Gut microbiota imbalance and its correlations with hormone and inflammatory factors in patients with stage 3/4 endometriosis

Shan, Jing; Ni, Zhexin; Cheng, Wen; Zhou, Ling; Zhai, Dongxia; Sun, Shuai; Yu, Chaoqin

doi:10.1007/s00404-021-06057-z

Cited by 56 publications

(75 citation statements)

References 18 publications

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“…Our results indicate a dysbiosis in the GI and UG microbiomes of P-EOSIS concomitant with alterations in the production of estrogen and its metabolites. Our findings are supported by the recently published study by Shan et al, where they elucidated the associations between gut microbial species and serum hormones and inflammatory cytokines [ 57 ]. However, the mechanism(s) of action between specific GI/UG species and estrogen metabolism in endometriosis still need further investigation.…”

Section: Discussionsupporting

confidence: 90%

Association of microbial dynamics with urinary estrogens and estrogen metabolites in patients with endometriosis

Cregger

Brown

et al. 2021

PLoS ONE

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Endometriosis is an estrogen dependent gynecological disease associated with altered microbial phenotypes. The association among endogenous estrogen, estrogen metabolites, and microbial dynamics on disease pathogenesis has not been fully investigated. Here, we identified estrogen metabolites as well as microbial phenotypes in non-diseased patients (n = 9) and those with pathologically confirmed endometriosis (P-EOSIS, n = 20), on day of surgery (DOS) and ~1–3 weeks post-surgical intervention (PSI). Then, we examined the effects of surgical intervention with or without hormonal therapy (OCPs) on estrogen and microbial profiles of both study groups. For estrogen metabolism analysis, liquid chromatography/tandem mass spectrometry was used to quantify urinary estrogens. The microbiome data assessment was performed with Next generation sequencing to V4 region of 16S rRNA. Surgical intervention and hormonal therapy altered gastrointestinal (GI), urogenital (UG) microbiomes, urinary estrogen and estrogen metabolite levels in P-EOSIS. At DOS, 17β-estradiol was enhanced in P-EOSIS treated with OCPs. At PSI, 16-keto-17β-estradiol was increased in P-EOSIS not receiving OCPs while 2-hydroxyestradiol and 2-hydroxyestrone were decreased in P-EOSIS receiving OCPs. GI bacterial α-diversity was greater for controls and P-EOSIS that did not receive OCPs. P-EOSIS not utilizing OCPs exhibited a decrease in UG bacterial α-diversity and differences in dominant taxa, while P-EOSIS utilizing OCPs had an increase in UG bacterial α-diversity. P-EOSIS had a strong positive correlation between the GI/UG bacteria species and the concentrations of urinary estrogen and its metabolites. These results indicate an association between microbial dysbiosis and altered urinary estrogens in P-EOSIS, which may impact disease progression.

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Section: Discussionsupporting

confidence: 90%

Association of microbial dynamics with urinary estrogens and estrogen metabolites in patients with endometriosis

Cregger

Brown

et al. 2021

PLoS ONE

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“…A larger study conducted on human stool samples suggested that both alpha (the microbial diversity of a single sample) and beta (a measure of similarity or dissimilarity between two communities) diversities, as well as the Firmicutes-to-Bacteroidetes ratio (Svensson et al 2021), were higher in the stool samples of controls (n = 198) than in patients with endometriosis (n = 66) (Svensson et al 2021). This study appears to contradict another study in which those with stage three or stage four endometriosis (n = 12) had lower alpha diversity of gut microbiota and a higher Firmicutes-to-Bacteroidetes ratio than healthy controls (Shan et al 2021). In the largest study to date, Svensson et al reported the abundance of 12 bacteria belonging to the classes Bacilli, Bacteroidia, Clostridia, Coriobacteriia, and gammaproteobacteria that differed significantly between stool samples from endometriosis patients (n = 66) and those from matched healthy controls (n = 198) (Svensson et al 2021).…”

Section: Gut Microbiota and Endometriosis In Humanscontrasting

confidence: 90%

Female reproductive dysfunctions and the gut microbiota

Chadchan

Singh

Kommagani

2022

Journal of Molecular Endocrinology

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The gut microbiome is considered an endocrine organ that can influence distant organs and associated biological pathways. Recent advances suggest that gut microbial homeostasis is essential for reproductive health and that perturbations in the gut microbiota can lead to reproductive pathologies. This review provides an updated overview of the relationship between the gut microbiome and female reproductive diseases. Specifically, we highlight the most recent findings on the gut microbiome in gynecological pathologies including polycystic ovarian syndrome (PCOS), endometriosis, and endometrial cancer. Most studies revealed associations between altered gut microbial compositions and these reproductive diseases, though few have suggested cause-effect relationships. Future studies should focus on determining the molecular mechanisms underlying associations between gut microbiota and reproductive diseases. Understanding this bidirectional relationship could lead to the development of novel and effective strategies to prevent, diagnose and treat female reproductive organ-related diseases.

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“…Lactobacillus has long been used as a probiotic supplement to maintain health as well as prevent and treat diseases, but its proportion in GM elevated in EMS models ( Ni et al, 1989b ; Cao et al, 2020 ), which may be due to suppression of the differentiation of Th17 cells by Lactobacillus ( Wilck et al, 2017 ) . Furthermore, we found that the proportion of bifidobacteriaceae was elevated in some reports ( Ni et al, 1989b ; Yuan et al, 2018 ; Shan et al, 2021 ), and a high proportion of bifidobacteriaceae promoted the differentiation of Th17 cells ( Ang et al, 2020 ). Furthermore, feces from mice with EMS were transplanted into antibiotic gavaged EMS mice which exhibited more severe EMS symptoms, such as an increased number of endometriotic foci ( Chadchan et al, 2021 ).…”

Section: Relationship Between Ems and Gm Imbalancementioning

confidence: 83%

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

Li¹,

Wang²,

Ding³

et al. 2022

Front. Pharmacol.

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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.

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Gut microbiota imbalance and its correlations with hormone and inflammatory factors in patients with stage 3/4 endometriosis

Cited by 56 publications

References 18 publications

Association of microbial dynamics with urinary estrogens and estrogen metabolites in patients with endometriosis

Association of microbial dynamics with urinary estrogens and estrogen metabolites in patients with endometriosis

Female reproductive dysfunctions and the gut microbiota

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

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