Press review #1: Gut microbiota

Gut microbiota composition in women with polycystic ovary syndrome

The gut microbiota is increasingly viewed as an invisible organ-like system that not only plays an important role in a woman’s wellbeing but also affects the pathophysiology of some disorders such as polycystic ovarian syndrome (PCOS). Knowing about microbial metabolite pathways may elucidate effective treatments.

A recent meta-analysis that included 948 women with PCOS from 14 studies explored the relationships between gut microbiota among women from different regions and with different testosterone levels. Key findings revealed distinct gut microbiota compositions in PCOS patients compared with their healthy counterparts, and significantly different gut microbiota between PCOS patients with higher testosterone levels and those with lower testosterone levels. Also, gut bacterial genera differed among PCOS patients from different regions; European patients had high Alistipes levels, whereas Chinese patients had high Blautia and Roseburia levels.

These findings support current evidence showing that PCOS patients have fewer different types of bacteria and a less balanced microbial community compared with healthy women. The data also confirm the abundance in PCOS patients of specific bacterial genera such as Escherichia/Shigella and Alistipes, which are associated with insulin resistance and inflammation. This study implies that the gut microbiome is linked to various metabolic and hormonal disturbances associated with PCOS, which is compatible with previous research. Importantly, it demonstrates differences in bacterial taxa between Chinese and European women with PCOS, which may assist with personalised treatment strategies. Further research to determine PCOS-associated bacteria strains may enhance anti-PCOS microbial therapies and studies in different geographical regions would promote the global treatment of PCOS.

To conclude, characterising gut microbiota in PCOS patients from different countries may enable gut microbiota to act as a biomarker to distinguish different subtypes of PCOS, and thereby improve the clinical diagnosis and treatment of PCOS.