The role of bacterial contamination in the development of endometriosis


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Abstract

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 b-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-xB). As the disease progresses, there are elevated levels of SLPI and b-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.

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About the authors

Tatiana Yu. Smolnova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology Ministry of Health of Russia

Email: smoltat@list.ru/
MD., senior associate of the Surgery department Akademika Oparina street, 4, Moscow, Russia, 117997

Irina E. Dmitrieva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology Ministry of Health of Russia

Email: nika06@inbox.ru
1st year PhD candidate Akademika Oparina street, 4, Moscow, Russia, 117997

Stanislav V. Pavlovich

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University Ministry of Health of Russia

Email: s_pavlovich@oparina4.ru/
PhD/Med, scientific secretary and senior associate of the Pathologic Pregnancy department; associate professor of the Obstetrics, Gynaecology and Perinatology academic department of the Postgraduate Professional Medical Studies faculty Akademika Oparina street, 4, Moscow, Russia, 117997

Vladimir D. Chuprynin

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology Ministry of Health of Russia

Email: v_chuprynin@oparina4.ru/
PhD/Med, head of the Surgery department Akademika Oparina street, 4, Moscow, Russia, 117997

Tatiana V. Priputnevich

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology Ministry of Health of Russia

Email: priput1@gmail.com/
MD, head of the Microbiology, Clinical Pharmacology and Epidemiology department Akademika Oparina street, 4, Moscow, Russia, 117997

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