Features of intestinal microbiota taxonomic composition and their relation with hormonal and immune status assessed in women with external genital endometriosis
U. D. Belchenko,
E. E. Yakubova,
T. S. Popovich,
E. L. Agaeva,
E. Z. Kayalieva,
E.-S. Sh. Khudaiberdiev,
Y. R. Li,
S. R. Gasanov,
N. I. Perederenko,
E. Sh. Kadyrov,
K. V. Novikov,
E. A. Ostozhiev,
N. S. Prasolov,
L. E. Sorokina https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.534
Abstract
Aim: systemically assessed characteristics of intestinal microbiota taxonomic composition in relation to parameters of hormonal and immune status in patients with external genital endometriosis (EGE).
Materials and Methods. The controlled cross-sectional study included 33 patients with EGE comprising main group, and 30 healthy women enrolled to control group. All women underwent assessment of hormonal status and cytokine expression levels in peripheral blood. Level of blood hormones estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) was carried out using enzyme-linked immunosorbent and chemiluminescent assays. Expression levels of cytokines such as interleukin (IL) IL-6, IL-8, tumor necrosis factor alpha (TNF-α) were analyzed by an enzyme-linked immunosorbent assay. Taxonomic composition of intestinal microbiota at the level of phyla and genera was carried out by 16S ribosomal RNA gene sequencing. Microbial community a-diversity, the Chao1, ACE, and Sobs indices were used.
Results. The concentration of blood E2 in main group was significantly higher compared to control group. Also, women with EGE had higher plasma concentrations for IL-6, IL-8, IL-17 and TNF-a compared to those in control group (p < 0.001). While analyzing bacterial community a-diversity in main group, Chao1 index was found to be significantly decreased. At the phylum level, the Firmicutes/Bacteroidetes ratio was increased in patients with EGE compared with that in control group. Among the 20 largest genera in patients with EGE, significant abundance was observed for Lachnospira, Blautia, Dorea, Streptococcus, Eubacterium hallii_group paralleled with significant decline in Bifidobacterium and Eubacterium eligens_group. A positive correlation was obtained between estrogen levels and the number of representatives from the genera Eubacterium hallii_group and Streptococcus, IL-8 and Streptococcus, TNF-α and Streptococcus and Lachnospira, as well as a negative correlation between TNF-α and Bifidobacterium.
Conclusion. A relation between dysbiotic intestinal alterations and developing endometriosis was found. The identified correlations between altered taxonomic composition of the intestinal microflora and parameters of hormonal and immune status in patients with EGE suggest that intestinal microbiota is involved in pathophysiology of endometriosis.
About the Authors
U. D. Belchenko
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Ulyana D. Belchenko – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
E. E. Yakubova
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Edie E. Yakubova – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
T. S. Popovich
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Tatyana S. Popovich – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
E. L. Agaeva
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Elvira L. Agaeva – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
E. Z. Kayalieva
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Elmaz Z. Kayalieva – 6th year Student, 2nd Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
E.-S. Sh. Khudaiberdiev
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Elm-Sultan Sh. Khudaiberdiev – 5th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
Y. R. Li
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Yan R. Li – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
S. R. Gasanov
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Sarkhan R. Gasanov – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
N. I. Perederenko
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Nikita I. Perederenko – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
E. Sh. Kadyrov
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Ervin Sh. Kadyrov – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
K. V. Novikov
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Kirill V. Novikov – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
E. A. Ostozhiev
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Evgeniy A. Ostozhiev – 6th year Student, 1st Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
N. S. Prasolov
Vernadsky Crimean Federal University
Russian Federation
Russian Federation
Nikita S. Prasolov – 6th year Student, 2nd Medical Faculty, Order of the Red Banner of Labor of Georgievsky Medical Institute.
5/7 Lenin Avenue, Simferopol 295051
L. E. Sorokina
Academician Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Health Ministry of Russian Federation; Medical center in Kolomenskoye CJSC
Russian Federation
Russian Federation
Leya E. Sorokina – MD, Junior Researcher, Laboratory of Cytology; Allergist-Immunologist.
4 Academika Oparina Str., Moscow 117997; 19 bldg. 2, Vysokaya Str., Moscow 115533
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What is already known about this subject?
► External genital endometriosis (EGE) is an immune-inflammatory estrogen-dependent pathological process.
► It is evidenced about a relation between intestinal dysbiosis and impaired estrogen metabolism, an imbalance in innate and adaptive immune arms, as well as formation of chronic inflammation in specific pathologies.
► Previous studies provide convincing evidence about changes in intestinal biocenosis during developing NGE.
What are the new findings?
► It has been shown that patients with EGE, compared to healthy women, are characterized by lower bacterial α-diversity.
► The pattern of the taxonomic composition for intestinal microbiota in patients with EGE at the level of phylum and genera was clarified.
► Significant correlations between specific bacterial genera and systemic levels of estrogen and proinflammatory cytokines have been identified.
How might it impact on clinical practice in the foreseeable future?
► The role for intestinal dysbiosis as a crucial factor in EGE pathogenesis has been proven.
► Targeting the intestinal microbiota may help improve effectiveness of therapeutic approaches in EGE treatment.
Review
For citations:
Belchenko U.D., Yakubova E.E., Popovich T.S., Agaeva E.L., Kayalieva E.Z., Khudaiberdiev E.Sh., Li Y.R., Gasanov S.R., Perederenko N.I., Kadyrov E.Sh., Novikov K.V., Ostozhiev E.A., Prasolov N.S., Sorokina L.E. Features of intestinal microbiota taxonomic composition and their relation with hormonal and immune status assessed in women with external genital endometriosis. Obstetrics, Gynecology and Reproduction. 2024;18(4):464-474. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.534
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