Microbiota of the cervical canal and uterine cavity in hyperplastic diseases of the endometrium: comparative microbiological analysis

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Abstract

Objective: A comprehensive assessment of the microbiota composition in the cervical canal and endometrium in women with various forms of endometrial hyperplastic processes (EHP) – polyp/endometrial hyperplasia in combination with uterine myoma or adenomyosis – compared to patients without endometrial pathology, followed by the analysis of its potential pathogenetic role in hyperplastic changes in the endometrium.

Materials and methods: The study included 100 women of reproductive age, divided into 4 groups depending on the presence and nature of endometrial hyperplastic processes. Microbiological examination included polymerase chain reaction test (PCR test) of samples obtained from the cervical canal, as well as culture-based analysis of aspirates from the uterine cavity. To characterize microbial communities, an assessment of microbial saturation and biological diversity was carried out using alpha diversity indices (Shannon-Wiener diversity, Simpson diversity, Margalef's richness) and subsequent data statistical processing.

Results: We found that microbial richness and taxonomic diversity were significantly higher in the cervical canal compared to the endometrium in all study groups. The maximum frequency of endometrial sterility was observed in the control group (52%). However, this indicator was lower and amounted to 24% (p=0.042) in a combination of hyperplastic changes with adenomyosis. The leading representatives of normobiota were Lactobacillus jensenii, L. crispatus and L. gasseri. Opportunistic microorganisms, including Gardnerella vaginalis, Escherichia coli and Enterococcus faecalis, were more often detected in the endometrium of patients with EHP, which may indicate the presence of disorder in microbial homeostasis and the potential pathogenetic significance of these microorganisms.

Conclusion: The microbiological analysis revealed a decline in species diversity and an increase in the proportion of opportunistic microorganisms in the endometrium of patients with EHP. Such changes may indicate microbial transformation of the intrauterine environment and the supposed participation of microbiota in the pathogenesis of this pathology. The obtained results confirm the relevance of further research aimed at a detailed study of the interaction mechanisms between microbiota and endometrial tissue structures, as well as an assessment of its impact on the prevention and treatment of EHP.

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About the authors

Rita M. Sarkisyan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: ritamisakovna@mail.ru
ORCID iD: 0000-0002-4097-5537

PhD student

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Tatyana Yu. Gavrilova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_gavrilova@oparina4.ru
ORCID iD: 0000-0001-7424-4292

Dr. Med. Sci., obstetrician-gynecologist at the Gynecological Department

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Tatyana V. Priputnevich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: priput1@gmail.com
ORCID iD: 0000-0002-4126-9730

Corresponding Member of the Russian Academy of Sciences, Dr. Med. Sci., Director of the Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Vera V. Muravieva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_muravieva@oparina4.ru
ORCID iD: 0000-0003-0383-0731

PhD, Senior Researcher at the Laboratory of Molecular Microbiology, Department of Molecular Microbiology and Bioinformatics, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Pavel A. Denisov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: denisov@neuro.nnov.ru
ORCID iD: 0000-0003-1813-6718

Researcher at the Laboratory of Bioinformatic Analysis, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Olga D. Goncharuk

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: o_goncharuk@oparina4.ru
ORCID iD: 0000-0001-5876-8424

Head of the Laboratory of Medical Microbiology, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Leila V. Adamyan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Russian University of Medicine, Ministry of Health of Russia

Email: adamyanleila@gmail.com
ORCID iD: 0000-0002-3253-4512

Academician of the Russian Academy of Sciences, Dr. Med. Sci., Professor, Deputy Director for Research, Chief Specialist in Gynecology of the Ministry of Health of Russia; Head of the Department of Reproductive Medicine and Surgery of the Faculty of Postgraduate Education

Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4; Moscow

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Supplementary files

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1. JATS XML
2. Figure 1. Heat map of the central nervous system microbiota in women in the study groups

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3. Figure 2. Species richness index (Margalef) of the central nervous system microbiota in women in the study groups

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4. Figure 3. Relative proportion (%) of lactobacilli in the composition of microorganisms isolated from the cervical cysts of women in the study groups

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5. Fig. 4. Heat map of the endometrial microbiota in women in the study groups

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6. Fig. 5. Species richness index (Margalef) of the endometrial microbiota in women in the study groups

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