ObjectiveTo identify a microbial signature for endometriosis for use as a diagnostic non‐invasive biomarker.DesignProspective cohort pilot study.SettingNepean Hospital and UNSW Microbiome Research Centre, Australia.PopulationSixty‐four age‐ and sex‐matched subjects (n = 19 healthy control (HC); n = 24 non‐endometriosis (N‐ENDO) and n = 21 confirmed endometriosis (ENDO)). All study participants, besides healthy controls, underwent laparoscopic surgical assessment for endometriosis, and histology was performed on excised lesions.MethodsOral, stool and, vaginal samples were self‐collected at a single time point for healthy controls, and preoperatively for patients undergoing laparoscopy. Samples underwent 16S rRNA amplicon sequencing, followed by bioinformatics analysis.Main Outcome MeasuresCompositional differences between cohorts as identified by diversity analyses, and differentially abundant microbial taxa, as identified by LEfSE analysis.ResultsThe composition of the oral (adjusted p = 0.003), and stool (adjusted p = 0.042) microbiota is different between the three cohorts. Differentially abundant taxa are present within each cohort as identified by LEfSE analysis. Particularly, Fusobacterium was enriched in the oral samples of patients with moderate/severe endometriosis.ConclusionsTaxonomic and compositional differences were found between the microbiota in the mouth, gut and, vagina of patients with and without endometriosis and healthy controls. Fusobacterium was enriched in patients with moderate/severe endometriosis. Fusobacterium is noted as a key pathogen in periodontal disease, a common comorbidity in endometriosis. These findings suggest a role for the oral, stool and, vaginal microbiome in endometriosis, and present potential for microbial‐based treatments and the design of a diagnostic swab.

中文翻译：

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子宫内膜异位症患者的口腔、阴道和粪便微生物特征作为潜在的诊断性非侵入性生物标志物：一项前瞻性队列研究


目的确定子宫内膜异位症的微生物特征，用作诊断性无创生物标志物。设计前瞻性队列试点研究。地点澳大利亚新南威尔士大学医院和新南威尔士大学微生物组研究中心人口64 名年龄和性别匹配的受试者（n = 19 名健康对照 （HC）;n = 24 名非子宫内膜异位症 （N-ENDO） 和 n = 21 名确诊的子宫内膜异位症 （ENDO））。除健康对照外，所有研究参与者均接受了子宫内膜异位症的腹腔镜手术评估，并对切除的病灶进行了组织学检查。方法健康对照患者在单个时间点自行采集口腔、粪便和阴道样本，腹腔镜患者在术前自行采集。样品进行 16S rRNA 扩增子测序，然后进行生物信息学分析。主要结局指标通过多样性分析确定的队列之间的组成差异，以及通过 LEfSE 分析确定的差异丰富的微生物分类群。结果三个队列之间的口腔 （校正 p = 0.003） 和粪便 （校正 p = 0.042） 微生物群的组成不同。通过 LEfSE 分析确定的每个队列中存在差异丰富的分类群。特别是，中度/重度子宫内膜异位症患者的口腔样本中富集了梭杆菌。结论发现子宫内膜异位症患者和非子宫内膜异位症患者与健康对照者的口腔、肠道和阴道微生物群之间存在分类学和组成差异。梭杆菌在中/重度子宫内膜异位症患者中富集。梭杆菌被认为是牙周病的关键病原体，是子宫内膜异位症的常见合并症。 这些发现表明口腔、粪便和阴道微生物组在子宫内膜异位症中的作用，并具有基于微生物的治疗和诊断拭子设计的潜力。