Gut Microbiota Disorder Contributes to the Production of IL-17A That Exerts Chemotaxis via Binding to IL-17RA in Endometriosis
Gut microbiota dysregulation in endometriosis elevates IL-17A, which binds IL-17RA on myeloid cells to promote lesion migration, and altered bile acid metabolism, particularly elevated CDCA, contributes to pathogenesis.
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This study examined how IL-17A is produced and functions in endometriosis lesions, using single-cell data analysis to profile IL-17A activity in EM tissue and measuring Th17 cell proportions by flow cytometry. The authors found high IL-17 receptor A (IL-17RA) expression in myeloid cell subpopulations within EM lesions and confirmed elevated IL-17A in peritoneal and follicular fluids from EM patients, while fecal microbiota transplantation and assessments of gut microbiota and bile acid metabolism (16S rRNA sequencing and targeted metabolomics) linked dysregulated bile acids to changes in EM. In EM mouse models, chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) were increased, and CDCA administration reduced lesion burden and altered Th17 cell proportions, whereas UDCA had no significant effect. A key caveat is that causality and generalizability beyond the models and measured outcomes may be limited by the experimental design. This paper is centrally about endometriosis — it investigates gut microbiota–bile acid–driven IL-17A/IL-17RA signaling and its role in inflammatory cell chemotaxis and lesion recruitment.
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