How Do Microorganisms Influence the Development of Endometriosis? Participation of Genital, Intestinal and Oral Microbiota in Metabolic Regulation and Immunopathogenesis of Endometriosis

Abstract

Microorganisms inhabiting the human body play an extremely key role in its proper functioning, as well as in the development of the immune system, which, by maintaining the immune balance, allows you to enjoy health. Dysbiosis of the intestinal microbiota, or in the oral cavity or reproductive tract, understood as a change in the number and diversity of all microorganisms inhabiting them, may correlate with the development of many diseases, including endometriosis, as researchers have emphasized. Endometriosis is an inflammatory, estrogen-dependent gynecological condition defined by the growth of endometrial cells outside the uterine cavity. Deregulation of immune homeostasis resulting from microbiological disorders may generate chronic inflammation, thus creating an environment conducive to the increased adhesion and angiogenesis involved in the development of endometriosis. In addition, research in recent years has implicated bacterial contamination and immune activation, reduced gastrointestinal function by cytokines, altered estrogen metabolism and signaling, and abnormal progenitor and stem cell homeostasis, in the pathogenesis of endometriosis. The aim of this review was to present the influence of intestinal, oral and genital microbiota dysbiosis in the metabolic regulation and immunopathogenesis of endometriosis.

Microbiota in Irritable Bowel Syndrome and Endometriosis: Birds of a Feather Flock Together—A Review

“…The cutting-edge “genetic-epigenetic theory” proposed by Koninkx and colleagues [ 148 , 149 ] has led to the extensive investigation of factors related to the genetic-epigenetic cellular events underlying endometriosis onset and development, including immunologic, endocrine, paracrine, and microbiotal factors. In particular, dysbiosis has been extensively demonstrated in patients with endometriosis and animal models of the disease [ 28 , 30 , 147 , 150 , 151 , 152 ]. Eubiosis is characterized by high levels of Firmicutes and Bacteroidetes (>90%) and a low percentage of Proteobacteria , while dysbiosis is linked to an altered F/B ratio [ 153 ].…”

Gut Microbiota and Endometriosis: Exploring the Relationship and Therapeutic Implications

“…The chronic inflammation associated with endometriosis creates an environment that promotes increased adhesions and angiogenesis, critical disease features. Adhesions can cause organs and tissues to stick together, leading to pain, functional impairment, and the development of new blood vessels that can provide oxygen and nutrients to the endometrial lesions, allowing them to grow and spread [11,57]. A study by Huang et al [58], which compared the microbiome of peritoneal fluid, stool, and cervical mucus in endometriosis patients and healthy controls, observed an increased abundance of Gram-negative bacteria in the endometriosis group, including Pseudomonas and Prevotella, with the potential to release lipopolysaccharide (LPS).…”

Clinical indicators and reproductive tract microbiota abnormalities indicate the occurrence of endometriosis

“…Microorganisms and hosts establish synergistic interactions in almost every ecological niche of the human body, in uencing both physiological and pathological processes [5]. Female reproductive tract microbes, including vaginal and cervical microbes, have been shown to be site-speci c and play an important role in maintaining health and homeostasis [6] Imbalances in reproductive tract bacteria can lead to reproductive tract infections and elevate the risk of various diseases, including endometriosis [7], recurrent implantation failure [8] endometritis [9], and preterm birth [10].…”

“…Endometriosis is a complex disease with multifactorial causes involving genetic and immune pathways, as well as environmental in uences such as dietary habits, nutrition, and antibiotic treatments [5].…”

“…However, the pathogenesis of endometriosis has not been consistently explained. Although some studies have suggested that microbes play a small role in endometriosis [7], a growing number of recent studies have provided strong evidence in support of the important role of microbes, especially those in the reproductive tract, in endometriosis [5,7,11,12]. Research on vaginal or cervical microbiota could potentially aid in detecting common upper reproductive tract disorders [6].…”