Dantzler Michelle D, Miller Tiffani-Amber, Dougherty Michael W, Quevedo Amira
University of Florida College of Medicine, Gainesville, FL, USA.
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA.
Reprod Sci. 2025 Feb;32(2):251-260. doi: 10.1007/s43032-024-01766-7. Epub 2024 Dec 20.
Alterations in the microbiome composition have been identified in common gynecologic pathologies such as endometriosis carving a new frontier in diagnosis and treatment. We aimed to examine the existing literature on perturbations in the reproductive tract microbiome of individuals with adenomyosis informing future therapeutic targets. To examine the association between the reproductive tract microbiome composition among individuals with adenomyosis when compared to controls that can lead to new research evaluating novel mechanisms of action and treatment modalities. A systematic literature search identified studies that compared differences in microbiome composition using culture-independent microbiome analysis between individuals with adenomyosis when compared to controls. Five observational cross-sectional studies characterizing the lower and upper reproductive tract in humans were included. The diagnostic criteria of adenomyosis included surgical and imaging-based criteria. All studies used a 16S rRNA sequencing method. All individuals were recruited from either China or Thailand. An association between adenomyosis and alterations in the microbiome composition included relative deficiencies in Lactobacillus and relative enrichment of anaerobic and gram-negative bacteria when compared to control participants. Comparative studies suggest that there are significant perturbations in the microbiota composition of individuals with adenomyosis when compared with controls. Limiting conclusions include relative small sample sizes, a homogeneous population, and scant clinical phenotypic data. This systematic review identified significant alterations in the bacterial composition of adenomyosis cases that can be leveraged to design mechanistic studies and future innovative approaches to diagnose and manage this pathology. Trial registration: PROSPERO (CRD42023494563). Registered December 28, 2023.
在子宫内膜异位症等常见妇科疾病中已发现微生物群组成的改变，这为诊断和治疗开辟了新的前沿领域。我们旨在研究关于子宫腺肌病患者生殖道微生物群紊乱的现有文献，为未来的治疗靶点提供信息。为了研究子宫腺肌病患者与对照组相比生殖道微生物群组成之间的关联，这可能会引发新的研究，评估新的作用机制和治疗方式。一项系统的文献检索确定了一些研究，这些研究使用非培养微生物群分析比较了子宫腺肌病患者与对照组之间微生物群组成的差异。纳入了五项描述人类下生殖道和上生殖道的观察性横断面研究。子宫腺肌病的诊断标准包括基于手术和影像学的标准。所有研究都使用了16S rRNA测序方法。所有个体均来自中国或泰国。与对照组相比，子宫腺肌病与微生物群组成改变之间的关联包括乳酸杆菌相对缺乏以及厌氧菌和革兰氏阴性菌相对富集。比较研究表明，与对照组相比，子宫腺肌病患者的微生物群组成存在显著紊乱。局限性结论包括样本量相对较小、人群同质化以及临床表型数据匮乏。这项系统综述确定了子宫腺肌病病例细菌组成的显著改变，可用于设计机制研究以及未来诊断和管理这种疾病的创新方法。试验注册：PROSPERO（CRD42023494563）。于2023年12月28日注册。
