A role for the endometrial microbiome in dysfunctional menstrual bleeding. — ASN Events
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A role for the endometrial microbiome in dysfunctional menstrual bleeding. (#156)

Elise S Pelzer 1 , Dana L Willner 2 , Melissa Buttini 3 , Flavia Huygens 4
  1. Wesley Research Institute, Toowong, QLD, Australia
  2. University of Queensland, Australian Centre for Ecogenomics, Brisbane
  3. The Wesley Hospital, Brisbane, QLD, Australia
  4. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia

BACKGROUND: Molecular microbiological characterization of the female lower genital tract microbiota has highlighted significant variations present within the microbial communities of healthy women, and challenges much of what has been accepted regarding the community composition of the vaginal normal regional flora based on culture techniques. There is a paucity of data characterizing the microbiota of the female upper genital tract; in fact the central dogma remains: in the absence of overt infection, the upper genital tract is a sterile site.
METHODS/RESULTS: This study collected paired endocervical and endometrial biopsy samples from 145 women undergoing operative hysteroscopy and/or laparoscopy. Samples were cohorted based on pathology, indications for surgery, and histological dating of the endometrium. Samples were interrogated for the presence of microbial DNA using a two-step next generation sequencing technology approach to exploit the V8 and V9 regions of the 16S rRNA gene.
Pyrosequencing revealed that the endocervix and endometrium share a minor microbial community, but that each site harbours a distinct microbial population (p = 0.024). This was similar for women with menorrhagia and dysmenorrhoea (p = 0.017). Lactobacillus spp. were the most abundant microbial taxa present in 50% of cohorts, and across all endocervical groups. Lactobacilli presence-absence was associated with increased expression of a number of cytokines (IL-1β, IL-6, IL-10, IL-12p (70) and IFNγ, p > 0.05) and VEGF. Members of the genera Prevotella, Fusobacterium and Jonquetella were the most abundant taxa identified in samples collected from nulliparous women.
CONCLUSIONS: The female upper genital tract is not sterile. Microbial community profiling has revealed differences in the endometrial microbial community profiles for: (1) the endocervix compared to the endometrium, and (2), women with menorrhagia versus dysmenorrhoea. The distinct microbial community profiles and the local cytokine responses in these women may offer insight into the pathology and management of these conditions.

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