Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
STOPs
A TOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Research feed Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
Overview 
Research Feed Overview
A STOP (Suggested Termination Of Practice) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or standard practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions. STOPs are derived from rigorous analysis and are intended to optimize patient care by eliminating practices that current research has shown to exacerbate a condition or impede recovery. This concept is particularly relevant in fields where new findings challenge traditional approaches, guiding clinicians towards more effective, evidence-based practices. Overall, as microbiome research progresses, it is expected to challenge and refine many established medical practices, leading to more holistic and integrated approaches to health and disease management.
STOP Examples
The duration before a standard medical practice is revised or discontinued varies significantly, influenced by the emergence of new evidence, societal and cultural shifts, and advancements in technology. For instance, the use of high-dose glucocorticoids in acute spinal cord injury persisted for about 20 years until research demonstrated minimal benefits and significant risks. Thalidomide’s tragic effects were recognized within just 4 years of its introduction. Antibiotics for viral infections were commonly misused for around 40 years before significant efforts were made to curb their overprescription, and the radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective. These timelines underscore the importance of continuous investigation and reevaluation of medical practices to ensure they align with the best available evidence and meet contemporary standards of care.
| STOP Example | Standard Practice |
|---|---|
| Glucocorticoids in Acute Spinal Cord Injury | High-dose glucocorticoids, particularly methylprednisolone, were routinely used to reduce inflammation in acute spinal cord injuries. However, subsequent research showed minimal benefits and significant risks [x], prompting revised guidelines against routine use. |
| Thalidomide for Morning Sickness | Thalidomide was widely prescribed to treat morning sickness in pregnant women. Unfortunately, it caused severe birth defects, leading to its ban and a complete overhaul of drug safety regulations to prevent similar pharmaceutical disasters. |
| Antibiotics for Viral Infections | Antibiotics were frequently prescribed to treat viral infections like colds and flu. Later, research proved antibiotics are ineffective against viruses, and their overuse led to antibiotic resistance, prompting guidelines against their use for viral conditions. |
| Radical Mastectomy for Breast Cancer | Radical mastectomy, involving extensive tissue removal, was the standard treatment for breast cancer. Later, studies showed that less invasive surgeries often have similar outcomes, leading to a shift towards more conservative surgical approaches to preserve quality of life. |
Our STOPs
While our database focuses on the microbiome signature of conditions and their potential ASAPs, we often encounter information that warrants a Suggested Termination Of Practice. As this database progresses, more STOPs will likely be included. Although the microbiome signature database for Multiple Sclerosis is not yet finished, it is likely that a STOP for zinc supplementation in favor of zinc aspartate supplementation will be issued.
| Suggested Termination Of Practice Issued | Standard Practice |
|---|---|
| Ferrous Sulfate Supplementation for Endometriosis | Endometriosis often results in heavy menstrual bleeding and subsequent iron-deficiency anemia. Traditionally, clinicians prescribe iron supplementation to replenish iron stores and alleviate symptoms like fatigue. However, iron is a crucial growth factor for certain bacteria implicated in the pathogenesis of endometriosis; thus, iron supplementation can potentially exacerbate inflammatory processes further. Of note, studies indicate that some specific types of iron chelation therapy, which reduces excess iron, may instead be beneficial in managing endometriosis symptoms and improving iron absorption, suggesting a paradoxical effect. |
Research Feed
Exploring the link between dietary zinc intake and endometriosis risk: insights from a cross-sectional analysis of American women
October 23, 2024
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Endometriosis •
Endometriosis
Did you know?
Gut microbiota predict endometriosis better than vaginal microbiota.
STOPs •
STOPs
Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
This study links higher dietary zinc intake with increased endometriosis risk among American women, highlighting zinc’s complex role in immune modulation and estrogen-related pathways. Findings emphasize the importance of balanced intake for managing endometriosis risk.
What was studied?
This study investigated the association between dietary zinc intake and the risk of endometriosis among American women. Using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2006, the researchers aimed to evaluate whether zinc intake, as a key nutritional factor, was linked to the prevalence of endometriosis. Zinc is known for its essential roles in immune modulation, antioxidative defense, and regulation of matrix metalloproteinases (MMPs), all of which are implicated in endometriosis progression.
Who was studied?
The study included 4,315 American women aged 20–54 years, of whom 331 were diagnosed with endometriosis based on self-reported doctor diagnoses. Participants’ dietary zinc intake was assessed using 24-hour dietary recall interviews, with additional data on demographics, lifestyle, and health covariates collected. Women with extreme caloric intakes or incomplete data were excluded to ensure robustness of results.
What were the most important findings?
The study revealed a positive correlation between higher dietary zinc intake and the risk of endometriosis. Women consuming over 14 mg/day of zinc had a significantly higher adjusted odds ratio (1.60, 95% CI: 1.12–2.27, p = 0.009) compared to those with intake ≤8 mg/day. Zinc’s dual role in immune modulation and antioxidative defense was emphasized, particularly its regulation of matrix metalloproteinases (MMPs) like MMP-2 and MMP-9, which are key enzymes in tissue remodeling and endometriotic lesion invasion. Interestingly, despite zinc’s known antioxidative and anti-inflammatory roles, excessive intake appeared to have a counterproductive effect. These nuanced findings highlight zinc’s complex role in endometriosis pathophysiology.
What are the greatest implications of this study?
This research underscores the potential for dietary zinc as both a marker and modifiable factor in endometriosis risk. It raises questions about zinc’s dualistic effects, where optimal levels may support immune health, but excess intake could exacerbate estrogen-related pathways in endometriosis. Clinicians should be cautious when recommending zinc supplementation for reproductive health, particularly in populations at risk for endometriosis. Furthermore, this study strengthens the biological plausibility of microbiome involvement in endometriosis, as zinc is a crucial cofactor for microbial activity, and its imbalance may alter the gut and pelvic microbiota implicated in the disease.
Fruit and vegetable consumption and risk of endometriosis
January 12, 2018
/
Endometriosis •
Endometriosis
Did you know?
Gut microbiota predict endometriosis better than vaginal microbiota.
STOPs •
STOPs
Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
Higher fruit intake, especially citrus fruits, was inversely associated with laparoscopically confirmed endometriosis, suggesting a protective effect potentially linked to beta-cryptoxanthin. In contrast, cruciferous vegetables were linked to increased risk, highlighting the complex interplay between diet and endometriosis risk factors.
What Was Studied
This study explored the potential link between the consumption of fruits and vegetables and the risk of laparoscopically confirmed endometriosis. Using data collected from the Nurses' Health Study II, the researchers analyzed dietary habits over a 22-year period, investigating whether certain food groups and nutrients influenced the likelihood of developing endometriosis.
Who Was Studied
Participants included premenopausal women aged 25–42 years who were enrolled in the Nurses' Health Study II cohort. These women completed biennial surveys assessing health status, lifestyle factors, and dietary intake. Those with a history of endometriosis, cancer, infertility, or hysterectomy were excluded from the analysis, ensuring a focused evaluation of diet and disease development.
Most Important Findings
The study found an inverse relationship between fruit consumption, particularly citrus fruits, and the risk of endometriosis. Women who consumed citrus fruits frequently were less likely to develop endometriosis. Conversely, no significant association was found between total vegetable intake and the disease. Cruciferous vegetables, however, were unexpectedly linked to an increased risk. Beta-cryptoxanthin, a nutrient found in citrus fruits, appeared to play a protective role, and the beneficial effects of fruit consumption were especially notable among participants who had a history of smoking. These findings suggest a potential role for specific dietary components in either mitigating or exacerbating the risk of endometriosis.
Implications
The findings highlight the importance of dietary considerations in understanding endometriosis risk. The protective association of citrus fruits underscores the potential of targeted nutritional interventions to reduce risk. The increased risk observed with cruciferous vegetables raises questions about the role of gastrointestinal symptoms, as these vegetables are high in fermentable oligosaccharides, which could exacerbate symptoms and lead to increased diagnosis rates. Future studies exploring these dietary patterns in greater depth are warranted to clarify the underlying mechanisms and to guide dietary recommendations for those at risk.
Molecular detection of intrauterine microbial colonization in women with endometriosis
April 1, 2024
/
Endometriosis •
Endometriosis
Did you know?
Gut microbiota predict endometriosis better than vaginal microbiota.
STOPs •
STOPs
Did you know?
The radical mastectomy for breast cancer was standard practice for nearly 60 years before less invasive options were proven effective.
A case-controlled molecular study on 32 women, half with endometriosis and half without, investigated microbial colonization in the intrauterine environment and ovarian cystic fluid. It found significant bacterial variations, with certain bacteria types increasing or decreasing, particularly after treatment with gonadotropin-releasing hormone agonist (GnRHa). The study suggests GnRHa treatment might promote sub-clinical infections in the intrauterine and ovarian environments.
What was studied?
The research focused on investigating microbial colonization in women’s intrauterine environment and cystic fluid, utilizing a molecular approach to detect bacterial presence. This involved examining variations in bacterial types and their implications in the context of endometriosis and treatment effects.
Who was studied?
The study included 32 women, evenly divided between those diagnosed with endometriosis and those without the condition. Each group was further split, with half receiving gonadotropin-releasing hormone agonist (GnRHa) treatment, to explore the treatment’s impact on microbial colonization.
What were the most important findings?
Key findings revealed a broad range of bacterial presence in both endometrial swabs and cystic fluids, with significant changes in bacterial families (decrease in Lactobacillacae and increase in Streptococcaceae, Staphylococaceae, and Enterobacteriaceae) observed in GnRHa-treated women with endometriosis. The 16S metagenome assay was more effective than traditional culture methods, particularly in identifying bacteria in ovarian endometrioma cystic fluid.
What are the greatest implications of this study?
The study’s findings suggest the presence of sub-clinical infections in the intrauterine environment and ovarian endometrioma cystic fluid, particularly following GnRHa treatment. This raises concerns about the potential for GnRHa therapy to promote silent infections, indicating a need for careful consideration and monitoring of such treatments in women with endometriosis.
Zinc
Zinc is an essential trace element vital for cellular functions and microbiome health. It influences immune regulation, pathogen virulence, and disease progression in conditions like IBS and breast cancer. Pathogens exploit zinc for survival, while therapeutic zinc chelation can suppress virulence, rebalance the microbiome, and offer potential treatments for inflammatory and degenerative diseases.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Women's Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
STOPs
A STOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Zinc
Zinc is an essential trace element vital for cellular functions and microbiome health. It influences immune regulation, pathogen virulence, and disease progression in conditions like IBS and breast cancer. Pathogens exploit zinc for survival, while therapeutic zinc chelation can suppress virulence, rebalance the microbiome, and offer potential treatments for inflammatory and degenerative diseases.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Matrix Metalloproteinases (MMPs)
Matrix Metalloproteinases (MMPs) are zinc-dependent enzymes that regulate extracellular matrix remodeling, with critical roles in health, disease, and interactions with the microbiome.
Matrix Metalloproteinases (MMPs)
Matrix Metalloproteinases (MMPs) are zinc-dependent enzymes that regulate extracellular matrix remodeling, with critical roles in health, disease, and interactions with the microbiome.
Women's Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
STOPs
A STOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
STOPs
A STOP (Suggested Termination Of Practices) is a recommendation that advocates for the discontinuation of certain medical interventions, treatments, or practices based on emerging evidence indicating that these may be ineffective, harmful, or counterproductive in the management of specific conditions.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.