Fecal Microbiota Transplantation: A Potential Tool for Treatment of Human Female Reproductive Tract Diseases

Abstract

The gastro-intestinal tract is an extensive organ involved in several activities, with a crucial role in immunity. Billions of commensal and transient microorganisms, known as the gut microbiota, and potential pathogens, which are constantly stimulating intestinal immunity, colonize the intestinal epithelial surface. The gut microbiota may be regarded as analogous to a solid organ with multiple different functions. In the last decade, many studies have demonstrated that intestinal bacteria can be a decisive factor in the health-disease balance of the intestine, and they can also be responsible for illnesses in other locations. For this reason, fecal microbiota transplantation (FMT) represents an important therapeutic option for Clostridium difficile infections and hold promise for different clinical conditions, such as multiple sclerosis, autism, obesity, and other systemic diseases. FMT consists of the infusion of a fecal suspension from a healthy donor to a recipient in order to restore gut flora alterations. Similar to the gut, the female reproductive tract is an example of a very complex biological ecosystem. Recent studies indicate a possible relationship between the gut and female tract microbiota, associating specific intestinal bacteria patterns with genital female diseases, such as polycystic ovary syndrome (PCOS), endometriosis and bacterial vaginosis (BV). FMT could represent a potential innovative treatment option in this field.

Guizhi Fuling Wan, Chinese Herbal Medicine, Ameliorates Insulin Sensitivity in PCOS Model Rats With Insulin Resistance via Remodeling Intestinal Homeostasis

“…Polycystic ovary syndrome (PCOS) is a complex multiorgan disorder associated with metabolic disorder as well as inflammation, seriously affecting the physical, and mental health of affected women. The gut is the largest microecological environment in the human body and the gut microbiota is regarded as an endocrine organ including the maintenance of energy homeostasis and host immunity, the imbalance of gut microbiota has a decisive influence on human health including metabolism and immunity of the body (31). The increasing knowledge of the role of microbiota in PCOS has provided new perspectives and methods to understand and treat PCOS (32,33).…”

New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future?

“…In fact, the Food and Drug Administration (FDA, USA) has communicated a warning regarding the risk of severe bacterial infection after FMT [149]. The hypothesis for the uterine bacterial transmission route originating from the gut exists [30,150], thus FMT was proposed as a promising (future) tool for treatment female reproductive tract diseases [151]. It was shown on broad-spectrum antibiotics-treated endometriosis mice that the FMT from mice with endometriosis resumed the growth of endometriotic lesions suggesting that the gut microbiota could promote endometriosis progression [131].…”

Female Gut and Genital Tract Microbiota-Induced Crosstalk and Differential Effects of Short-Chain Fatty Acids on Immune Sequelae

“…The gut microbiota is a complex heterogeneous ecosystem consisting of obligate anaerobes which are 2-3 times more than facultative anaerobes and aerobes (2). The bacterial population weighs up to 1.5 kg with more than 1100 species (1,12).…”

“…The gut microbiota is involved in several immune, metabolic, and nutrients absorption functions that are integral to the host survival (1,14). Importantly, there is interaction between gut microbiota and host immune system that ensures tolerance of commensal bacteria and antigens ingested with food, while maintaining the ability to identify and attack potential pathogens and prevent invasion and infection (2,20). The gut microbiota also contribute to innate and adaptive immunity.…”

“…The gut and genital tract microbiota of females represent very complex biological ecosystems. The gut microbiota is composed of about 10 13 -10 14 bacterial cells (1,2). While the upper reproductive tract (uterine cavity) was largely considered sterile (3,4), the lower reproductive tract (cervicovaginal region) harbors trillions of bacteria (2).…”