The causality between gut microbiota and endometriosis: a bidirectional Mendelian randomization study.

BACKGROUND

Observational studies and animal experiments had suggested a potential relationship between gut microbiota abundance and pathogenesis of endometriosis (EMs), but the relevance of this relationship remains to be clarified.

METHODS

We perform a two-sample bidirectional Mendelian randomization (MR) analysis to explore whether there is a causal correlation between the abundance of the gut microbiota and EMs and the direction of causality. Genome-wide association study (GWAS) data ukb-d-N80, finn-b-N14-EM, and MiBinGen were selected. Inverse variance weighted (IVW), weighted median, and MR Egger are selected for causal inference. The Cochran Q test, Egger intercept test, and leave-one-out analysis are performed for sensitivity analyses.

RESULTS

In the primary outcome, we find that a higher abundance of class Negativicutes, genus , genus , genus xylanophilum group, genus and order Selenomonadales predict a higher risk of EMs, and a higher abundance of genus and genus predict a lower risk of EMs. During verifiable outcomes, we find that a higher abundance of phylum Cyanobacteria, genus UCG002, and genus 3 predict a higher risk of EMs, and a higher abundance of genus , genus , and genus RC9 predict a lower risk of EMs. In primary reverse MR analysis, we find that EMs predict a lower abundance of the genus fissicatena group, genus , genus , family , and a higher abundance of genus UCG009. In verifiable reverse MR analysis, we find that EMs predict a lower abundance of the genus UCG004 and a higher abundance of the genus .

CONCLUSION

Our study implies a mutual causality between gut microbiota abundance and the pathogenesis of EMs, which may provide a novel direction for EMs diagnosis, prevention, and treatment, may promote future functional or clinical analysis.