The Endobiota Study: Comparison of Vaginal, Cervical and Gut Microbiota Between Women with Stage 3/4 Endometriosis and Healthy Controls Original paper
Researched by:
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Kimberly Eyer
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Kimberly Eyer
Kimberly Eyer, a Registered Nurse with 30 years of nursing experience across diverse settings, including Home Health, ICU, Operating Room Nursing, and Research. Her roles have encompassed Operating Room Nurse, RN First Assistant, and Acting Director of a Same Day Surgery Center. Her specialty areas include Adult Cardiac Surgery, Congenital Cardiac Surgery, Vascular Surgery, and Neurosurgery.
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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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Kimberly Eyer
Researched by:
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Kimberly Eyer
ID
Kimberly Eyer
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, titled “The Endobiota Study: Comparison of Vaginal, Cervical, and Gut Microbiota Between Women with Stage 3/4 Endometriosis and Healthy Controls,” aimed to evaluate the differences in microbial composition across the vaginal, cervical, and gut microbiomes in women with advanced-stage (3/4) endometriosis compared to healthy controls. Researchers collected and analyzed samples from three anatomical sites—vaginal swabs, cervical swabs, and stool—using 16S rRNA sequencing to determine the diversity and abundance of bacterial genera. The primary objective was to identify specific microbial signatures and dysbiosis patterns associated with advanced endometriosis.
Who Was Studied?
The study included 28 Caucasian women, 14 diagnosed with histologically confirmed stage 3/4 endometriosis and 14 healthy controls. All participants were of reproductive age, with similar age and BMI distributions between groups. Vaginal, cervical, and stool samples were collected from each participant under sterile conditions to prevent contamination. The endometriosis patients were all confirmed to have deep infiltrating endometriosis with extensive lesions, while the control group consisted of asymptomatic women with no clinical or ultrasound evidence of endometriosis.
What Were the Most Important Findings?
The study uncovered notable dysbiosis in the microbiota composition of women with advanced endometriosis compared to healthy controls. In vaginal samples, Gemella and Atopobium were completely absent in the endometriosis group, suggesting a protective role in healthy women. Cervical samples showed a complete loss of Atopobium and Sneathia in endometriosis patients, while Alloprevotella was significantly elevated. This microbial shift in the cervical microbiota is particularly significant given Atopobium’s known associations with maintaining vaginal health. In stool samples, Sneathia, Barnesella, and Gardnerella were significantly decreased in endometriosis patients, while Escherichia/Shigella dominance was observed in two women who subsequently required segmental colon resection for severe bowel involvement. Sensitivity analyses excluding Lactobacillus revealed that Gardnerella represented a significantly higher proportion of the remaining microbiota in the vaginal and cervical niches of the endometriosis group compared to controls (72.9% vs. 36.8% in the vagina and 67.7% vs. 36.8% in the cervix, respectively). Furthermore, Escherichia/Shigella, Streptococcus, and Ureaplasma were markedly elevated, while Prevotella, Dialister, and Megasphaera were significantly reduced. These microbial changes suggest an altered immune response and heightened inflammatory state in women with advanced endometriosis, highlighting potential microbial markers of disease progression.
| Anatomical Site | Microbiota Findings in Advanced Endometriosis Patients |
|---|---|
| Vaginal Samples | Gemella and Atopobium completely absent. Gardnerella significantly elevated (72.9% of microbiota, excluding Lactobacillus). |
| Cervical Samples | Complete loss of Atopobium and Sneathia. Marked increase in Alloprevotella. Gardnerella elevated (67.7% of microbiota, excluding Lactobacillus). |
| Stool Samples | Significant decreases in Sneathia, Barnesella, and Gardnerella. Dominance of Escherichia/Shigella observed in two patients requiring bowel resection. |
| Additional Microbial Shifts | Marked elevation of Escherichia/Shigella, Streptococcus, and Ureaplasma. Reductions in Prevotella, Dialister, and Megasphaera. |
| Inflammatory Associations | Dysbiosis patterns suggest an altered immune response and heightened inflammatory state in advanced 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.