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Differential oral, vaginal, and stool microbial signatures in patients with and without endometriosis
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  • Chloe HICKS,
  • Mathew Leonardi,
  • Xin-Yi CHUA,
  • Lisa MARI-BREEDT,
  • Mercedes Espada,
  • Emad El-Omar,
  • George CONDOUS,
  • Fatima El-Assaad
Chloe HICKS
University of New South Wales Saint George and Sutherland Clinical Campuses
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Mathew Leonardi
The University of Sydney Nepean Clinical School
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Xin-Yi CHUA
University of New South Wales Saint George and Sutherland Clinical Campuses
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Lisa MARI-BREEDT
University of New South Wales Saint George and Sutherland Clinical Campuses
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Mercedes Espada
The University of Sydney Nepean Clinical School
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Emad El-Omar
University of New South Wales Saint George and Sutherland Clinical Campuses
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George CONDOUS
The University of Sydney Nepean Clinical School
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Fatima El-Assaad
University of New South Wales Saint George and Sutherland Clinical Campuses

Corresponding Author:f.el-assaad@unsw.edu.au

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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.
Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
18 Feb 2024Review(s) Completed, Editorial Evaluation Pending
25 Feb 2024Editorial Decision: Revise Major
16 Jul 20241st Revision Received
06 Sep 2024Assigned to Editor
06 Sep 2024Submission Checks Completed
06 Sep 2024Review(s) Completed, Editorial Evaluation Pending
16 Sep 2024Editorial Decision: Accept