The bidirectional relationship between endometriosis and microbiome Original paper
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
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Women’s Health
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.
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Endometriosis
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.
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Karen Pendergrass
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
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
What Was Reviewed?
The review article explored the bidirectional relationship between endometriosis and the microbiome, emphasizing the role of dysbiosis in the pathogenesis and progression of this chronic inflammatory condition. It discussed microbiome alterations across different sites, including the gut, peritoneal fluid, and female reproductive tract, and evaluated how these microbial shifts influence inflammation, immune modulation, and estrogen metabolism. Furthermore, it highlighted experimental and clinical evidence supporting the potential of microbiome-targeted interventions as both diagnostic tools and treatments for endometriosis.
Who Was Reviewed?
The review synthesized findings from human and animal studies investigating microbiota composition in patients with endometriosis compared to healthy controls. It included a comprehensive analysis of bacterial, viral, and fungal associations across diverse microbiome sites, focusing on patterns of dysbiosis, enriched taxa, and diminished microbial diversity. Specific populations reviewed included women diagnosed with various stages of endometriosis and animal models with surgically induced disease.
What Were the Most Important Findings?
The most notable findings included alterations in gut, cervical, and peritoneal fluid microbiota in women with endometriosis. In the gut, elevated levels of Proteobacteria and reduced Lactobacillaceae were observed. The peritoneal fluid showed enrichment of Acinetobacter and Pseudomonas, while the cervical and vaginal microbiomes exhibited decreased diversity and increased abundance of pathogenic species from the Gardnerella and Streptococcus genus. Dysbiosis was associated with heightened inflammatory responses mediated by lipopolysaccharide (LPS) from Escherichia coli, potentially driving lesion formation through the NF-κB pathway. The concept of “estrobolomes,” gut bacteria influencing estrogen reabsorption, was linked to the hyperestrogenic state characteristic of endometriosis. Notably, antibiotic and probiotic treatments in animal models reduced lesion size, supporting the potential therapeutic role of microbiome modulation.
What Are the Greatest Implications?
The implications of this review are twofold: first, the microbiome holds promise as a non-invasive diagnostic tool for endometriosis, potentially reducing diagnostic delays. Second, microbiome-targeted interventions (MBTIs), such as probiotics, prebiotics, and dietary modifications, may offer novel therapeutic avenues. The findings underscore the necessity for further research into microbiome signatures and their clinical applications, particularly in differentiating disease stages and addressing infertility associated with endometriosis.
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.
Streptococcus spp.
Streptococcus is a genus of gram-positive, facultatively anaerobic bacteria commonly found in pairs or chains. Important human pathogens include Streptococcus pneumoniae, Streptococcus pyogenes (group A strep), and Streptococcus agalactiae (group B strep).
Lipopolysaccharides (LPS)
Lipopolysaccharide (LPS), a potent endotoxin present in the outer membrane of Gram-negative bacteria that causes chronic immune responses associated with inflammation.
Estrobolome
The estrobolome is a group of gut bacteria that metabolize estrogen, impacting its levels and effects in the body. By modulating estrogen reabsorption and excretion, the estrobolome influences hormonal balance and risks of estrogen-related conditions, making it a target for therapeutic interventions.
Microbiome-Targeted Interventions (MBTIs)
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.