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

Hiroshi Kobayashi
Biomedical reports · 2023 · vol. 19(1) , pp. 43 · doi:10.3892/br.2023.1626 · PMID:37324168 · PMC10265574 · W4378717110
review OA: gold CC0 ⤵ 11 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review examines how gut and reproductive tract microbial imbalances (dysbiosis) in endometriosis may contribute to disease pathogenesis and inflammation via the microbiota-gut-reproductive tract axis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This review investigates whether gut and reproductive tract microbiome dysbiosis contributes to endometriosis pathogenesis by summarizing studies up to March 2022 that compare microbiota composition and function in endometriosis versus controls, including evidence from mice and nonhuman primates. It reports that endometriosis is associated with decreased beneficial probiotics, increased pathogenic microbes, and downstream estrobolomic/metabolomic changes, with animal models showing bidirectional effects between gut microbiome alterations and lesion growth. The paper notes a major caveat that it remains unclear whether microbiome imbalance is a cause or a consequence of endometriosis. This paper is centrally about endometriosis — it reviews mechanisms linking gut/reproductive microbiome dysbiosis to immune and inflammatory pathways in endometriosis.

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Abstract

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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Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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