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My microbiota as a woman

A bacterium to blame for endometriosis?

Endometriosis
Vaginal Microbiota #11

Endometriosis is known to leave young girls and women bedridden during each menstrual cycle. However, this could soon become a distant memory. So suggests a Japanese study 1 published in 2023.

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About this article

Created 03 October 2023
Updated 02 May 2024

A significant new hope has arisen for all women suffering from (sidenote: Endometriosis Endometriosis is a chronic gynecological disease linked to the presence of tissue similar to the uterine mucosa outside the uterine cavity, particularly in the peritoneum and ovaries. ) : a bacterium of the (sidenote: Fusobacterium Fusobacterium is a genus of filamentous bacteria that lives in the mouth (dental plaque), digestive system, vagina and, to a lesser extent, the uterine cavity. This pathogenic bacterium is implicated in periodontitis (inflammation at the base of the tooth) and colorectal cancer. ) genus may be involved, representing a potential target for treatment. In particular, a simple course of antibiotics may be enough to make this pathogenic bacterium retreat, reducing the painful lesions.

1 in 10 women is affected by endometriosis, which rises to 1 in 7 or 1 in 5 for women of childbearing age.

Almost half of women do not know exactly what the vaginal flora is.

(sidenote: 1. Kvaskoff M. Epidémiologie de l’endométriose. In : Petit E, Lhuillery D, Loriau J, Sauvanet E. Endométriose : Diagnostic et prise en charge. Issy-les-Moulineaux : Elsevier Masson ; 2020. P.9-14.    2. https://www.biocodexmicrobiotainstitute.com/en/international-microbiota-observatory-focus-women-health )

Bacterial effect countered by an antibiotic

Japanese researchers from Nagoya University 2  have shown that, in laboratory mice used as a model, vaginal inoculation with bacteria from the genus Fusobacterium induced lesions typical of endometriosis, which were more numerous and more severe than in control mice.  This suggests that Fusobacterium is involved in the genesis of the disease; but it also leads to possible solutions. Indeed, antibiotic treatment targeting Fusobacterium reduced the number and weight of lesions in the mice. This discovery raises the hope that this antibiotic treatment may also be effective in women.

“Eradication of this bacterium by antibiotic treatment could be an approach to treat endometriosis for women who are positive for Fusobacteria infection, and such women could be easily identified by vaginal swab or uterus swab.”

Prof. Yutaka Kondo of Nagoya University, lead author of the study
23.02.2022 Diagnosing endometriosis: can the microbiota help? Read more

Analysis of the mechanisms at play

But that’s not all. The Japanese team carried out numerous experiments to try and understand the mechanisms involved. This meticulous work led to the following hypothesis: the presence of Fusobacteria in the uterus activates the women’s immune system, provoking a cascade of reactions that leads to the production of a protein called transgelin, which in turn promotes the development of endometriosis.

Endometriosis and microbiota: is there a link?

Learn more

Clinical study underway

The involvement of the microbiota in endometriosis has been suspected for some time. For example, analyses of the vaginal flora have been used to predict the severity of the disease, while 90% of women affected by endometriosis also have associated digestive disorders (irritable bowel syndrome in particular). Nevertheless, these new results were sufficiently promising for the Department of Obstetrics and Gynecology at Nagoya University Hospital to launch a clinical study in 2023 3 into the use of an antibiotic.

Pending the results, please do not take antibiotics without a prescription or medical advice. If used incorrectly, you may reduce their effectiveness for when you really need them.

Antibiotics

Antibiotics should be used with caution and only on the basis of medical advice 4 .

Sources

1. Muraoka A, Suzuki M, Hamaguchi T et al. Fusobacterium infection facilitates the development of endometriosis through the phenotypic transition of endometrial fibroblasts. Sci Transl Med. 2023 Jun 14;15(700):eadd1531.

2. https://en.nagoya-u.ac.jp/

3. https://www.nagoya-u.ac.jp/researchinfo/result-en/2023/06/20230615-01.html

4. https://www.who.int/fr/director-general/speeches/detail/antimicrobials-handle-with-care-united-to-preserve-antimicrobials

Tags
Women health Endometriosis Antibiotics Microbiome Flora

    See also

    Actu GP : Endométriose : le microbiote vaginal comme outil prédictif de sévérité ? Can the vaginal microbiota be used as a tool for predicting the severity of endometriosis?
    Actu GP : Règles douloureuses : et si le microbiote vaginal était en cause ? Is the vaginal microbiota to blame for painful periods?
    Created 03 October 2023
    Updated 02 May 2024

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