Antibiotic Therapy and Vaginal Microbiota Transplantation Reduce Endometriosis Disease Progression in Female Mice via NF-κB Signaling Pathway

Feilei Lu, Wei Jing, Jing Wei, Yanying Zhong, Ying Feng, Bo Ma, Yifei Xiong, Kehong Wei, Buzhen Tan, Tingtao Chen
Frontiers in medicine · 2022 · vol. 9 , pp. 831115 · doi:10.3389/fmed.2022.831115 · PMID:35433736 · W4221003332
article OA: gold CC0 ⤵ 19 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Antibiotic therapy or vaginal microbiota transplantation inhibited endometriosis progression in mice by reducing inflammation and cell proliferation, potentially via the NF-κB pathway.

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

The study examined whether vaginal microbiota differs between women with endometriosis (n=16) and healthy controls (n=18) using 16S rRNA high-throughput sequencing, then tested causality in a mouse endometriosis model created by intraperitoneal injection of donor endometrial fragments. Endometriotic mice received either vaginal topical mixed antibiotics or vaginal microbiota transplantation (VMT), and the resulting ectopic lesion outcomes and inflammatory readouts (peritoneal cytokines IL-1β, IL-6, TNF-α, lesion Ki-67, and Iba-1 macrophage marker) were reduced; mechanistically, effects were linked to NF-κB signaling inhibition via intraperitoneal NF-κB pathway inhibitor and were also compared with leuprorelin acetate in parallel experiments. A key limitation explicitly stated is that vaginal microbiota differs greatly between humans and mice, leaving mechanism and clinical translation uncertain. This paper is centrally about endometriosis — it links vaginal microbiota alterations and NF-κB signaling to reduced endometriosis disease progression after antibiotics or VMT in mice.

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Abstract

Endometriosis (EMS) is a disease characterized by estrogen-dependent, chronic inflammatory, and annoying symptoms, which inflicts about 10% reproductive-age women. The diagnosis of endometriosis mainly depends on pathological examination after surgical resection while the pathogenesis of EMS is not clear enough. Surgical resection and drug therapy (including painkillers and hormone therapy, especially gonadotropin-releasing hormone analogs, GnRH-a) are widely used, but they are expensive and have many side effects. There are few studies on vaginal microorganisms in women with endometriosis. We collected vaginal secretions from women with EMS confirmed by pathology and demonstrated that they were different from that of healthy women by 16s rRNA high-throughput sequencing. Additionally, we established the EMS model in female mice by intraperitoneally injecting fragments from donor mice (3-week growth). Then, the mice were treated with mixed antibiotics (vagina) and NF-κB signaling pathway inhibitors (intraperitoneal injection), respectively. The result suggested that the ectopic lesions were inhibited. In addition, inflammatory cytokines IL-1β, IL-6, and TNF-α in peritoneal fluid, cell proliferation marker ki-67, and macrophage marker Iba-1 in ectopic lesions decreased significantly from that of mock mice. We also observed similar results as above by vaginal microbiota transplantation (VMT) and subcutaneous injection of leuprorelin acetate (LA, one of GnRH-a) for mice with EMS. These results showed that vaginal use of antibiotics or VMT is helpful to treat endometriosis in mice. However, due to the great difference between human and mouse vaginal microbiota, its mechanism and clinical transformation application still need to be further studied in the future.

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endometriosis

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