Hicks Chloe, Leonardi Mathew, Chua Xin-Yi, Mari-Breedt Lisa, Espada Mercedes, El-Omar Emad M, Condous George, El-Assaad Fatima
Microbiome Research Centre, School of Clinical Medicine, UNSW Medicine & Health, St George & Sutherland Clinical Campuses, UNSW Sydney, Sydney, New South Wales, Australia.
Endometriosis Ultrasound and Advanced Endosurgery Unit, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Sydney, New South Wales, Australia.
BJOG. 2025 Feb;132(3):326-336. doi: 10.1111/1471-0528.17979. Epub 2024 Oct 21.
To identify a microbial signature for endometriosis for use as a diagnostic non-invasive biomarker.
Prospective cohort pilot study.
Nepean Hospital and UNSW Microbiome Research Centre, Australia.
Sixty-four age- and sex-matched subjects (n = 19 healthy control (HC); n = 24 non-endometriosis (N-ENDO) and n = 21 confirmed endometriosis (ENDO)). All study participants, besides healthy controls, underwent laparoscopic surgical assessment for endometriosis, and histology was performed on excised lesions.
Oral, stool and, vaginal samples were self-collected at a single time point for healthy controls, and preoperatively for patients undergoing laparoscopy. Samples underwent 16S rRNA amplicon sequencing, followed by bioinformatics analysis.
Compositional differences between cohorts as identified by diversity analyses, and differentially abundant microbial taxa, as identified by LEfSE analysis.
The composition of the oral (adjusted p = 0.003), and stool (adjusted p = 0.042) microbiota is different between the three cohorts. Differentially abundant taxa are present within each cohort as identified by LEfSE analysis. Particularly, Fusobacterium was enriched in the oral samples of patients with moderate/severe endometriosis.
Taxonomic and compositional differences were found between the microbiota in the mouth, gut and, vagina of patients with and without endometriosis and healthy controls. Fusobacterium was enriched in patients with moderate/severe endometriosis. Fusobacterium is noted as a key pathogen in periodontal disease, a common comorbidity in endometriosis. These findings suggest a role for the oral, stool and, vaginal microbiome in endometriosis, and present potential for microbial-based treatments and the design of a diagnostic swab.
确定子宫内膜异位症的微生物特征，用作诊断性非侵入性生物标志物。
前瞻性队列先导研究。
澳大利亚内佩恩医院和新南威尔士大学微生物组研究中心。
64名年龄和性别匹配的受试者（n = 19名健康对照（HC）；n = 24名非子宫内膜异位症患者（N-ENDO）和n = 21名确诊的子宫内膜异位症患者（ENDO））。除健康对照外，所有研究参与者均接受了腹腔镜手术评估以诊断子宫内膜异位症，并对切除的病变进行了组织学检查。
健康对照在单个时间点自行采集口腔、粪便和阴道样本，接受腹腔镜手术的患者在术前采集。样本进行16S rRNA扩增子测序，随后进行生物信息学分析。
通过多样性分析确定队列之间的组成差异，以及通过线性判别分析效应大小（LEfSE）分析确定差异丰富的微生物分类群。
三个队列的口腔（校正p = 0.003）和粪便（校正p = 0.042）微生物群组成不同。通过LEfSE分析确定每个队列中存在差异丰富的分类群。特别是，梭杆菌在中度/重度子宫内膜异位症患者的口腔样本中富集。
在有和没有子宫内膜异位症的患者以及健康对照的口腔、肠道和阴道微生物群之间发现了分类学和组成差异。梭杆菌在中度/重度子宫内膜异位症患者中富集。梭杆菌是牙周病的关键病原体，而牙周病是子宫内膜异位症常见的合并症。这些发现表明口腔、粪便和阴道微生物群在子宫内膜异位症中起作用，并为基于微生物的治疗和诊断拭子的设计提供了潜力。
