Features of the reproductive tract microbiota in patients with genital endometriosis. A literature review

BACKGROUND: Due to the widespread prevalence, steady growth and insufficient effectiveness of existing treatment regimens for external genital endometriosis, further study of the etiology and pathogenesis of the disease remains relevant. Inflammation is known to be one of the links in the pathogenesis of endometriosis; therefore, there is reason to believe that microorganisms are involved in the pathogenesis of this disease. AIM: The aim of this study was to analyze the role of the reproductive tract microbiota in patients with endometriosis.

This literature review was performed using systematic reviews, meta-analyses and experimental studies from such electronic databases as PubMed, CyberLeninka, and ScienceDirect published in the period from 1992 to 2021.

AND CONCLUSIONS: In the review, we present the pathogenetic relationship between pelvic inflammatory diseases and endometriosis. The quantitatively and qualitatively altered microbiota composition of the reproductive tract, the genetic-epigenetic theory on the pathogenesis of endometriosis, which is based on mutations that accumulate directly under the influence of infectious agents, as well as the mechanisms of an abnormal immune response modeled by microorganisms, reflect the interconnection between the microbiota and the pathogenesis of endometriosis. Based on a number of studies, the relationship between the intestinal microbiota and the abdominal microbiome has been confirmed. Since endometriosis is the estrogen-dependent disease, of importance is the ability of the intestinal microbiota to produce β-glucuronidase, which is enhanced by gut microbial dysbiosis, thus possibly contributing to the progression of endometriosis. One of the important practical directions is the drug correction of dysbiotic conditions. The effectiveness of antibiotic therapy has been demonstrated by experimentally induced endometriosis model. Currently, there are very few highly specific methods for non-invasive diagnosis of the disease, therefore, the study of the reproductive tract and intestinal microflora of women with endometriosis is promising for the introduction of new laboratory diagnostic methods. Full Text About the authors Olga E. Kazymova The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Author for correspondence. Email: [email protected] ORCID iD: 0000-0003-3869-010X SPIN-code: 5986-3469 MD Russian Federation, 3, Mendeleevskaya Line, Saint Petersburg, 199034Maria I. Yarmolinskaya The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. Mechnikov Email: [email protected] ORCID iD: 0000-0002-6551-4147 SPIN-code: 3686-3605 Scopus Author ID: 7801562649 ResearcherId: P-2183-2014 MD, Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences Russian Federation, 3, Mendeleevskaya Line, Saint Petersburg, 199034; Saint PetersburgAlevtina M. Savicheva The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University Email: [email protected] ORCID iD: 0000-0003-3870-5930 SPIN-code: 8007-2630 Scopus Author ID: 6602838765 ResearcherId: P-6788-2015 MD, Dr. Sci. (Med.), Professor, Honored Scientist of the Russian Federation Russian Federation, 3, Mendeleevskaya Line, Saint Petersburg, 199034; Saint PetersburgReferences - Jarmolinskaja MI, Ajlamazjan JeK. Genital’nyj jendometrioz. Razlichnye grani problemy. Saint Petersburg: Jeko-Vektor; 2017. - Khan KN, Fujishita A, Hiraki K, et al. 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