Altered Microbiome-Derived Extracellular Vesicles in Peritoneal Fluid of Women with Endometriosis: Implications for Pathogenesis and Therapy Original paper
Researched by:
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Karen Pendergrass
ID
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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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 study examined the microbiota composition in the peritoneal fluid of women with ovarian endometrioma, focusing specifically on microbiome analyses of extracellular vesicles (EVs). Extracellular vesicles are nanometer-sized particles released by cells, including bacteria, that carry microbial DNA and signaling molecules. The research aimed to determine if women with ovarian endometrioma exhibit distinct microbiota profiles in their peritoneal fluid compared to women without endometriosis. Microbial DNA was sequenced using next-generation sequencing (NGS) of the 16S rDNA V3–V4 regions, allowing for detailed taxonomic identification and comparative analysis.
Who was studied?
The study included 45 women diagnosed with histological evidence of ovarian endometrioma and 45 surgical controls confirmed to be free of endometriosis. Participants were recruited from Asan Medical Center, and peritoneal fluid samples were collected during laparoscopic procedures. Women with endometriosis were classified as having advanced-stage disease, and none of the participants had taken antibiotics, probiotics, or hormonal treatments for 12 weeks prior to sample collection.
What were the most important findings?
The microbiota composition of extracellular vesicles in peritoneal fluid was markedly different between women with ovarian endometrioma and controls. Alpha diversity analysis showed no significant differences in species richness between groups, but beta diversity analysis revealed distinct microbial community shifts in the endometriosis group (p <0.001). Taxonomic profiling demonstrated increased abundances of Acinetobacter, Pseudomonas, Streptococcus, and Enhydrobacter in women with ovarian endometrioma. Conversely, Propionibacterium, Actinomyces, and Rothia were significantly decreased in the endometriosis group (p <0.05).
At the family level, Pseudomonadaceae and Moraxellaceae were notably enriched in the endometriosis samples, while Veillonellaceae, Propionibacteriaceae, and Actinomycetaceae were reduced. The data also indicated a significant increase in Pseudomonadales and a decline in Actinomycetales at the order level (p <0.05). These findings suggest that the altered microbiota composition in extracellular vesicles of the peritoneal fluid may contribute to the inflammatory microenvironment observed in ovarian endometrioma.
| Microbial Group | Ovarian Endometrioma | Clinical Implications |
|---|---|---|
| Acinetobacter | Increased | Linked to inflammation and immune response in the peritoneal cavity |
| Pseudomonas | Increased | Associated with pathogenic processes in ovarian endometrioma |
| Streptococcus | Increased | Potential contributor to local inflammation and immune modulation |
| Enhydrobacter | Increased | May play a role in extracellular signaling and immune responses |
| Propionibacterium | Decreased | Loss may disrupt protective anti-inflammatory effects |
| Actinomyces | Decreased | Reduced presence suggests compromised mucosal defenses |
| Rothia | Decreased | May contribute to a disrupted microbial ecosystem |
| Pseudomonadaceae (Family) | Enriched | Suggests pathogenic influence in peritoneal fluid |
| Moraxellaceae (Family) | Enriched | Associated with peritoneal inflammation |
| Veillonellaceae, Propionibacteriaceae, Actinomycetaceae (Families) | Reduced | Indicates loss of protective and commensal populations |
What are the greatest implications of this study?
The study provides compelling evidence that women with ovarian endometrioma possess distinct microbial communities in the peritoneal environment, carried via extracellular vesicles. The enrichment of pathogenic genera such as Pseudomonas and Acinetobacter, alongside the depletion of protective taxa like Propionibacterium and Actinomyces, suggests that these microbial imbalances could play a role in local inflammation and disease progression. These findings underscore the potential of microbiota-derived EVs as non-invasive biomarkers for ovarian endometrioma and open the door for targeted microbiome-modulating therapies to alleviate inflammatory responses and halt disease progression.
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.