To examine the associations between microbiome composition and immune and ECM-related protein composition in PTL patients to identify key factors, such as specific cytokines and MMPs, and predictive models associated with the risk of PTB.
Key Findings:
Dysbiosis and CST IV were more prevalent in the PTL-PTB group.
IL-1β was highest in CST III, while MMP-9 and other MMPs were elevated in CST IV.
CVF MMP-9 was consistently increased across PTL-PTB cases, dysbiosis, and CST IV.
A logistic regression model demonstrated excellent predictive performance (AUC = 0.910) for PTB.
IGFBP-1, MMP-8, and MMP-13 were significantly different by clinical outcome but not correlated with microbiome composition.
Interpretation:
Distinct microbial and immune profiles are associated with the progression from PTL to PTB, with MMP-9 potentially serving as a key effector linking dysbiosis to extracellular matrix remodeling and the risk of PTB.
Limitations:
The study was conducted at a single center, which may limit generalizability.
The sample size may not be sufficient to capture all variations in microbiome and immune responses.
Potential biases or confounding factors were not fully addressed.
Conclusion:
Integrative biomarker models may support early risk stratification in women with PTL, enhancing clinical decision-making.
