The importance of the genital tract microflora in the endometriosis development

Abstract

Endometriosis is a common pathology among women of reproductive age. In the pathogenesis of its development a great importance is paid to the process of regulation of estrogens and other sex hormones, the implementation of the immune response at the general and local levels, the inflammatory response, and genetic background. In recent years, the role of the microbiota in different parts of the genital tract of the female organism has been studied not only from the standard approach of inflammatory diseases research of the reproductive organs and pathological vaginal discharge, but its contribution into the development of other gynecological diseases, in particular endometriosis, is presented.The article is devoted to a review of scientific publications about researches devoted to the significance of the genital tract microflora in the pathophysiology of endometriosis. The article presents the concepts of states of eubiosis and dysbiosis, describes the features of the microflora of the lower (vagina, cervix) and upper parts (uterus, fallopian tubes) of the genital tract in healthy women. The data on the importance of Lactobacillus in maintaining an optimal state of acidity in the vaginal environment are presented. The difference in the composition of the microbiota of the vagina, cervical mucus, uterine cavity and peritoneal fluid in women with and without endometriosis is revealed. The pathogenetic mechanisms of the role of the microbiota in the processes of endometriosis pathogenesis, namely, the regulation of the immune response and inflammation processes in this pathology, are described. It has been shown that in women with endometriosis there are differences in the microflora composition of the vagina, cervix, uterine cavity, peritoneal fluid, manifested by a decreased concentration of Lactobacillus and the presence of a variety of other microorganisms in relation to healthy women. The data about the role of gut microflora in patients with this pathology are also presented. The results of research about the diagnosis of various stages of endometriosis by studying the composition of the genital tract microbiota are described.