Dr. Anjeza Xholli and colleagues from the University of Genova, Italy, conducted a comprehensive review on the potential impact of gut microbiota on gastrointestinal symptoms in endometriosis patients, publishing their findings in Pharmaceuticals, in the leadership of Dr.Cagnacci.
Approximately 90% of endometriosis patients experience gastrointestinal symptoms, including bloating, nausea, constipation, diarrhea, and vomiting. Recent research has highlighted a connection between gut microbiota and female reproductive health, suggesting that microbial imbalances may contribute to disease progression.
The authors performed a systematic literature search using PubMed, Scopus, and Google Scholar with the keywords endometriosis, gut microbiota, dysbiosis, probiotics, and leaky gut. Non-peer-reviewed articles and withdrawn publications were excluded, and discrepancies were resolved through consensus by three senior researchers.
Despite various pathogenetic theories, no single explanation fully accounts for why some women develop endometriotic lesions while others do not. Dysbiosis, or gut microbiota imbalance, is now recognized as a factor that may disrupt immune regulation by increasing proinflammatory cytokines, altering immune cell profiles, and impairing immunosurveillance.
Experimental studies in both humans and animal models suggest a bidirectional relationship between microbiota and endometriosis. Microbial imbalances may influence endometriosis development and progression, while the presence of endometriosis itself may alter gut microbiota composition. Additionally, dysbiosis triggers the release of zonulin, a molecule that disrupts tight junctions in the intestinal epithelium, increasing antigen permeability and potentially exacerbating inflammation.
The authors conclude that further research is essential to determine the optimal probiotic interventions and their specific mechanisms in managing endometriosis.
