Influence of the gut microbiota on endometriosis: Potential role of chenodeoxycholic acid and its derivatives

Abstract

The gut microbiota (GM) has received extensive attention in recent years, and its key role in the establishment and maintenance of health and in the development of diseases has been confirmed. A strong correlation between the GM and the progression of endometriosis (EMS) has been observed in emerging research. Alterations in the composition and function of the GM have been described in many studies on EMS. In contrast, the GM in the environment of EMS, especially the GM metabolites, such as bile acids and short-chain fatty acids that are related to the pathogenesis of EMS, can promote disease progression. Chenodeoxycholic acid (CDCA), as one of the primary bile acids produced in the liver, is metabolized by various enzymes derived from the GM and is critically important in maintaining intestinal homeostasis and regulating lipid and carbohydrate metabolism and innate immunity. Given that the complexity of CDCA as a signalling molecule and the interaction between the GM and EMS have not been clarified, the role of the CDCA and GM in EMS should be understood from a novel perspective. However, few articles on the relationship between CDCA and EMS have been reviewed. Therefore, we review the available and possible potential links between CDCA, the GM and EMS and put forward the hypothesis that CDCA and its derivative obeticholic acid can improve the symptoms of EMS through the GM.

Effects of the gut microbiota and its metabolite short-chain fatty acids on endometriosis

“…In recent years, with increasing research on the interaction between gut microbiota and EMS, it has been proposed that gut microbiota metabolites (such as short-chain fatty acids and bile acids) can affect EMS occurrence and development ( Chadchan et al., 2021 ; Li et al., 2022 ; Chadchan et al., 2023 ). SCFAs, key signaling molecules involved in the interaction between the gut microbiota and host, mediate the NF-κB signaling pathway and MAPK signaling mainly by activating G protein-coupled receptors (GPCRs) and inhibiting histone deacetylase (HDAC).…”

Association between gut microbiota and endometriosis: a two-sample Mendelian randomization study

“…Numerous studies have indicated that an imbalance in the human gut microbiota (GM) could be a significant contributing factor to EMS. GM can affect the growth and diffusion of endometriotic tissue in various ways, as part of the endometriosis micro-environment ( Salliss et al, 2021 ; Li et al, 2022 ). Leonardi et al showed that the structure and composition of GM in patients with EMS would change significantly compared with healthy people, EMS is related to the increase of Proteobacteria, Enterobacteriaceae , Streptococcus, and Escherichia coli ( Leonardi et al, 2020 ) .…”

Endometriosis: Pathogenesis, diagnosis, treatment and the role of gut microbiota

“…Therefore, it can't be overlooked when discussing the pathogenesis of endometriosis. Researchers have established a correlation between lipopolysaccharide and macrophage stimulation, thereby promoting the angiogenesis and proliferation seen in endometriosis [46,47,48]. Yu et al Examined the connection of the profile of the gut microbiota in patients with stage 3/4 endometriosis.…”