Infertility Center, Kouseikai Mihara Hospital/Katsura Mihara Clinic, 6-8, Kamikatsura Miyanogo-cho, Nishikyo-ku, Kyoto 615-8227, Japan.
Department of Obstetrics and Gynecology, Otsu City Hospital, Otsu 520-0804, Japan.
Int J Mol Sci. 2023 Jan 20;24(3):2059. doi: 10.3390/ijms24032059.
Chronic endometritis (CE) is a local mucosal inflammatory disorder of the uterine lining, which is histopathologically recognized as the unusual infiltration of CD138(+) plasmacytes into the endometrial stromal compartment. Accumulating body of research documented that CE is associated with female infertility and several obstetric/neonatal complications. The major cause of CE is thought to be intrauterine infection represented by common bacteria (, , , and ), , and . Additionally, local dysbiosis in the female reproductive tract may be involved in the onset and development of CE. Antibiotic treatments against these microorganisms are effective in the elimination of endometrial stromal plasmacytes in the affected patients. Meanwhile, endometriosis is a common female reproductive tract disease characterized by endometriotic tissues (ectopic endometrium) growing outside the uterus and potentially causes chronic pelvic symptoms (dysmenorrhea, dyspareunia, dyschezia, and dysuria), infertility, and ovarian cancers. Endometriosis involves endocrinological, genetic, and epigenetic factors in its etiology and pathogenesis. Recent studies focus on immunological, inflammatory, and infectious aspects of endometriosis and demonstrate several common characteristics between endometriosis and CE. This review aimed to better understand the immunological and microbial backgrounds underlying endometriosis and CE and look into the therapeutic potential of the novel antibiotic treatment strategy against endometriosis in light of endometrial infectious disease.
慢性子宫内膜炎(CE)是一种子宫黏膜的局部炎症性疾病,其组织病理学特征为 CD138(+)浆细胞异常浸润子宫内膜基质。越来越多的研究表明,CE 与女性不孕和多种产科/新生儿并发症有关。CE 的主要病因被认为是以内膜基质中常见细菌(如、、、和 )、病毒和支原体感染为代表的宫内感染。此外,女性生殖道局部微生态失调也可能参与了 CE 的发生和发展。针对这些微生物的抗生素治疗对清除受影响患者的子宫内膜基质浆细胞有效。同时,子宫内膜异位症是一种常见的女性生殖道疾病,其特征是子宫内膜组织(异位内膜)在子宫外生长,并可能导致慢性盆腔症状(痛经、性交困难、排便困难和排尿困难)、不孕和卵巢癌。子宫内膜异位症的病因和发病机制涉及内分泌、遗传和表观遗传因素。最近的研究集中在子宫内膜异位症和 CE 的免疫学、炎症和感染方面,并显示出它们之间的几个共同特征。本综述旨在更好地了解子宫内膜异位症和 CE 的免疫学和微生物学背景,并探讨针对子宫内膜感染性疾病的新型抗生素治疗策略对子宫内膜异位症的治疗潜力。