Abstract：
To deeply analyze the alterations of cervical canal microbiota in intrauterine adhesion (IUA) patients and microbiota\'s relation to intrauterine adhesion (IUA) severity, we prospectively enrolled 23 consecutive patients diagnosed with mild-to-severe IUA and 8 women with infertility, 3 women with submucous myomas, or 8 women with endometrial polyps, but without IUA, as non_IUA subjects. For deep grouping analysis, these enrolled women were divided into six groups, two groups, and four groups respectively. Cervical mucus was drawn from the cervical canal of each participant. The bacterial composition was identified by 16S rDNA high-throughput sequencing. For analysis of six groups, mild IUA patients had similar cervical canal microbiota diversity and composition with submucous myomas patients. Compared with mild IUA participants, patients with moderate or severe IUA had a significantly lower diversity of bacteria and higher load of Firmicutes. For analysis of two groups, IUA patients had a significantly lower diversity of bacteria and higher load of Firmicutes than non_IUA subjects. KEGG pathway function analysis showed that metabolic pathways, biosynthesis of secondary metabolites, and microbial metabolism in diverse environments were mostly enriched for these cervical canal microbiota in all enrolled patients. The severity of IUA was associated with the altered abundance of phylum Firmicutes/Acinetobacteria or genus Lactobacillus/Gardnerella in the cervical canal. Higher bacterial load but less diversity in the cervical canal may be related with the severity of IUA. The function of these cervical canal microbiota were mostly involved in metabolic pathways.
摘要：
深入分析宫腔粘连(IUA)患者宫颈管微生物群的变化及其与宫腔粘连(IUA)严重程度的关系,我们前瞻性纳入23例诊断为轻度至重度IUA的连续患者和8例不孕症女性，3名患有粘膜下肌瘤的女性，或8名患有子宫内膜息肉的女性，但没有IUA,作为非IUA科目。对于深度分组分析，这些登记的妇女分为六组，两组,分别为四组。从每个参与者的宫颈管中抽出宫颈粘液。通过16SrDNA高通量测序鉴定细菌组成。为了分析六组，轻度IUA患者与粘膜下肌瘤患者的宫颈管微生物群多样性和组成相似。与轻度IUA参与者相比，中度或重度IUA患者的细菌多样性和Firmicutes负荷显著降低.为了分析两组，IUA患者的细菌多样性明显低于非IUA患者，而Firmicutes的负荷明显高于非IUA患者。KEGG通路功能分析显示,代谢通路,次级代谢产物的生物合成，在所有入选患者中，不同环境中的微生物代谢大多富集了这些宫颈管微生物群。IUA的严重程度与宫颈管中Firmicutes门/Acinetobacteria或乳酸杆菌/加德纳菌的丰度变化有关。宫颈管的细菌负荷较高，但多样性较低可能与IUA的严重程度有关。这些宫颈管微生物群的功能主要涉及代谢途径。
