Gynecology and Obstetrics Clinical Medicine (Sep 2021)
The study of endometriosis and adenomyosis related microbiota in female lower genital tract in Northern Chinese population
Abstract
Background: Endometriosis is a chronic disease that affects women in reproductive age, and adenomyosis was known as “endometriosis in the uterus”. Endometriosis is an immune-dysfunction-related disease, contributing to the diversity of microbiota in the lower genital tract. Endometriosis is also an infection-related disease, the number of bacteria may contribute to some unknown mechanisms. Presently, the feature of microbiota between endometriosis patients and normal people is not fully understood. Methods: To identify the microbiota differences and features of endometriosis patients, 298 samples from the cervical canal, posterior fornix of the vagina and uterine cavity were analyzed by 16s-rRNA sequencing. Raw data were filtered, analyzed, and visualized. We conducted diversity analysis, statistical data of microbiota abundance, biomarker identification, random forest, and environmental factors analysis. Results: Alpha diversity was not distinctive in endometriosis and adenomyosis patients. Posterior fornix near cervix was a better sampling location to analyze the dysmenorrhea-related microbiota feature; few dysmenorrhea-related bacteria were identified. Endometrial bacteria is controversial, and the result of 16s-rRNA sequencing was not good enough to conduct further analysis. Anaerococcus was a possible biomarker of adenomyosis-endometriosis patients. The identified bacteria were representative only in specific periods during the menstrual cycle. GnRH-a treatment impacted microbiota feature the most compared with other environmental factors. Conclusion: This study provided us with a new concept of endometriosis and bacteria; different microbiota features may relate to endometriosis. The bacterial involvement should be considered in the future study of endometriosis. New non-invasive diagnosis and therapeutic methods through bacterial medication are prospective.
