The role of whole metagenomic sequencing in the chronic endometritis diagnosis and treatment

Abstract

Whole metagenomic sequencing is a new field of genomics and bioinformatics based on the construction of a random nucleotide sequence from the total DNA of a sample followed by deep sequencing. One of the advantages of this method, compared to culture and 16S rRNA sequencing, is the possibility of obtaining a more complete characterization of the biodiversity of the studied sample with the identification of unculturable microorganisms from the kingdoms of bacteria, archaea, viruses, fungi, and protozoa. Despite the high cost and complexity of technical implementation, whole metagenomic sequencing is increasingly used in clinical studies to investigate changes in the uterine and vaginal microbiomes in inflammatory diseases of the female reproductive system organs. The use of whole metagenomic sequencing within the framework of complex diagnostics of chronic endometritis is promising. Compared to traditional diagnostic methods (histologic, hysteroscopic, immunohistochemical and microbiologic studies), this method allows not only to identify potential causative agents of the disease at the species level, but also to determine the genes of drug resistance in microorganisms, which is especially important against the background of widespread strengthening of antibiotic resistance. In addition, some authors point to the relationship of bacterial vaginosis pathogens with the development of chronic endometritis, which should also be taken into account when prescribing antibacterial drugs. In this regard, it is highly relevant to study the biodiversity of uterine and vaginal microbiomes using whole metagenomic sequencing. This will allow not only to avoid such serious complications as premature birth, habitual pregnancy failure, failure of embryo implantation after IVF cycles, infertility, but also to develop adequate tactics of etiotropic therapy of chronic endometritis.