.5\) & \(0.0426^{*}\) & \(0.2350\) & \(1.1\pm 0.2\) & \(0.7028\) & \(1.2\pm 0.2\) & \(0.4629\) & \(0.5121\) \\ \multicolumn{1}{c}{_L.