Microbiome Profile of Deep Endometriosis Patients: Comparison of Vaginal Fluid, Endometrium and Lesion

Abstract

This work aimed to identify and compare the bacterial patterns present in endometriotic lesions, eutopic endometrium and vaginal fluid from endometriosis patients with those found in the vaginal fluid and eutopic endometrium of control patients. Vaginal fluid, eutopic endometrium and endometriotic lesions were collected. DNA was extracted and the samples were analyzed to identify microbiome by high-throughput DNA sequencing of the 16S rRNA marker gene. Amplicon sequencing from vaginal fluid, eutopic endometrium and endometriotic lesion resulted in similar profiles of microorganisms, composed most abundantly by the genus Lactobacillus, Gardnerella, Streptococcus and Prevotella. No significant differences were found in the diversity analysis of microbiome profiles between control and endometriotic patients; however deep endometriotic lesions seems to present different bacterial composition, less predominant of Lactobacillus and with more abundant Alishewanella, Enterococcus and Pseudomonas.

New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future?

“…Several studies demonstrated that asymptomatic women harbour commensal microbial communities in their uterus [8,11,16,22,102], and that the uterine microbiome seems to be altered in women who suffer gynaecological pathologies such CE [14][15][16], endometriosis [17,19,20], dysfunctional endometrial bleeding [22], endometrial polyps [16], endometrial cancer or hyperplasia [16,[23][24][25], and infertility [4,8,11,13] (Table 1). All these studies support the evidence that the uterine microbial composition is clinically relevant and requires further investigation.…”

“…Acinetobacter [20], Barnesiella [18], Comamonadaceae [20], Enterobacteriaceae [19], Flavobacterium [18], Gardnerella [17], Lactobacillus [17,18,20], Moraxellaceae [19], Prevotella [17], Pseudomonas [18,20], Sphingobium [20], Staphylococaceae [19], Streptococcaceae [17,19], Vagococcus [20] Chronic endometritis…”

“…The uterine microbiome of 'healthy' women was mostly investigated as a control group in studies of infertile women or those with a gynaecological pathology [7,8,11,[13][14][15][16][17][18][19][22][23][24] (Table 1). Nevertheless, these data suggest that commensal microorganisms can inhabit the upper reproductive tract of healthy women.…”

“…Another study investigating women with endometriosis identified the presence of Pseudomonas, Acinetobacter, Vagococcus and Sphingobium in uterus and revealed that uterine microbiota composition is significantly different in infertile women due to endometriosis [20]. A recently published study analysing endometriotic lesions found that the microbial diversity of lesions was higher compared to eutopic endometrium, where Lactobacillus, Enterococcus, Gardnerella, Pseudomonas, Alishewanella, Ureaplasma and Aerococcus prevailed [17].…”

“…The initial studies of endometrial microbiome suggest its association with reproductive outcomes in assisted reproduction [4][5][6][7][8][9][10][11][12][13] and with different gynaecological pathologies such as chronic endometritis (CE) [14][15][16], endometriosis [13,[17][18][19][20][21], dysfunctional endometrial bleeding [22], endometrial polyps [16], and endometrial cancer or hyperplasia [23][24][25]. Nevertheless, causality has been difficult to prove because the reproductive tract represents a polymicrobial niche [26], and it is not clear whether dysbiosis within the uterus is a cause or a consequence of a pathology.…”