The Impact of Microbiota-Mediated Immune Regulation on Recurrent Pregnancy Loss and Intervention Strategies

IF 2.4 3区 医学 Q3 IMMUNOLOGY
Yao Yao, Yiqing Ye, Caihong Zheng
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引用次数: 0

Abstract

Recurrent pregnancy loss (RPL) significantly affects reproductive health in couples of childbearing age. Its pathogenesis is complex, with nearly 50% of cases remaining unexplained, and immune regulation plays a key role in its development. This review focuses on the relationship between human microbiota (gut, reproductive tract, and endometrial microbiota), immune regulation, and RPL, systematically summarizing related research progress. RPL patients exhibit characteristic changes in the gut, reproductive tract, and endometrial microbiota, such as reduced gut microbial diversity, decreased beneficial bacteria, increased harmful bacteria in the reproductive tract, and an imbalanced endometrial microbiota structure. Dysbiosis can lead to immune regulation abnormalities, increasing the risk of RPL by disrupting immune tolerance, triggering inflammatory responses, and interfering with metabolism. Although microbiota-based interventions, such as probiotics, prebiotics, and fecal microbiota transplantation, show potential, they face challenges related to strain selection, donor screening, and unclear mechanisms. Current research also faces limitations in detection technology and sample size, and the understanding of the microbiota-immune-RPL relationship requires further deepening. Future studies should clarify causal relationships using advanced technologies, develop more effective detection and intervention methods, and create personalized treatment plans based on individual patient characteristics to improve clinical diagnosis and treatment of RPL and safeguard women's reproductive health.

微生物群介导的免疫调节对复发性妊娠丢失的影响及干预策略
反复流产严重影响育龄夫妇的生殖健康。其发病机制复杂,近50%的病例仍无法解释,免疫调节在其发展中起关键作用。本文就人体微生物群(肠道、生殖道和子宫内膜微生物群)、免疫调节和RPL之间的关系进行综述,系统总结相关研究进展。RPL患者肠道、生殖道和子宫内膜微生物群发生特征性变化,如肠道微生物多样性降低,生殖道有益菌减少,有害菌增加,子宫内膜微生物群结构失衡。生态失调可导致免疫调节异常,通过破坏免疫耐受、引发炎症反应和干扰代谢,增加RPL的风险。尽管基于微生物群的干预措施,如益生菌、益生元和粪便微生物群移植,显示出潜力,但它们面临着与菌株选择、供体筛选和机制不明确相关的挑战。目前的研究还面临检测技术和样本量的限制,对微生物群-免疫- rpl关系的认识需要进一步深化。未来的研究应利用先进的技术,明确因果关系,制定更有效的检测和干预方法,并根据患者的个体特征制定个性化的治疗方案,以提高RPL的临床诊断和治疗水平,保障妇女生殖健康。
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来源期刊
CiteScore
6.20
自引率
5.60%
发文量
314
审稿时长
2 months
期刊介绍: The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.
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