Gut microbiota imbalance and its correlations with hormone and inflammatory factors in patients with stage 3/4 endometriosis

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Stage 3/4 endometriosis patients exhibit reduced gut microbiota diversity, altered microbial composition, and increased Prevotella_7 abundance compared to controls, alongside elevated E2 and IL-8 levels and microbial enrichment in endocrine and immune pathways.

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This study compared fecal gut microbiota and systemic markers between 12 patients with stage 3/4 endometriosis and 12 healthy controls, using 16S rRNA high-throughput sequencing along with serum hormone and inflammatory cytokine measurements. The endometriosis group showed lower gut microbiota α-diversity, a higher Firmicutes/Bacteroidetes ratio, and significant differences in multiple taxa, with Prevotella_7 most abundant in endometriosis and Coprococcus_2 most abundant in controls. Serum estradiol (E2) and IL-8 were higher in endometriosis, and functional predictions suggested enrichment of environmental information processing, endocrine system, and immune system-related categories in the endometriosis microbiota. The authors note that these findings require verification in future studies, and relevance to endometriosis is direct because the paper studies gut microbiota imbalance, hormones, and inflammatory factors specifically in stage 3/4 endometriosis patients.

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Abstract

Endometriosis (EM) in reproductive females has an incidence of 6-10% and greatly affects female fertility, quality of life, and long-term health. The gut microbiota can affect the physiological and pathological processes of humans through various pathways, such as those involving the nervous and endocrine systems and immunity, and it plays important roles in endocrine and inflammatory diseases. Whether the gut microbiota plays a role in EM has gradually attracted researchers' attention. In the present study, fecal and blood samples were collected from 12 patients with stage 3/4 EM and 12 healthy controls. We performed 16S rRNA high-throughput sequencing to compare the gut microbiota between the EM and control groups. Serum levels of hormones and inflammatory cytokines were measured. We found that compared with the control group, the EM group had a lower α diversity of gut microbiota and a higher Firmicutes/Bacteroidetes ratio. The abundances of various taxa (such as Actinobacteria, Tenericutes, Blautia, Bifidobacterium, Dorea, and Streptococcus) were significantly different between the two groups. The taxon with the highest abundance in the EM group was Prevotella_7, and that in the control group was Coprococcus_2. The serum levels of E2 and IL-8 were significantly higher in the EM group than in the control group (E2: EM group 74.7 ± 22.5 pg/L vs CON group 47.9 ± 12.5 pg/L; IL-8: EM group 6.39 ± 1.59 pg/mL vs CON group 4.14 ± 0.73 pg/mL). Additionally, the gut microbiota of the EM group was enriched for the microbial function categories environmental information processing, endocrine system, and immune system. Correlations were detected between each of Blautia and Dorea abundance and estradiol level and between Subdoligranulum abundance and IL-8 level. This study elucidated the associations between the gut microbiota and both serum hormones and inflammatory factors in EM. However, the findings need to be verified in future studies.
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Abstract

Endometriosis (EM) in reproductive females has an incidence of 6–10% and greatly affects female fertility, quality of life, and long-term health. The gut microbiota can affect the physiological and pathological processes of humans through various pathways, such as those involving the nervous and endocrine systems and immunity, and it plays important roles in endocrine and inflammatory diseases. Whether the gut microbiota plays a role in EM has gradually attracted researchers’ attention. In the present study, fecal and blood samples were collected from 12 patients with stage 3/4 EM and 12 healthy controls. We performed 16S rRNA high-throughput sequencing to compare the gut microbiota between the EM and control groups. Serum levels of hormones and inflammatory cytokines were measured. We found that compared with the control group, the EM group had a lower α diversity of gut microbiota and a higher Firmicutes/Bacteroidetes ratio. The abundances of various taxa (such as Actinobacteria, Tenericutes, Blautia, Bifidobacterium, Dorea, and Streptococcus) were significantly different between the two groups. The taxon with the highest abundance in the EM group was Prevotella_7, and that in the control group was Coprococcus_2. The serum levels of E2 and IL-8 were significantly higher in the EM group than in the control group (E2: EM group 74.7 ± 22.5 pg/L vs CON group 47.9 ± 12.5 pg/L; IL-8: EM group 6.39 ± 1.59 pg/mL vs CON group 4.14 ± 0.73 pg/mL). Additionally, the gut microbiota of the EM group was enriched for the microbial function categories environmental information processing, endocrine system, and immune system. Correlations were detected between each of Blautia and Dorea abundance and estradiol level and between Subdoligranulum abundance and IL-8 level. This study elucidated the associations between the gut microbiota and both serum hormones and inflammatory factors in EM. However, the findings need to be verified in future studies. Similar content being viewed by others

References

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JS and ZN wrote the paper. JS was responsible for the critical revision of the paper. JS and ZN contributed equally to this work. All authors read and approved the final manuscript. Corresponding authors Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Shan, J., Ni, Z., Cheng, W. et al. Gut microbiota imbalance and its correlations with hormone and inflammatory factors in patients with stage 3/4 endometriosis. Arch Gynecol Obstet 304, 1363–1373 (2021). https://doi.org/10.1007/s00404-021-06057-z Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-021-06057-z

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endometriosis

MeSH descriptors

Endometriosis Gastrointestinal Microbiome Female Hormones Humans Quality of Life RNA, Ribosomal, 16S RNA, Ribosomal, 16S

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