Vaginal microbiome differences between patients with adenomyosis with different menstrual cycles and healthy controls

Abstract

Abstract Background Adenomyosis is a commonly observed benign gynecological disease that affects the quality of life and social psychology of women of childbearing age. However, because of the unknown etiology and incidence of adenomyosis, its pathophysiological mechanism remains unclear; further, because no noninvasive, accurate, and individualized diagnostic methods are available, treatment and efficacy evaluations are limited. Notably, the interaction between the changes in the microecological environment of the female reproductive tract and human immunity, endocrine, and other links leads to the occurrence and development of diseases. In addition, the vaginal microbiome differs in different menstrual cycles; therefore, assessing the differences between the microbiomes of patients with adenomyosis and healthy individuals in different menstrual cycles will improve the understanding of the disease and provide references for the search for noninvasive diagnosis and individualized precision treatment of adenomyosis. This study aimed to explored the data of individuals in different menstrual cycles. Results Differences in the vaginal microbiome between patients with adenomyosis and healthy individuals were observed. At the phylum level, the relative abundance of Firmicutes species in the adenomyosis group was higher when compared with the control group. At the genus level, the relative abundance of Lactobacillus in the adenomyosis and control groups was the highest, which contributed the most to the species difference between the two groups. Alpha-diversity analysis showed significant differences in the adenomyosis and control group during luteal phase (Shannon index p = 0.0087, Simpson index, p = 0.0056). Beta-diversity analysis showed lower microbial richness in the adenomyosis group than that in the control group by weighted unifrac distance (p = 0.0018). In the same disease group, differences between different menstrual cycles were also observed. Finally, 50 possible biomarkers including were screened and predicted based on the PICRUSt. Conclusions The vaginal microbiome differs between patients with adenomyosis and healthy individuals during difference menstrual periods especially during the luteal phase. These findings facilitate the search for specific biological markers within a limited range and provide a more accurate, objective, and individualized diagnostic and therapeutic evaluation method for patients with adenomyosis than is currently available.