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对人工机械子宫设计的最新概念与母体微生物组关系的批判性回顾:对过去研究的更新。

A critical review of the recent concept of artificial mechanical uterus design in relation to the maternal microbiome: An Update to past researches.

机构信息

Department of Food Biotechnology, Branch for Northwest & West Region, Agricultural Biotechnology Research Institute of Iran, Agricultural Research, Education and Extension Organization (AREEO), Tabriz, Iran.

Regenerative Medicine Research Center (RMRC), Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

J Reprod Immunol. 2023 Mar;156:103828. doi: 10.1016/j.jri.2023.103828. Epub 2023 Feb 3.

Abstract

The microbiome in the female reproductive tract plays an essential role in immune modulation and reproductive health. However, various microbes become established during pregnancy, the balance of which plays a crucial role in embryonic development and healthy births. The contribution of disturbances in the microbiome profile to embryo health is poorly understood. A better understanding of the relationship between reproductive outcomes and the vaginal microbiota is needed to optimize the chances of healthy births. In this regards, microbiome dysbiosis refers to conditions in which the pathways of communication and balance within the normal microbiome are imbalanced due to the intrusion of pathogenic microorganisms into the reproductive system. This review summarizes the current state of knowledge on the natural human microbiome, with a focus on the natural uterine microbiome, mother-to-child transmission, dysbiosis, and the pattern of microbial change in pregnancy and parturition, and reviews the effects of artificial uterus probiotics during pregnancy. These effects can be studied in the sterile environment of an artificial uterus, and microbes with potential probiotic activity can be studied as a possible therapeutic approach. The artificial uterus is a technological device or biobag used as an incubator, allowing extracorporeal pregnancy. Establishing beneficial microbial communities within the artificial womb using probiotic species could modulate the immune system of both the fetus and the mother. The artificial womb could be used to select the best strains of probiotic species to fight infection with specific pathogens. Questions about the interactions and stability of the most appropriate probiotics, as well as dosage and duration of treatment, need to be answered before probiotics can be a clinical treatment in human pregnancy.

摘要

女性生殖道中的微生物组在免疫调节和生殖健康中发挥着重要作用。然而,在怀孕期间,各种微生物会定植,其平衡对胚胎发育和健康分娩起着至关重要的作用。微生物组谱的紊乱对胚胎健康的影响知之甚少。需要更好地了解生殖结局与阴道微生物群之间的关系,以优化健康分娩的机会。在这方面,微生物组失调是指由于致病性微生物侵入生殖系统,正常微生物组内的通讯和平衡途径失衡的情况。本文综述了目前关于天然人类微生物组的知识状况,重点介绍了天然子宫微生物组、母婴传播、失调以及妊娠和分娩期间微生物变化模式,并综述了妊娠期间人工子宫益生菌的作用。这些作用可以在人工子宫的无菌环境中进行研究,具有潜在益生菌活性的微生物可以作为一种可能的治疗方法进行研究。人工子宫是一种用作孵化器的技术设备或生物袋,允许体外妊娠。在人工子宫内建立有益的微生物群落,可以调节胎儿和母亲的免疫系统。人工子宫可以用来选择对抗特定病原体感染的最佳益生菌菌株。在益生菌成为人类妊娠的临床治疗方法之前,需要回答关于最适宜益生菌的相互作用和稳定性、剂量和治疗持续时间的问题。

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