Gut and reproductive tract microbiota: Insights into the pathogenesis of endometriosis (Review)

Kobayashi, Hiroshi

doi:10.3892/br.2023.1626

Cited by 9 publications

(4 citation statements)

References 85 publications

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“…The only previous study focused on gut microbiota and adenomyosis was performed in mice and did not find differences regarding alpha and beta diversity between groups. Nonetheless, loss of microbiota diversity is of note the most constant finding of intestinal dysbiosis and has previously been linked to different chronic conditions 33 including endometriosis 34 …”

Section: Discussionmentioning

confidence: 99%

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Comparative analysis of endometrial, vaginal, and gut microbiota in patients with and without adenomyosis

Valdés‐Bango,

Gracia,

Rubio

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionAlterations in microbiota composition have been implicated in a variety of human diseases. Patients with adenomyosis present immune dysregulation leading to a persistent chronic inflammatory response. In this context, the hypothesis that alterations in the microbiota may be involved in the pathogenesis of adenomyosis, by affecting the epigenetic, immunologic, and biochemical functions of the host, has recently been postulated. The aim of the present study was to compare the microbiota composition in the vagina, endometrium, and gut of individuals with and without adenomyosis.Material and MethodsCross‐sectional study including 38 adenomyosis patients and 46 controls, performed between September 2021 and October 2022 in a university hospital‐based research center. The diagnosis of adenomyosis was based on sonographic criteria. Fecal, vaginal, and endometrial samples were collected. Study of the microbiota using 16S rRNA gene sequencing.ResultsPatients with adenomyosis exhibited a significant reduction in the gut microbial alpha diversity compared with healthy controls (Chao1 p = 0.012, Fisher p = 0.005, Observed species p = 0.005). Beta‐diversity analysis showed significant differences in the compositions of both gut and vaginal microbiota between adenomyosis patients and the control group (Adonis p‐value = 0.001; R2 = 0.03 and Adonis p‐value = 0.034; R2 = 0.04 respectively). Specific bacterial taxa were found to be either overrepresented (Rhodospirillales, Ruminococcus gauvreauii group, Ruminococcaceae, and Actinomyces) or underrepresented in the gut and endometrial microbiota of adenomyosis patients compared with controls. Distinct microbiota profiles were identified among patients with internal and external adenomyosis phenotypes.ConclusionsThe study revealed reduced gut microbiota diversity in adenomyosis patients, accompanied by distinct compositions in gut and vaginal microbiota compared with controls. Overrepresented or underrepresented bacterial taxa were noted in the gut and endometrial microbiota of adenomyosis patients, with variations in microbiota profiles among those with internal and external adenomyosis phenotypes. These findings suggest a potential association between microbiota and adenomyosis, indicating the need for further research to comprehensively understand the implications of these differences.

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Section: Discussionmentioning

confidence: 99%

“…Nonetheless, loss of microbiota diversity is of note the most constant finding of intestinal dysbiosis and has previously been linked to different chronic conditions 33 including endometriosis. 34 …”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of endometrial, vaginal, and gut microbiota in patients with and without adenomyosis

Valdés‐Bango,

Gracia,

Rubio

et al. 2024

Acta Obstet Gynecol Scand

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show abstract

“…The microbiota, particularly the gut microbiota, has been recognized as a potentially influential factor in various gynecological conditions, including endometriosis 131 . Studies have shown that there may be alterations in the gut microbiota composition in women with endometriosis 131,132 . These changes include differences in the abundance and diversity of certain bacterial species compared with women without the condition.…”

Section: The Microbiota and Postmenopausal Endometriosismentioning

confidence: 99%

Postmenopausal endometriosis: a challenging condition beyond menopause

Vallée,

Carbonnel,

Ceccaldi

et al. 2024

Menopause

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Importance and Objective Postmenopausal endometriosis is a complex condition that challenges the conventional belief that endometriosis resolves with menopause. Despite the cessation of menstruation, a subset of women continues to experience or develop endometriosis-related symptoms during the postmenopausal period. Thus, this review aimed to shed light on postmenopausal endometriosis, exploring its clinical features, diagnostic considerations, management approaches, and the potential impact on women's health. Methods PubMed/Medline, Scopus, and Web of Science databases were used for the research, with only articles in English language, using the following terms: “postmenopausal endometriosis,” “menopause,” “management,” “treatment,” and “quality of life,” from inception to 2023. Discussion and Conclusion The clinical features of postmenopausal endometriosis include persistent or recurrent pelvic pain, dyspareunia, bowel, or urinary symptoms and, occasionally, abnormal vaginal bleeding. The absence of menstrual cycles presents a diagnostic challenge, as the traditional diagnostic criteria for endometriosis rely on menstrual patterns. Visual cues may be less evident, and the symptoms often overlap with other gynecological conditions, necessitating a thorough evaluation to differentiate postmenopausal endometriosis from other potential causes. Management approaches for postmenopausal endometriosis encompass surgical intervention, hormonal therapies, pain management, and individualized care. Postmenopausal endometriosis significantly impacts the quality of life, sexual health, and long-term well-being of women. Understanding the clinical features, diagnostic challenges, and management approaches of postmenopausal endometriosis is crucial for healthcare professionals to provide effective care and to improve the quality of life of women affected by this condition.

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“…It is noteworthy that in animal models, transplantation of diseased gut microbiota can induce endometriosis. [ 14 ] Moreover, the transplanted gut microbiota can further promote the growth and expression of inflammation in endometrial lesions. [ 15 ] In contrast, models of endometriosis developed in mice and rhesus monkeys also manifest changes or dysbiosis in gut microbiota.…”

Section: Introductionmentioning

confidence: 99%

A large-scale causal analysis of gut microbiota and endometriosis associated infertility: A Mendelian randomization study

Wang,

Li,

2024

Medicine

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Endometriosis is a prevalent condition with notable impacts on fertility. Recent studies have implicated gut microbiota in the development of endometriosis associated infertility (EAI). This study employs Mendelian randomization (MR) to elucidate the causal relationship between specific gut microbes and EAI. Using MR, we selected single nucleotide polymorphisms associated with 211 gut microbiota taxa from large-scale genome-wide association studies summary data. We applied statistical methods including inverse variance weighting, weighted median, and MR-Egger for analysis. Outliers were identified through the leave-one-out method. MR-Egger intercept tests were conducted to address horizontal pleiotropy, while Cochran Q and P values assessed heterogeneity. The false discovery rate method was used for multiple testing correction. Sensitivity analysis and F statistics evaluated the reliability and potential biases of our results. The inverse variance weighting method indicated a significant association of the genus Actinomyces (OR = 1.657, 95% CI: 1.187–2.312, P = .00298) with an increased risk of EAI. Conversely, genera Holdemania (OR = 0.630, 95% CI: 0.444–0.894, P = .00969) and Ruminococcaceae NK4A214 group (OR = 0.689, 95% CI: 0.481–0.999, P = .0439) appeared as protective factors. MR-PRESSO global test and MR-Egger regression indicated no significant horizontal pleiotropy (P > .05). Leave-one-out analysis confirmed the robustness of these findings. Our study provides evidence of a causal relationship between specific gut microbiome taxa and EAI. These findings offer novel insights and may guide the development of new preventive and therapeutic strategies for managing EAI.

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Gut and reproductive tract microbiota: Insights into the pathogenesis of endometriosis (Review)

Cited by 9 publications

References 85 publications

Comparative analysis of endometrial, vaginal, and gut microbiota in patients with and without adenomyosis

Comparative analysis of endometrial, vaginal, and gut microbiota in patients with and without adenomyosis

Postmenopausal endometriosis: a challenging condition beyond menopause

A large-scale causal analysis of gut microbiota and endometriosis associated infertility: A Mendelian randomization study

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