Common Bacteria May Trigger Endometriosis

Scientists discovered that Fusobacterium, a bacterial species typically found in the mouth, gastrointestinal tract, and female genital tract, may play a role in the development of endometriosis.

Estimates indicate that endometriosis impacts up to 15% of women of childbearing age. The disorder causes tissue from the endometrium, or lining of the uterus, to grow in other places in the body, such as the ovaries, bladder, and fallopian tubes.

While the mechanisms behind endometriosis are not fully understood, some research suggests that an altered gut biome might play a role in the development and progression of the condition.

In a new study published on June 14 in Science Translational Medicine, researchers investigated whether Fusobacterium, which is found in the flora of the mouth, GI tract, and female reproductive tract, might contribute to endometriosis development.

The scientists analyzed tissue samples from 79 women with endometriosis and 76 without the condition who had all undergone surgery. They found that in women with endometriosis, 64% had infiltration of Fusobacterium in their endometrium. In contrast, less than 10% of women without endometriosis had an infiltration of the bacterium.

When the researchers conducted further analyses, they found that activated transforming growth factor–β (TGF-β) signaling from the infiltration of Fusobacterium in the endometrial cells changed specific fibroblasts into transgelin (TAGLN)–positive myofibroblasts. These myofibroblasts then had the ability to proliferate, adhere, and migrate in lab experiments.

Moreover, when the investigators injected Fusobacterium into mice modeled to exhibit endometriosis, both TAGLN-positive myofibroblasts and endometriosis lesions increased.

Then, when the investigators gave the rodents two types of antibiotics — metronidazole and chloramphenicol — the treatment reduced the number of lesions and prevented endometriosis from establishing.

The researchers suggest that eliminating a Fusobacterium infection could be a new way to treat endometriosis.

However, the study authors say it's unclear how or why Fusobacterium infiltrates endometrial tissue. In addition, treating the bacterial infection might not eradicate endometriosis permanently and could lead to antibacterial resistance.

Still, these findings could open the door to additional endometriosis treatments, such as the development of drugs that block the actions of TAGLN-positive myofibroblasts.

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