Abstract
Current knowledge suggests that the uterus harbours its own microbiota, where the microbes could influence the uterine functions in health and disease; however, the core uterine microbial composition and the host-microbial relationships remain to be fully elucidated. Different studies are indicating, based on next-generation sequencing techniques, that microbial dysbiosis could be associated with several gynaecological disorders, such as endometriosis, chronic endometritis, dysfunctional menstrual bleeding, endometrial cancer, and infertility. Treatments using antibiotics and probiotics and/or prebiotics for endometrial microbial dysbiosis are being applied. Nevertheless there is no unified protocol for assessing the endometrial dysbiosis and no optimal treatment protocol for the established dysbiosis. With this review we outline the microbes (mostly bacteria) identified in the endometrial microbiome studies, the current treatments offered for bacterial dysbiosis in the clinical setting, and the future possibilities such as pro- and prebiotics and microbial transplants for modifying uterine microbial composition.
Highlights
For a long time it was assumed that the uterus is a sterile organ, with microbial colonisation present only in infection or in a pathological process [1]
We summarise the microorganisms identified in microbiome studies in human endometrium, the current treatments offered for bacterial dysbiosis in clinical setting, and the future possibilities for modifying uterine microbial composition
It was shown on broad-spectrum antibiotics-treated endometriosis mice that the Faecal microbiota transfer (FMT) from mice with endometriosis resumed the growth of endometriotic lesions suggesting that the gut microbiota could promote endometriosis progression [131]
Summary
For a long time it was assumed that the uterus is a sterile organ, with microbial colonisation present only in infection or in a pathological process [1]. The ‘sterile womb’ hypothesis has been challenged by recent studies using next-generation sequencing (NGS) where unique uterine microbial composition was detected. Different studies suggest that microbial composition is highly influenced by the vaginal microbes [8,11,34,35,36]. The NGS-based studies conducted so far focused on detecting microbial DNA sequences. While this approach provides knowledge of possible taxa present and describes the microbiome, the mere presence of a DNA sequence does not equate with the presence of a live bacteria. We summarise the microorganisms identified in microbiome studies in human endometrium, the current treatments offered for bacterial dysbiosis in clinical setting, and the future possibilities for modifying uterine microbial composition
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