2023 Fiscal Year Annual Research Report
Relationship between intrauterine infection and endometriosis and its association with infertility
| Project/Area Number |
18K09268
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| Research Institution | Kyoto Prefectural University of Medicine |
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Principal Investigator |
カーン カレク 京都府立医科大学, 医学(系)研究科(研究院), 准教授 (60336162)
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| Project Period (FY) |
2018-04-01 – 2024-03-31
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| Keywords | endometriosis / uterine infection / LVFX / GnRHa |
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| Outline of Annual Research Achievements |
This is a prospective non-randomized observational study to evaluate microbial profiles in endometrial samples that were collected from women with and without endometriosis. Endometrial and endometriotic samples were collected from 53 women with endometriosis and 47 control women and were treated with levofloxacin (LVFX, 500mg, once per os) or GnRHa (1.88mg/IM for 3 months) before surgery.
16S rDNA metagenome assay indicated that treatment with either of LVFX or GnRHa+LVFX significantly decreased some components of major bacterial genera comparing to untreated group.
Immunohistochemical analysis with antibody against CD138 indicated that the occurrence rate of chronic endometritis was significantly decreased after GnRHa+LVFX treatment comparing to GnRHa treatment group (P=0.041).
These findings suggest the effectiveness of a broad spectrum antibiotic, as a non-hormonal agent, in improving uterine infection in human endometriosis.
As an extended study, we evaluated association between ano-genital distance (AGD) (distance between anal rim and posterior fourchette of the vagina) and vaginal pH (an indicator of vaginal eubiosis and dysbiosis) in women with (n=67) and without (n=40) endometriosis. We found that there was no significant difference in the median AGD among control women (21.5mm) and women with either early (22.0mm) or advanced endometriosis (20.0mm).The univariate analysis showed that alkaline shifting of vaginal pH (more than 4.5) was associated with the presence of endometriosis (OR [95% CI] = 0.40 [0.17, 0.93], P=0.034) and was independent of the length of AGD.
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