Hanna Aya, Abbas Hassan, Yassine Fayez, AlBush Alia, Bilen Melhem
Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Centre for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon.
Front Microbiol. 2025 May 14;16:1549499. doi: 10.3389/fmicb.2025.1549499. eCollection 2025.
Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting around 12% of women globally, associated with infertility and various comorbidities. Emerging evidence suggests a crucial role of gut microbiota in PCOS pathophysiology, prompting research to investigate alterations in gut microbial composition in patients with PCOS.
This systematic review aims to analyze human and animal studies that compare gut microbiota composition, gut-derived metabolites, and treatment interventions in PCOS patients versus healthy controls. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, yielding studies examining gut microbiota, metabolomic shifts, and treatment responses in PCOS models and human populations.
Our analysis revealed decreases in alpha diversity in PCOS patients, with more pronounced changes in beta diversity in animal models. Specific bacterial taxa, such as and , showed implication in PCOS pathogenesis, suggesting potential microbial markers. Furthermore, discrepancies between human and animal studies show the need for humanized mouse models to bridge this gap. Interventions like probiotics and fecal microbiota transplantation (FMT) showed varying levels of efficacy, with FMT emerging as a more promising but invasive option, offering live bacteriotherapy as a potential therapeutic alternative. Alterations in gut-derived metabolites, including short-chain fatty acids and bile acids, highlighted the multifaceted nature of PCOS, with implications extending to metabolic, hormonal, and gut-brain axis disruptions.
In conclusion, PCOS exhibits complex interactions between gut microbiota and metabolic pathways, necessitating further research with standardized methods and larger sample sizes to elucidate the microbiome's role in PCOS.
多囊卵巢综合征（PCOS）是一种内分泌紊乱疾病，全球约12%的女性受其影响，与不孕及多种合并症相关。新出现的证据表明肠道微生物群在PCOS病理生理学中起关键作用，促使研究人员调查PCOS患者肠道微生物组成的改变。
本系统评价旨在分析比较PCOS患者与健康对照者肠道微生物群组成、肠道衍生代谢物及治疗干预措施的人体和动物研究。使用PubMed、Scopus和Web of Science进行了全面的文献检索，获得了关于PCOS模型和人群中肠道微生物群、代谢组学变化及治疗反应的研究。
我们的分析显示PCOS患者的α多样性降低，动物模型中的β多样性变化更明显。特定细菌类群，如 和 ，在PCOS发病机制中具有一定作用，提示可能存在微生物标志物。此外，人体和动物研究之间的差异表明需要人源化小鼠模型来弥合这一差距。益生菌和粪便微生物群移植（FMT）等干预措施显示出不同程度的疗效，FMT作为一种更有前景但具有侵入性的选择，提供了活菌疗法作为一种潜在的治疗替代方案。肠道衍生代谢物的改变，包括短链脂肪酸和胆汁酸，突出了PCOS的多方面性质，其影响延伸至代谢、激素和肠-脑轴紊乱。
总之，PCOS在肠道微生物群和代谢途径之间表现出复杂的相互作用，需要采用标准化方法并扩大样本量进行进一步研究，以阐明微生物组在PCOS中的作用。
