反复着床失败女性阴道微生物群及相关代谢组学的改变。
Alterations in Vaginal Microbiota and Associated Metabolome in Women with Recurrent Implantation Failure.
机构信息
Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
出版信息
mBio. 2020 Jun 2;11(3):e03242-19. doi: 10.1128/mBio.03242-19.
Recurrent implantation failure (RIF) refers to repeated failure to become pregnant after transferring embryos with normal morphology. However, the pathogenesis of RIF remains unrevealed, especially for those without any pathological features. In this study, we characterized the vaginal microbiota and metabolomes of patients with unexplained RIF, while patients who achieved clinical pregnancy in the first frozen embryo transfer (FET) cycle were used as controls. Based on 16S rRNA gene sequencing of the vaginal microbiota, the vaginal showed a significant positive correlation with the pregnancy rate, and the RIF group presented higher microbial α-diversity than the control group ( value = 0.016). The metabolomic profile identified 2,507 metabolites, of which 37 were significantly different between the two groups ( value < 0.05, variable importance for the projection [VIP] > 1). Among them, 2',3-cyclic UMP and inositol phosphate were the top two metabolites that were higher in the RIF group, while glycerophospholipids and benzopyran were important metabolites that were lower in the RIF group. A lack of lysobisphosphatidic acid and prostaglandin metabolized from glycerophospholipids will lead to deferred implantation and embryo crowding. Benzopyran, as a selective estrogen receptor modulator, may affect the outcome of pregnancy. All of the changes in metabolite profiles may result in or from the differential microbiota compositions in RIF patients. In conclusion, significant differences were presented in the vaginal microbiota and metabolomes between patients with unexplained RIF and women who became pregnant in the first FET cycle. For the first time, this study elaborates the possible pathogenesis of RIF by investigating the vaginal microbiota and metabolites in RIF patients. fertilization-embryo transfer (IVF-ET) is now widely applied for treating infertility, and unexplained recurrent implantation failure (RIF) has become a substantial challenge. We hypothesize that vaginal microbial dysbiosis is associated with RIF, as it is linked to many female reproductive diseases. In this study, we characterized the vaginal microbiota and metabolomes of patients with unexplained RIF, while patients who achieved clinical pregnancy in the first IVF cycle were set as controls. In general, significant differences were discovered in the vaginal microbiota and metabolomes between the two groups. This study is the first detailed elaboration of the vaginal microbiota and metabolites associated with RIF. We believe that our findings will inspire researchers to consider the dynamics of microbiomes related to the microenvironment as a critical feature for future studies of nosogenesis not only for RIF but also for other reproductive diseases.
反复种植失败(RIF)是指胚胎形态正常但移植后仍反复妊娠失败。然而,RIF 的发病机制仍未阐明,尤其是对于那些没有任何病理特征的患者。在这项研究中,我们对不明原因 RIF 患者的阴道微生物群和代谢组进行了特征描述,同时将首次冷冻胚胎移植(FET)周期中临床妊娠的患者作为对照组。基于阴道微生物群的 16S rRNA 基因测序,阴道微生物多样性与妊娠率呈显著正相关,RIF 组的微生物 α多样性高于对照组( value = 0.016)。代谢组学分析鉴定出 2507 种代谢物,其中两组间有 37 种代谢物存在显著差异( value < 0.05,变量重要性投影[VIP] > 1)。其中,2',3-环乌苷一磷酸和肌醇磷酸是 RIF 组中含量较高的前两种代谢物,而甘油磷脂和苯并吡喃是 RIF 组中含量较低的重要代谢物。缺乏甘油磷脂代谢产生的溶血磷脂酸和前列腺素会导致着床延迟和胚胎拥挤。苯并吡喃作为一种选择性雌激素受体调节剂,可能会影响妊娠结局。所有代谢物谱的变化可能导致或来自 RIF 患者的差异微生物组成。总之,不明原因 RIF 患者与首次 FET 周期妊娠的女性之间,阴道微生物群和代谢组存在显著差异。本研究首次通过研究 RIF 患者的阴道微生物群和代谢物,阐述了 RIF 可能的发病机制。体外受精-胚胎移植(IVF-ET)目前已广泛应用于治疗不孕不育,不明原因的反复种植失败(RIF)已成为一个重大挑战。我们假设阴道微生物失调与 RIF 有关,因为它与许多女性生殖疾病有关。在这项研究中,我们对不明原因 RIF 患者的阴道微生物群和代谢组进行了特征描述,同时将首次 IVF 周期妊娠的患者作为对照组。总的来说,两组间在阴道微生物群和代谢组上存在显著差异。本研究是对与 RIF 相关的阴道微生物群和代谢物的首次详细阐述。我们相信,我们的发现将促使研究人员将与微环境相关的微生物组动力学视为未来研究发病机制的一个关键特征,不仅针对 RIF,还针对其他生殖疾病。