A New Perspective on Endometriosis: How Gut and Reproductive Tract Microbiota Influence Disease Progression?

Area of Science:

• Reproductive Medicine
• Microbiome Research
• Immunology

Background:

• Endometriosis affects 10% of reproductive-aged individuals and is poorly understood.
• The gut and reproductive tract microbiota are increasingly recognized as key players in disease pathogenesis.
• Microbiota influence estrogen metabolism, immune function, and inflammation, offering new therapeutic avenues.

Purpose of the Study:

• Synthesize evidence on microbiota's role in endometriosis.
• Evaluate microbial biomarkers for diagnosis and microbiota-targeted interventions for treatment.
• Identify research priorities for clinical translation.

Main Methods:

• Systematic review of PubMed, Scopus, and Web of Science.
• Search terms included "endometriosis" combined with "microbiota," "reproductive tract," and "gut."
• Included preclinical and clinical studies on microbiota-endometriosis interactions.

Main Results:

• Dysbiosis, with reduced Lactobacillus and increased Fannyhessea, correlates with altered estrogen metabolism and inflammation (IL-6, TNF-α).
• Preclinical studies show probiotics and fecal microbiota transplantation (FMT) reduce endometriosis lesion growth and inflammation.
• Noninvasive microbial signatures show diagnostic potential, but human data and causal validation are limited.

Conclusions:

• Microbiota significantly modulate endometriosis through hormonal, immune, and inflammatory mechanisms.
• Microbial biomarkers and therapies offer potential for improved diagnosis and treatment.
• Further research is needed for clinical validation and development of personalized microbiota-based strategies.