Differential oral, vaginal, and stool microbial signatures in patients
with and without endometriosis
Abstract
Objective To identify a diagnostic microbial signature for
endometriosis. Design Prospective cohort study Setting
Nepean Hospital and UNSW Microbiome Research Centre, St George Hospital,
Australia Population 64 age- and sex-matched subjects (
n=19 HC; n=24 N-ENDO and n=21 ENDO). All study
participants, besides healthy controls, underwent laparoscopic surgical
assessment for endometriosis, and histology was performed on excised
lesions. Methods Oral, stool, and vaginal samples were
self-collected at a single time point for healthy controls, and
pre-operatively for patients undergoing laparoscopy. Samples underwent
16S rRNA amplicon sequencing, followed by bioinformatics analysis.
Main Outcome Measures Compositional differences between cohorts
as identified by diversity analyses, and differentially abundant
microbial taxa, as identified by LEfSE analysis. Results The
composition of the oral, stool, and vaginal microbiota is different
between healthy controls and patients with and without endometriosis.
Differentially abundant taxa are present within each cohort.
Particularly , Fusobacterium was enriched in the oral samples
from patients with moderate/severe endometriosis. Conclusions
Distinct taxonomic and compositional differences were found between the
microbiota in the mouth, gut and vagina of patients with and without
endometriosis and healthy controls. Fusobacterium is noted as a
key pathogen in periodontal disease, a common comorbidity in
endometriosis. These findings support a role for the oral, vaginal, and
stool microbiome in endometriosis, and present potential for
microbial-based treatments and the design of a diagnostic swab.