Gut microbiota alterations reveal potential gut-brain axis changes in polycystic ovary syndrome.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder companied with neuroendocrine and metabolic disorders. Gut microbiota has been implicated to play a key role in metabolic diseases and the production of neurotransmitters. Previous studies have reported the alterations in the gut microbiota of PCOS patients and animal models, however, most of the articles did not take the effect of age or diet on gut microbiota into account. The aim of this study was to identify the differential gut microbial species in PCOS patients compared with age and BMI-matched healthy control women. METHODS: We performed physical examinations and dietary survey in 20 women with PCOS (lean PCOS, PL, n = 10; overweight PCOS, PO, n = 10) and 20 healthy control women (lean control, CL, n = 10; overweight control, CO, n = 10), and collected the blood on the days 1-3 of the menstrual cycle for the measurement of endocrine and metabolic profiles, and inflammatory factors; and collected the feces in non-menstrual period to investigate the composition of gut microbiota by sequencing the V4 region of the 16S rDNA gene in fecal samples. The correlations between clinical parameters and the differential species were evaluated. RESULTS: Dietary analysis showed that the intake of dietary fiber, vitamin D were significantly decreased in PCOS. For the first time, our study found an increase of gamma-aminobutyric acid (GABA)-producing species in PCOS, including Parabacteroides distasonis, Bacteroides fragilis and Escherichia coli, which significantly positively correlated with serum LH levels and LH:FSH ratios. CONCLUSIONS: GABA-producing bacteria that were increased in PCOS, including Parabacteroides distasonis, Bacteroides fragilis and Escherichia coli, showed positive relationship with serum LH levels and LH:FSH ratios. In conclusion, gut microbial dysbiosis in women with PCOS is associated with neuroendocrine changes, revealing a potential gut-brain axis in PCOS.

Utility of arterial spin labelling MRI for discriminating atypical high-grade glioma from primary central nervous system lymphoma.

AIM: To evaluate the ability of arterial spin labelling (ASL) magnetic resonance imaging (MRI) in differentiating primary central nervous system lymphoma (PCNSL) from atypical high-grade glioma (HGG), as well as exploring the underlying pathological mechanisms. METHODS AND MATERIALS: Twenty-three patients with PCNSL and 17 patients with atypical HGG who underwent ASL-MRI were identified retrospectively. Absolute cerebral blood flow (aCBF) and normalised cerebral blood flow (nCBF) values were obtained, and were compared between PCNSL and atypical HGG using the Mann-Whitney U-test. The performance in discriminating between PCNSL and atypical HGG was evaluated using receiver-operating characteristics analysis and area-under-the-curve (AUC) values for aCBF and nCBF. The correlation between microvessel density (MVD) and aCBF was determined by Spearman's correlation analysis. RESULTS: Atypical HGG demonstrated significantly higher aCBF, nCBF, and MVD values than PCNSL (p<0.05). The diagnostic accuracy of discriminating PCNSL from atypical HGG showed AUC=0.877 (95% confidence interval [CI] 0.735-0.959) for aCBF, and AUC=0.836 (95% confidence interval [CI] 0.685-0.934) for nCBF. There was a moderate positive correlation between aCBF values of region of interest (ROI >30 mm2) in the enhanced area and MVD values (rho=0.579, p=0.0001), and a strong positive correlation between aCBF values MVD based on "point-to-point biopsy" (rho=0.83, p=0.0029). Interobserver agreements for aCBF and nCBF were excellent (ICC >0.75). CONCLUSIONS: ASL perfusion MRI is a useful imaging technique for the discrimination between atypical HGG and PCNSL, which may be determined by the difference of MVD between them.

Value of three-dimensional hysterosalpingo-contrast sonography with SonoVue in the assessment of tubal patency.

OBJECTIVE: To investigate the accuracy of transvaginal three-dimensional hysterosalpingo-contrast sonography using SonoVue (3D SonoVue-HyCoSy) in the assessment of Fallopian tubal patency. METHODS: We recruited 75 infertile patients undergoing 3D SonoVue-HyCoSy before standard diagnostic laparoscopy with chromotubation (lap and dye). Tubal patency was assessed by automated 3D coded contrast imaging (3D SonoVue-HyCoSy), and the findings were compared with the results of lap and dye. RESULTS: For detecting tubal patency among the 150 Fallopian tubes assessed, 3D SonoVue-HyCoSy had a sensitivity of 93.5%, specificity of 86.3%, positive and negative predictive values of 87.8% and 92.6%, respectively, and diagnostic accuracy of 90.0%. The test-positive rates of 3D SonoVue-HyCoSy vs lap and dye were not significantly different (82/150 vs 77/150, P > 0.05). CONCLUSION: 3D SonoVue-HyCoSy should be considered clinically valuable as a practical, non-invasive, primary investigatory tool for evaluating tubal patency.