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Postbiotic-Based Regenerative Therapy for Intrauterine Adhesions: Mechanisms, Microbiota Crosstalk, and Translational
Hui Li1,2,3, Ziqin Li4, Zhaoqi Liu2
1Department of Gynaecology and Obstetrics, School of Maternity and Children's Clinical Medicine, China Three Gorges University, Yichang, 443002, China.
Abstract:
Intrauterine adhesions (IUA) correlate with reproductive tract dysbiosis, including reduced Lactobacillus, overgrowth of Gardnerella, Prevotella, and Klebsiella, and fungal imbalance involving Candida albicans. These changes promote endometrial fibrosis through TGF-β/Smad activation, TLR4/NF-κB-driven inflammation, and ferroptosis. Postbiotics, probiotic-derived metabolites, suppress fibrotic signaling, modulate immunity, and restore microbial balance. This review synthesizes current evidence on microbiota-IUA interplay and promising postbiotic-based therapies, highlighting translational platforms such as hydrogel delivery systems and multi-omics integration.
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