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阴道微生物群与外阴痛、外阴疼痛综合征相关:一项病例对照研究。

Vaginal Microbiome Is Associated With Vulvodynia, Vulvar Pain Syndrome: A Case-Control Study.

作者信息

Park So Yun, Lee Eun Sil, Lee Sa Ra, Kim Sung Hoon, Chae Hee Dong

机构信息

Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.

Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.

出版信息

Sex Med. 2021 Apr;9(2):100314. doi: 10.1016/j.esxm.2020.100314. Epub 2021 Feb 27.

Abstract

INTRODUCTION

Vulvodynia, vulvar pain syndrome, is defined as vulvar pain of at least a 3-month duration without a clear identifiable cause, which may have associated factor and the etiology and treatment of this challenging disease is still unclear. Dyspareunia is a relevant symptom of patients with vulvodynia. Vaginal microbiome has known an important role in local immune-inflammatory responses and it may be important pathogenic mechanism in vulvodynia.

AIM

The objective of this study was to investigate the association of vaginal microbiome and vulvodynia.

METHODS

We analyzed the microbial compositions of the vestibule and vagina among women with clinically diagnosed vulvodynia (n = 22) and age-matched healthy controls (n = 22) without vulvodynia. The compositions of bacterial microbiomes were compared by pyrosequencing of the 16S rRNA.

MAIN OUTCOME MEASURE

Vaginal microbiome alpha and beta diversity were assessed using the Shannon diversity index and Heat map. Linear discriminant analysis effect size was used to find out marker for vulvodynia.

RESULTS

There were no significant differences in the age, duration of marriage, history of gynecologic surgery, parity, and menopause status between cases and controls. A total of 1,661,934 high-quality pyrosequencing reads was obtained to evaluate bacterial diversity, and 50,246 unique sequences represented all phylotypes. The type and mean number of the genera were not different between cases and controls. However, the most predominant phyla of bacteria were significantly different between cases and controls. 3 phyla (Firmicutes, Actinobacteria, and Tenericutes) and 11 genera including Gardnerella, Ureaplasma, Achromobacter, Mycoplasma, and Bifidobacteria were significantly more prevalent in cases than in controls (P < .05). Linear discriminant analysis effect size analysis suggest the Bifidobacterium, Mycoplasma, and Fenollaria species can be potential markers for vulvodynia.

CONCLUSION

Our results suggest the differences in vaginal microbiome can be associated with the vulvodynia. Park SY, Lee ES, Lee SR, et al. Vaginal Microbiome Is Associated With Vulvodynia, Vulvar Pain Syndrome: A Case-Control Study. Sex Med 2021;9:100314.

摘要

引言

外阴痛,即外阴疼痛综合征,被定义为持续至少3个月且无明确可识别病因的外阴疼痛,其可能存在相关因素,而这种具有挑战性的疾病的病因和治疗方法仍不明确。性交困难是外阴痛患者的一个相关症状。阴道微生物群在局部免疫炎症反应中发挥着重要作用,可能是外阴痛的重要致病机制。

目的

本研究的目的是调查阴道微生物群与外阴痛之间的关联。

方法

我们分析了临床诊断为外阴痛的女性(n = 22)和年龄匹配的无外阴痛健康对照者(n = 22)的前庭和阴道的微生物组成。通过对16S rRNA进行焦磷酸测序比较细菌微生物群的组成。

主要观察指标

使用香农多样性指数和热图评估阴道微生物群的α和β多样性。使用线性判别分析效应大小来找出外阴痛的标志物。

结果

病例组和对照组在年龄、婚姻持续时间、妇科手术史、产次和绝经状态方面无显著差异。共获得1,661,934条高质量焦磷酸测序读数以评估细菌多样性,50,246条独特序列代表所有系统发育型。病例组和对照组之间属的类型和平均数没有差异。然而,病例组和对照组之间最主要的细菌门显著不同。3个门(厚壁菌门、放线菌门和柔膜菌门)以及包括加德纳菌属、脲原体属、无色杆菌属、支原体属和双歧杆菌属在内的11个属在病例组中比对照组中显著更普遍(P < 0.05)。线性判别分析效应大小分析表明双歧杆菌属、支原体属和费诺拉菌属可能是外阴痛的潜在标志物。

结论

我们的结果表明阴道微生物群的差异可能与外阴痛有关。朴世英、李恩硕、李素荣等。阴道微生物群与外阴痛、外阴疼痛综合征相关:一项病例对照研究。性医学2021;9:100314。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d569/8072171/0d0c9c5131c3/gr1.jpg

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