Division of General Medicine, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
Department of Pharmacy, University of Pisa, 56126 Pisa, Italy.
Biomolecules. 2024 Oct 18;14(10):1325. doi: 10.3390/biom14101325.
BACKGROUND/OBJECTIVES: Microbiota modification at the endometrial level can favor gynecological diseases and impair women's fertility. The overgrowth of pathogen microorganisms is related to the contemporary alteration of estrogen-metabolizing bacteria, including β-glucuronidase, thereby enhancing estrogen-related inflammatory states and decreasing anti-inflammatory cells. The possible connection between estrobolome impairment and gynecological diseases has been suggested in animal models. Nevertheless, in humans, coherent evidence on the estrobolome alteration and functionality of the female reproductive tract is still lacking. The objective of this study was to explore alterations in estrogen-related signaling and the putative link with endometrial dysbiosis. METHODS: Women with infertility and repeated implantation failure (RIF, N = 40) were enrolled in order to explore the putative link between estrogen metabolism and endometrial dysbiosis. Endometrial biopsies were used to measure inflammatory and growth factor molecules. β-glucuronidase enzyme activity and estrogen receptor (ER) expression were also assessed. RESULTS: Herein, increased levels of inflammatory molecules (i.e., IL-1β and HIF-1α) and decreased levels of the growth factor IGF-1 were found in the endometrial biopsies of patients presenting dysbiosis compared to eubiotic ones. β-glucuronidase activity and the expression of ERβ were significantly enhanced in patients in the dysbiosis group. Interestingly, Lactobacilli abundance was inversely related to β-glucuronidase activity and to ERβ expression, thus suggesting that an alteration of the estrogen-activating enzyme may affect the expression of ERs as well. CONCLUSIONS: Overall, these preliminary data suggested a link between endometrial dysbiosis and estrobolome impairment as possible synergistic contributing factors to women infertility and RIF.
背景/目的:子宫内膜水平的微生物组改变可能有利于妇科疾病并损害女性的生育能力。病原体微生物的过度生长与雌激素代谢细菌(包括β-葡糖苷酸酶)的当代改变有关,从而增强了与雌激素相关的炎症状态并减少了抗炎细胞。在动物模型中已经提出了estrobolome 损伤与妇科疾病之间的可能联系。然而,在人类中,关于雌性生殖道的estrobolome 改变和功能的一致性证据仍然缺乏。本研究的目的是探索与雌激素相关的信号转导的改变,并探讨其与子宫内膜失调的可能联系。
方法:招募了患有不孕和反复着床失败(RIF,N=40)的妇女,以探讨雌激素代谢与子宫内膜失调之间的可能联系。使用子宫内膜活检来测量炎症和生长因子分子。还评估了β-葡糖苷酸酶酶活性和雌激素受体(ER)表达。
结果:在此,与生态失调的患者相比,发现患有生态失调的患者的子宫内膜活检中存在炎症分子(即 IL-1β和 HIF-1α)水平升高和生长因子 IGF-1 水平降低。在失调组的患者中,β-葡糖苷酸酶活性和 ERβ 的表达显着增强。有趣的是,乳杆菌丰度与β-葡糖苷酸酶活性和 ERβ 表达呈负相关,这表明雌激素激活酶的改变可能会影响 ERs 的表达。
结论:总的来说,这些初步数据表明子宫内膜失调与 estrobolome 损伤之间存在联系,这可能是导致女性不孕和 RIF 的协同致病因素。
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