The gut microbiota: a double-edged sword in endometriosis

Talwar, Chandni; Singh, Vertika; Kommagani, Ramakrishna

doi:10.1093/biolre/ioac147

Cited by 16 publications

(16 citation statements)

References 190 publications

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“…Therefore, endometriosis-associated pain may be affected by regulation of microglia and astrocytes via the dysbiotic gut-brain axis ( 65 ). Severe pain and infertility associated with endometriosis have been reported to be associated with decreased cervical microbial diversity and abundance ( 66 ).…”

Section: Resultsmentioning

confidence: 99%

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

Kobayashi

2023

Biomed Rep

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Endometriosis is characterized by the presence of endometrial-like tissue outside the uterus and is associated with an inflammatory immune response. The gut and reproductive tract microbiota constitute a protective barrier against infection by pathogens and regulate inflammatory and immune functions. This review summarizes microbiota imbalance (i.e., dysbiosis) in endometriosis and discusses how dysbiosis influences disease development. The literature was searched for studies published from inception to March 2022 in the PubMed and Google Scholar databases using a combination of specific terms. An altered gut and reproductive tract microbiome has been reported in numerous conditions, such as inflammatory bowel disease, allergies, autoimmunity, cancer and reproductive disorders (e.g., endometriosis). Furthermore, microbial dysbiosis is a hallmark of endometriosis and is characterized by a decrease in beneficial probiotics and an increase in pathogenic microbes, which leads to a series of estrobolomic and metabolomic changes. Gut or reproductive tract microbiome dysbiosis was reported in mice, nonhuman primates, and females with endometriosis. Animal models of endometriosis demonstrated the effects of the gut microbiome on lesion growth and vice versa. The immune system mediated by the microbiota-gut-reproductive tract axis triggers an inflammatory response that damages reproductive tract tissue, which possibly leads to endometriosis. However, whether the alteration of eubiosis (a balanced microbiota) to dysbiosis is a cause or a result of endometriosis is unclear. In conclusion, this review provides an overview of the relationship between the gut and reproductive tract microbiome and endometriosis, focusing on the mechanisms by which dysbiosis may increase the risk of disease.

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Section: Resultsmentioning

confidence: 99%

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

Kobayashi

2023

Biomed Rep

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“…Animal studies have demonstrated that gut microbiome plays a crucial pro-inflammatory role in the progression of endometriosis and results in higher levels of IL-1β, TNF-α, IL-6, and TGF-β1 and an increase in macrophages at the lesion site [ 26 ]. Short-chain fatty acids, like acetate, propionate, and n-butyrate, are bioactive metabolites produced through the processing of indigestible nutrients by the gut microbiome [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Blood lipids mediate the effects of gut microbiome on endometriosis: a mendelian randomization study

Su,

Wan,

Ding

et al. 2024

Lipids Health Dis

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Background There is evidence for an association between the gut microbiome and endometriosis. However, their causal relationship and the mediating role of lipid metabolism remain unclear. Methods Using genome-wide association study (GWAS) data, we conducted a bidirectional Mendelian randomization (MR) analysis to investigate the causal relationships between gut microbiome and endometriosis. The inverse variance weighted (IVW) method was used as the primary model, with other MR models used for comparison. Sensitivity analysis based on different statistical assumptions was used to evaluate whether the results were robust. A two-step MR analysis was further conducted to explore the mediating effects of lipids, by integrating univariable MR and the multivariate MR method based on the Bayesian model averaging method (MR-BMA). Results We identified four possible intestinal bacteria genera associated with the risk of endometriosis through the IVW method, including Eubacterium ruminantium group (odds ratio [OR] = 0.881, 95% CI: 0.795–0.976, P = 0.015), Anaerotruncus (OR = 1.252, 95% CI: 1.028–1.525, P = 0.025), Olsenella (OR = 1.110, 95% CI: 1.007–1.223, P = 0.036), and Oscillospira (OR = 1.215, 95% CI: 1.014–1.456, P = 0.035). The further two-step MR analysis identified that the effect of Olsenella on endometriosis was mediated by triglycerides (proportion mediated: 3.3%; 95% CI = 1.5−5.1%). Conclusion This MR study found evidence for specific gut microbiomes associated with the risk of endometriosis, which might partially be mediated by triglycerides.

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“…While there is evidence of a dysregulated gut or reproductive tract microbiome in women with endometriosis, there is little consensus regarding the particular microbiota that may lead to endometriotic lesion growth 101 . Additionally, some bacteria promote endometriosis and others potentially protect against it highlighting the need for further investigations into this area 102 …”

Section: New Concepts On the Etiology Of Endometriosismentioning

confidence: 99%

“… 101 Additionally, some bacteria promote endometriosis and others potentially protect against it highlighting the need for further investigations into this area. 102 …”

Section: New Concepts On the Etiology Of Endometriosismentioning

confidence: 99%

New concepts on the etiology of endometriosis

Cousins

McKinnon

Mortlock

et al. 2023

J of Obstet and Gynaecol

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Endometriosis is a serious, chronic disorder where endometrial tissue grows outside the uterus, causing severe pelvic pain and infertility. It affects 11% of women. Endometriosis is a multifactorial disorder of unclear etiology, although retrograde menstruation plays a major role. It has a genetic component with over 40 genetic risk factors mapped, although their mechanism of action is still emerging. New evidence suggests a role for retrograde menstruation of endometrial stem/progenitor cells, now that identifying markers of these cells are available. Recent lineage tracing and tissue clearing microscopy and 3D reconstruction has provided new understanding of endometrial glandular structure, particularly the horizontal orientation and interconnection of basalis glands. New sequencing technologies, particularly whole genome DNA sequencing are revealing somatic mutations, including in cancer driver genes, in normal and eutopic endometrium of patients with endometriosis, as well as ectopic endometriotic lesions. Methylome sequencing is offering insight into the regulation of genes and the role of the environmental factors. Single cell RNA sequencing reveals the transcriptome of individual endometrial cells, shedding new light on the diversity and range of cellular subpopulations of the major cell types present in the endometrium and in endometriotic lesions. New endometrial epithelial organoid cultures replicating glandular epithelium are providing tractable models for studying endometriosis. Organoids derived from menstrual fluid offer a non‐invasive source of endometrial tissue and a new avenue for testing drugs and developing personalized medicine for treating endometriosis. These new approaches are rapidly advancing our understanding of endometriosis etiology.

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The gut microbiota: a double-edged sword in endometriosis

Cited by 16 publications

References 190 publications

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

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

Blood lipids mediate the effects of gut microbiome on endometriosis: a mendelian randomization study

New concepts on the etiology of endometriosis

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