Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI; Perinatal Research Initiative in Maternal, Perinatal and Child Health, Wayne State University School of Medicine, Detroit, MI; Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, and Detroit, MI.
Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI; Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI.
Am J Obstet Gynecol. 2019 Mar;220(3):267.e1-267.e39. doi: 10.1016/j.ajog.2018.10.018.
BACKGROUND: The human placenta has been traditionally viewed as sterile, and microbial invasion of this organ has been associated with adverse pregnancy outcomes. Yet, recent studies that utilized sequencing techniques reported that the human placenta at term contains a unique microbiota. These conclusions are largely based on the results derived from the sequencing of placental samples. However, such an approach carries the risk of capturing background-contaminating DNA (from DNA extraction kits, polymerase chain reaction reagents, and laboratory environments) when low microbial biomass samples are studied. OBJECTIVE: To determine whether the human placenta delivered at term in patients without labor who undergo cesarean delivery harbors a resident microbiota ("the assemblage of microorganisms present in a defined niche or environment"). STUDY DESIGN: This cross-sectional study included placentas from 29 women who had a cesarean delivery without labor at term. The study also included technical controls to account for potential background-contaminating DNA, inclusive in DNA extraction kits, polymerase chain reaction reagents, and laboratory environments. Bacterial profiles of placental tissues and background technical controls were characterized and compared with the use of bacterial culture, quantitative real-time polymerase chain reaction, 16S ribosomal RNA gene sequencing, and metagenomic surveys. RESULTS: (1) Twenty-eight of 29 placental tissues had a negative culture for microorganisms. The microorganisms retrieved by culture from the remaining sample were likely contaminants because corresponding 16S ribosomal RNA genes were not detected in the same sample. (2) Quantitative real-time polymerase chain reaction did not indicate greater abundances of bacterial 16S ribosomal RNA genes in placental tissues than in technical controls. Therefore, there was no evidence of the presence of microorganisms above background contamination from reagents in the placentas. (3) 16S ribosomal RNA gene sequencing did not reveal consistent differences in the composition or structure of bacterial profiles between placental samples and background technical controls. (4) Most of the bacterial sequences obtained from metagenomic surveys of placental tissues were from cyanobacteria, aquatic bacteria, or plant pathogens, which are microbes unlikely to populate the human placenta. Coprobacillus, which constituted 30.5% of the bacterial sequences obtained through metagenomic sequencing of placental samples, was not identified in any of the 16S ribosomal RNA gene surveys of these samples. These observations cast doubt as to whether this organism is really present in the placenta of patients at term not in labor. CONCLUSION: With the use of multiple modes of microbiologic inquiry, a resident microbiota could not be identified in human placentas delivered at term from women without labor. A consistently significant difference in the abundance and/or presence of a microbiota between placental tissue and background technical controls could not be found. All cultures of placental tissue, except 1, did not yield bacteria. Incorporating technical controls for potential sources of background-contaminating DNA for studies of low microbial biomass samples, such as the placenta, is necessary to derive reliable conclusions.
背景:传统观点认为胎盘是无菌的,而微生物入侵胎盘与不良妊娠结局有关。然而,最近利用测序技术的研究报告称,足月胎盘含有独特的微生物群。这些结论主要基于从胎盘样本测序中得出的结果。然而,当研究低微生物生物量样本时,这种方法存在捕获背景污染 DNA(来自 DNA 提取试剂盒、聚合酶链反应试剂和实验室环境)的风险。
目的:确定在没有分娩的足月剖宫产患者的胎盘是否存在常驻微生物群(“存在于特定小生境或环境中的微生物集合”)。
研究设计:这项横断面研究包括 29 名足月无分娩剖宫产患者的胎盘。该研究还包括技术对照,以考虑潜在的背景污染 DNA,包括 DNA 提取试剂盒、聚合酶链反应试剂和实验室环境中的 DNA。使用细菌培养、定量实时聚合酶链反应、16S 核糖体 RNA 基因测序和宏基因组调查来描述和比较胎盘组织和背景技术对照的细菌特征。
结果:(1)29 个胎盘组织中有 28 个微生物培养结果为阴性。从剩余样本中培养出的微生物很可能是污染物,因为在同一样本中未检测到相应的 16S 核糖体 RNA 基因。(2)定量实时聚合酶链反应并未表明胎盘组织中细菌 16S 核糖体 RNA 基因的丰度高于技术对照。因此,胎盘组织中没有来自试剂的微生物背景污染的证据。(3)16S 核糖体 RNA 基因测序未显示细菌特征的组成或结构在胎盘样本和背景技术对照之间存在一致差异。(4)从胎盘组织宏基因组调查中获得的大多数细菌序列来自蓝藻、水生细菌或植物病原体,这些微生物不太可能定植于人类胎盘。从胎盘样本的宏基因组测序中获得的细菌序列中,Coprobacillus 占 30.5%,但在这些样本的任何 16S 核糖体 RNA 基因调查中均未发现。这些观察结果使人怀疑在没有分娩的足月患者的胎盘是否真的存在这种生物。
结论:使用多种微生物学调查模式,无法在无分娩的足月妇女的胎盘组织中鉴定出常驻微生物群。在胎盘组织和背景技术对照之间没有发现微生物丰度和/或存在的一致显著差异。除 1 个外,所有胎盘组织培养均未产生细菌。对于低微生物生物量样本(如胎盘)的研究,需要纳入用于潜在背景污染 DNA 源的技术对照,以得出可靠的结论。
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