Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200080, China.
Department of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China.
Arch Gynecol Obstet. 2021 Nov;304(5):1363-1373. doi: 10.1007/s00404-021-06057-z. Epub 2021 Apr 11.
Endometriosis (EM) in reproductive females has an incidence of 6-10% and greatly affects female fertility, quality of life, and long-term health. The gut microbiota can affect the physiological and pathological processes of humans through various pathways, such as those involving the nervous and endocrine systems and immunity, and it plays important roles in endocrine and inflammatory diseases. Whether the gut microbiota plays a role in EM has gradually attracted researchers' attention. In the present study, fecal and blood samples were collected from 12 patients with stage 3/4 EM and 12 healthy controls. We performed 16S rRNA high-throughput sequencing to compare the gut microbiota between the EM and control groups. Serum levels of hormones and inflammatory cytokines were measured. We found that compared with the control group, the EM group had a lower α diversity of gut microbiota and a higher Firmicutes/Bacteroidetes ratio. The abundances of various taxa (such as Actinobacteria, Tenericutes, Blautia, Bifidobacterium, Dorea, and Streptococcus) were significantly different between the two groups. The taxon with the highest abundance in the EM group was Prevotella_7, and that in the control group was Coprococcus_2. The serum levels of E2 and IL-8 were significantly higher in the EM group than in the control group (E2: EM group 74.7 ± 22.5 pg/L vs CON group 47.9 ± 12.5 pg/L; IL-8: EM group 6.39 ± 1.59 pg/mL vs CON group 4.14 ± 0.73 pg/mL). Additionally, the gut microbiota of the EM group was enriched for the microbial function categories environmental information processing, endocrine system, and immune system. Correlations were detected between each of Blautia and Dorea abundance and estradiol level and between Subdoligranulum abundance and IL-8 level. This study elucidated the associations between the gut microbiota and both serum hormones and inflammatory factors in EM. However, the findings need to be verified in future studies.
子宫内膜异位症（EM）在育龄女性中的发病率为 6-10%，极大地影响了女性的生育能力、生活质量和长期健康。肠道微生物群可以通过各种途径影响人类的生理和病理过程，例如涉及神经系统和内分泌系统以及免疫系统的途径，并在内分泌和炎症性疾病中发挥重要作用。肠道微生物群是否在 EM 中发挥作用，已逐渐引起研究人员的关注。本研究收集了 12 例 3/4 期 EM 患者和 12 例健康对照者的粪便和血液样本。我们进行了 16S rRNA 高通量测序，比较了 EM 组和对照组的肠道微生物群。测量了血清激素和炎症细胞因子水平。结果发现，与对照组相比，EM 组肠道微生物群的α多样性较低，厚壁菌门/拟杆菌门比值较高。两组间各种分类群（如放线菌、柔膜菌、布劳特氏菌、双歧杆菌、多拉菌和链球菌）的丰度差异有统计学意义。EM 组丰度最高的分类群是普雷沃氏菌属 7，对照组是粪球菌属 2。EM 组的 E2 和 IL-8 血清水平明显高于对照组（E2：EM 组 74.7±22.5 pg/L 比 CON 组 47.9±12.5 pg/L；IL-8：EM 组 6.39±1.59 pg/mL 比 CON 组 4.14±0.73 pg/mL）。此外，EM 组的肠道微生物群富集了微生物功能类别环境信息处理、内分泌系统和免疫系统。发现布劳特氏菌和多拉菌丰度与雌二醇水平之间存在相关性，以及 Subdoligranulum 丰度与 IL-8 水平之间存在相关性。本研究阐明了 EM 患者肠道微生物群与血清激素和炎症因子之间的关联。然而，这些发现需要在未来的研究中得到验证。
