A More Diverse Cervical Microbiome Associates with Better Clinical Outcomes in Patients with Endometriosis: A Pilot Study Original paper
Researched by:
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Karen Pendergrass
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Karen Pendergrass
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Endometriosis
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
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Infertility
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
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Karen Pendergrass
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
What Was Studied?
This pilot study investigated the cervical microbiome in patients with endometriosis and its association with clinical outcomes. The research focused on the microbial diversity, composition, and functional roles in cervical mucus, analyzed using 16S rRNA sequencing. The study included healthy women and patients diagnosed with endometriosis to compare microbial profiles and explore the connection between microbiome alterations, disease progression, and associated symptoms like pain, CA125 levels, and infertility.
Who Was Studied?
The study involved 33 women: 10 healthy controls and 23 patients diagnosed with endometriosis (classified by severity into stages I-II and III-IV). The cervical microbiome was analyzed to assess its correlation with clinical features, such as deep infiltrating endometriosis (DIE), CA125 biomarker levels, pain severity, and infertility.
What Were the Most Important Findings?
The study revealed that cervical microbiome diversity is significantly associated with clinical outcomes in endometriosis patients. Specifically, a higher microbial diversity was linked to better outcomes, while notable microbial imbalances characterized advanced disease stages and severe symptoms. Patients with advanced stages of endometriosis exhibited a microbial shift, with an increase in Firmicutes and a decrease in Actinobacteria and Bacteroidetes. Unique microbial profiles were observed, such as elevated Lactobacillus jensenii and Streptococcus agalactiae (GBS), alongside reduced Atopobium vaginae in patients with advanced stages.
Patients presenting severe symptoms, including elevated CA125 biomarker levels, infertility, and higher pain scores, showed significantly reduced microbial richness and diversity. Infertility, a common complication of endometriosis, was associated with an increased Firmicutes/Bacteroidetes ratio. Notably, infertility treatments appeared to reverse these imbalances, restoring microbial diversity and community structure to resemble that of fertile individuals. Additionally, deep infiltrating endometriosis (DIE), a severe form of the condition, was correlated with an overrepresentation of Streptococcus and Prevotella at the genus level.
The study’s functional analyses provided insight into the role of the cervical microbiome in disease progression. Pathways associated with microbial alterations, such as signal transduction, secondary bile acid biosynthesis, and nutrient metabolism, were identified. These pathways may contribute to inflammation, immune dysregulation, and potentially malignancy in severe cases. Such findings underscore the intricate relationship between cervical microbial composition and the pathophysiology of endometriosis. This research positions the cervical microbiome as a critical factor in both the diagnosis and management of endometriosis, offering potential for therapeutic interventions targeting microbial imbalances.
What Are the Greatest Implications of This Study?
The findings suggest that cervical microbiome diversity may serve as a biomarker for diagnosing and monitoring endometriosis progression and complications. The research highlights the therapeutic potential of targeting microbial imbalances to improve clinical outcomes, particularly in infertility. It also underscores the potential link between microbiome alterations and malignancy risks in severe cases, paving the way for preventive and precision medicine approaches in endometriosis management.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Streptococcus agalactiae (GBS)
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a Gram-positive, facultative anaerobe commonly found as a commensal organism in the gastrointestinal and urogenital tracts of humans. While asymptomatic colonization is frequent, GBS is also a major pathogen, particularly in neonates, pregnant women, and immunocompromised individuals.
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Streptococcus spp.
Streptococcus is a genus of gram-positive, facultatively anaerobic bacteria commonly found in pairs or chains. Important human pathogens include Streptococcus pneumoniae, Streptococcus pyogenes (group A strep), and Streptococcus agalactiae (group B strep).