| Background and purposeStudies have shown that patients with endometriosis(EMs)have dysbiosis in their gut microbiota.This study aims to explore and compare the composition of gut microbiota in patients with early and advanced endometriosis,evaluate the correlation between clinical characteristics of endometriosis patients and characteristic gut microbiota,and analyze the effects of characteristic microbiota on endometriosis.The results will lay a foundation for further exploring the role of microbiota in the pathogenesis of endometriosis.Research methodIn this study,a total of 100 patients diagnosed with endometriosis by laparoscopy were included as research subjects based on inclusion and exclusion criteria.According to the r-AFS score,patients were staged into early-stage endometriosis(stage Ⅰ-Ⅱ)and advanced-stage endometriosis(stage Ⅲ-Ⅳ)groups.The gut microbiota of the patients was sequenced using 16S rRNA sequencing based on the Illumina NovaSeq platform.Differences in gut microbiota composition and diversity between the two groups were compared using R software.Important gut microbiota and different species between the two groups were analyzed,and metabolic function prediction was performed using PICRUSt2.In addition,clinical physiological and biochemical indicators such as blood routine,gynecological tumor markers,liver and kidney electrolytes,and coagulation factors were collected through the electronic medical record system,and clinical features that differed between the two groups were identified by statistical analysis using SPSS,taking into account the abundance of gut microbiota in the patients.Correlation analysis was performed between characteristic clinical indicators and gut microbiota abundance using R software.Research results(1)16S rRNA analysis revealed similar gut microbial composition and no significant differences in α and β diversity between early and late stage endometriosis patients.Using a random forest classification algorithm,28 important bacterial taxa were identified in the gut microbiome of endometriosis patients,with the Herminiimonas showing the highest importance score and a significantly higher relative abundance in the early stage group than in the late stage group.(2)PICRUSt2 metabolic function prediction revealed enhanced metabolism of myo-inositol degradation,isoprenoid biosynthesis pathway Ⅱ,polyamine biosynthesis superpathway Ⅲ,and tryptophan biosynthesis in the late stage endometriosis group.(3)Clinical data comparison between early and late stage endometriosis patients showed no significant differences in age,dysmenorrhea,infertility,body mass index,liver and kidney function indicators,dietary and exercise habits,etc.The late stage group had a higher likelihood of a family history of endometriosis than the early stage group.Spearman correlation analysis revealed that CA125,CA199,Rome index,peripheral blood mononuclear cells,and D-dimer were correlated with the severity of endometriosis(P<0.05),and ROC curve analysis demonstrated that CA125 alone was a more effective predictor of endometriosis severity than combined indicators(AUC=0.847).(4)The heatmap of the relative abundance of gut microbiota and characteristic clinical features of endometriosis revealed no significant correlation between Lactobacillus abundance and endometriosis,a strong negative correlation between Bifidobacterium and endometriosis severity,and a strong positive correlation between Gluconacetobacter and endometriosis severity,which was important in the late stage group.ConclusionEarly and late stage endometriosis patients have similar gut microbiota composition.The abundance of Herminiimonas is significantly higher in the early-stage group and plays an important role in differentiating the two groups of patients.There is a strong negative correlation between Bifidobacterium and the severity of endometriosis.The severity of endometriosis is positively correlated with the abundance of Gluconacetobacter,which plays an important role in the late-stage endometriosis group. |
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