The role of bacterial contamination in the development of endometriosis
The current concepts of the etiology and mechanisms of endometriosis, including the new theory of bacterial contamination, are analyzed. The review includes data from foreign and Russian articles published in the PubMed, UpToDate and eLibrary databases over the past 10 years. Antimicrobial peptide (AMP), in particular secretory leukocyte protease inhibitor (SLPI) and β-defensin, are elements of the local line of epithelial defense against an infectious agent. Their level in the endometrium and other tissues of the female genital tract decreases during menstruation under cyclic hormonal fluctuations, which increases the risk of bacterial contamination of menstrual blood and genital tract tissues. In addition, a change in AMP secretion may play a role in the implantation of endometrioid heterotopias through the influence on the synthesis and activity of matrix metalloproteinases and transcription nuclear factor kappa B (NF-κB). As the disease progresses, there are elevated levels of SLPI and β-defensins. AMPs are present in virtually all human epithelial tissues; and a decrease in their secretion by epithelial cells is one of the components in the development of common forms of endometriosis. The results of ongoing studies confirm the role of AMP as a trigger in the development of endometriosis, which exacerbates bacterial contamination during menstruation and forms a vicious circle in the pathogenesis of common forms of endometriosis.Smolnova T.Yu., Dmitrieva I.E., Pavlovich S.V., Chuprynin V.D., Priputnevich T.V.
Keywords
endometriosis
common forms of endometriosis
Escherichia coli
antimicrobial peptides
secretory protease inhibitor
β-defensins
infertility
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Received 03.10.2019
Accepted 04.10.2019
About the Authors
Tatiana Yu. Smolnova, MD., senior associate of the Surgery department of the V.I. Kulakov National Medical Research Center for Obstetrics, Gynaecology and Perinatology. Tel.: 8 (926) 310-80-90. Email: smoltat@list.ruAkademika Oparina street, 4, Moscow, Russia, 117997.
Irina E. Dmitrieva, 1st year PhD candidate of the V.I. Kulakov National Medical Research Center for Obstetrics, Gynaecology and Perinatology. Tel.: +7 (916)089-08-09.
Email: nika06@inbox.ru
Akademika Oparina street, 4, Moscow, Russia, 117997.
Stanislav V. Pavlovich, PhD/Med, scientific secretary and senior associate of the Pathologic Pregnancy department of the V.I. Kulakov National Medical Research Center for Obstetrics, Gynaecology and Perinatology, associate professor of the Obstetrics, Gynaecology and Perinatology academic department of the Postgraduate Professional Medical Studies faculty of the I.M. Sechenov First Moscow State Medical University (Sechenov University). Tel.: +7 (916)189-37-18. Email: s_pavlovich@oparina4.ru
Akademika Oparina street, 4, Moscow, Russia, 117997.
Vladimir D. Chuprynin, PhD/Med, head of the Surgery department of the V.I. Kulakov National Medical Research Center for Obstetrics, Gynaecology and Perinatology
Tel.:+7 (495)438-78-33. Email:v_chuprynin@oparina4.ru.
Akademika Oparina street, 4, Moscow, Russia, 117997.
Tatiana V. Priputnevich, MD, head of the Microbiology, Clinical Pharmacology and Epidemiology department of the V.I. Kulakov National Medical Research Center
for Obstetrics, Gynaecology and Perinatology.Tel.: +7(910)414-56-16. Email:priput1@gmail.com
Akademika Oparina street, 4, Moscow, Russia, 117997.
For citation: Smolnova T.Yu., Dmitrieva I.E., Pavlovich S.V., Chuprynin V.D., Priputnevich T.V. The role of bacterial contamination in the development of endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and gynecology. 2020; 1: 47-53. (In Russian).
https://dx.doi.org/10.18565/aig.2020.1.47-53