Research progress in the correlation between reproductive tract microbiota and intrauterine adhesion

Abstract

Intrauterine adhesion (IUA) is caused by damage of the basal layer of endometrium, which leads to fibrosis of the endometrium and the formation of adhesion, resulting in partial or complete occlusion of the uterine cavity, abnormal menstruation, infertility or recurrent miscarriage. The prevalence of IUA in women has been increasing in recent years, and the high recurrence rate of moderate to severe IUA makes IUA treatment more challenging. Iatrogenic endometrial injury is the main cause of IUA. However, the incidence of IUA and the severity of IUA vary among patients who have received similar uterine operations, suggesting that there may be other synergistic factors in the development of IUA. There is a certain correlation between the pathogenesis and the microbiota of the gential tract. In many IUA patients, it has been observed that the probiotics such as Lactobacillus in the vagina is significant reduced, and the pathogenic bacteria such as Gardnerella and Prevotella are excessive growth. The reproductive tract microbiota can be involved in the development and progression of IUA via impacting immune function and metabolism.

Keywords: cytokine; immune response; intrauterine adhesion; reproductive tract microbiota.

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IUA中TGF-β1/SMAD信号通路(本图由Figdraw绘制) Figure 1 TGF-β1/SMAD signaling pathways in IUA (drawn by Figfraw) TGF-β1: Transforming growth factor-β1; TβR: Transforming growth factor-β receptor; SMAD: Small mothers against decapentaplegic; CTGF: Connective tissue growth factor; MMP: Matrix metalloproteinase; ECM: Extracellular matrix; P: Phosphorylation.