Endometriosis and the microbiome: a systematic review

Area of Science:

• Microbiome research
• Gynecological health
• Pathogenesis of endometriosis

Background:

• The causes and development of endometriosis are not fully understood.
• Emerging evidence suggests a complex, two-way interaction between endometriosis and the microbiome.
• Investigating this interaction is crucial for understanding endometriosis.

Purpose of the Study:

• To systematically review existing literature on the endometriosis-microbiome interaction.
• To provide guidance for future research in this developing field.
• To synthesize current knowledge on microbial changes associated with endometriosis.

Main Methods:

• Comprehensive literature search of major databases (MEDLINE, Embase, Scopus, Web of Science) up to May 2019.
• Inclusion of published and unpublished studies comparing microbiome states in hosts with and without endometriosis.
• Independent screening, data extraction, and qualitative synthesis of evidence by two authors.

Main Results:

• Endometriosis is associated with a higher prevalence of Proteobacteria, Enterobacteriaceae, Streptococcus spp., and Escherichia coli in various microbiome sites.
• An association with the phylum Firmicutes and the genus Gardnerella was also noted, though less definitively.
• Microbiome composition differs between individuals with and without endometriosis.

Conclusions:

• This systematic review begins to characterize the intricate bidirectional relationship between the microbiome and endometriosis.
• Laboratory and clinical studies confirm distinct microbiome profiles in endometriosis patients.
• Further research is warranted to elucidate the precise mechanisms driving these associations.