The vaginal microbiome differs by race and contributes to inflammation by directly producing or consuming metabolites or by indirectly inducing host immune response, but its potential contributions to ovarian cancer (OC) disparities remain unclear. In this exploratory cross-sectional study, we examine whether vaginal fluid metabolites differ by race among patients with OC, if they are associated with systemic inflammation, and if such associations differ by race. Study participants were recruited from the Ovarian Cancer Epidemiology, Healthcare Access, and Disparities Study between March 2021 and September 2022. Our study included 36 study participants with ovarian cancer who provided biospecimens; 20 randomly selected White patients and all 16 eligible Black patients, aged 50–70 years. Acylcarnitines (n = 45 species), sphingomyelins (n = 34), and ceramides (n = 21) were assayed on cervicovaginal fluid, while four cytokines (IL-1β, IL-10, TNF-α, and IL-6) were assayed on saliva. Seven metabolites showed >2-fold differences, two showed significant differences using the Wilcoxon rank-sum test (p< 0.05; False Discovery Rate > 0.05), and 30 metabolites had coefficients > ±0.1 in a Penalized Discriminant Analysis that achieved two distinct clusters by race. Arachidonoylcarnitine, the carnitine adduct of arachidonic acid, appeared to be consistently different by race. Thirty-eight vaginal fluid metabolites were significantly correlated with systemic inflammation biomarkers, irrespective of race. These findings suggest that vaginal fluid metabolites may differ by race, are linked with systemic inflammation, and hint at a potential role for mitochondrial dysfunction and sphingolipid metabolism in OC disparities. Larger studies are needed to verify these findings and further establish specific biological mechanisms that may link the vaginal microbiome with OC racial disparities.
阴道微生物组因种族而异，其通过直接产生或消耗代谢物或间接诱导宿主免疫反应促进炎症发生，但其对卵巢癌（OC）种族差异的潜在影响尚不明确。本探索性横断面研究旨在探讨卵巢癌患者阴道液代谢物是否存在种族差异、是否与全身性炎症相关，以及此类关联是否因种族而异。研究参与者于2021年3月至2022年9月期间从卵巢癌流行病学、医疗可及性与差异研究中招募。本研究纳入36名提供生物样本的卵巢癌患者：随机选取的20名白人患者及所有16名符合条件的黑人患者，年龄范围为50-70岁。对宫颈阴道液检测了酰基肉碱（45种）、鞘磷脂（34种）和神经酰胺（21种），同时检测了唾液中的四种细胞因子（IL-1β、IL-10、TNF-α和IL-6）。七种代谢物显示超过2倍的差异，两种代谢物经Wilcoxon秩和检验显示显著差异（p<0.05；错误发现率>0.05），在惩罚判别分析中30种代谢物的系数大于±0.1，并形成两个明显的种族聚类。花生四烯酰肉碱（花生四烯酸的肉碱加合物）在不同种族间呈现持续差异。38种阴道液代谢物与全身性炎症生物标志物显著相关，且不受种族影响。这些发现表明阴道液代谢物可能存在种族差异，与全身性炎症相关，并提示线粒体功能障碍和鞘脂代谢可能在卵巢癌种族差异中发挥潜在作用。需要更大规模的研究验证这些发现，并进一步明确阴道微生物组与卵巢癌种族差异关联的具体生物学机制。
肿瘤(癌症)患者之家