子宮内膜症における子宮腔内細菌叢の同定と細菌環境が不妊医療に及ぼす影響
Project/Area Number |
18K09268
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Review Section |
Basic Section 56040:Obstetrics and gynecology-related
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Research Institution | Kyoto Prefectural University of Medicine |
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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Project Status |
Granted (Fiscal Year 2022)
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Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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Keywords | endometriosis / uterine infection / LVFX/GnRHa / inflammation / metagenone / GnRHa / エンドメトリオーシス / メタゲノム / 子宮内膜症 / 腟内細菌叢 |
Outline of Annual Research Achievements |
We examined the hypothesis that antibiotic treatment with and without gonadotropin releasing hormone agonist (GnRHa) may decrease intrauterine infection with consequent decrease in tissue inflammation, cell proliferation, angiogenesis and occurrence of chronic endometritis in women with endometriosis. We performed a prospective non-randomized observational study with collection of endometrial and endometriotic samples from 53 women with endometriosis and 47 women without endometriosis during surgery. These two groups of patients were treated with levofloxacin (LVFX, 500mg once per os) or GnRHa (1.88 mg/IM for 3 months) before surgery. Endometrial samples were analyzed by broad-range PCR amplification of bacteria targeting V5-V6 region of 16S rRNA gene. Immunohistochemistry was performed using respective target antibodies. 16S rDNA metagenome assay indicated that treatment with either LVFX or GnRHa+LVFX significantly decreased some components of major bacterial genera comparing to untreated group. Occurrence of chronic endometritis was significantly decreased after GnRHa+LVFX treatment. A significantly decreased CD68-stained macrophage infiltration, Ki-67-stained cell proliferation and CD31-stained micro-vessel density was found in endometria and endometriotic lesions with histology-proven improvement in the morphological appearance of endometriosis. These findings suggest that clinical application of a broad-spectrum antibiotic with or without GnRHa may be effective in improving uterine infection in human endometriosis.
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Current Status of Research Progress |
Current Status of Research Progress
4: Progress in research has been delayed.
Reason
Our proposed study is already completed and published recently (Khan et al. EJOGRB 264:103-116,2021). The second part of this study is still ongoing. Due to the effect of current Covid-19 pandemic and restrictions of artificial reproductive technology (ART) procedure, we could not enroll patients and collect samples as was mentioned in the research protocol. We plan to continue our research to investigate the relationship between uterine infection and reproductive outcome.
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Strategy for Future Research Activity |
(1) We plan to perform multinational and multi-center study on the single and combined effect of antibiotic and GnRHa to confirm the strength and validity of our completed and published study. (2) We plan to investigate molecular detection of intrauterine infection, occurrence of chronic endometritis and their effect on reproductive outcome in women undergoing ART.
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Report
(5 results)
Research Products
(43 results)
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[Journal Article] Levofloxacin or GnRHa treatment decreases intrauterine microbial colonization in human endometriosis2021
Author(s)
Khan KN, Fujishita A, Muto H, Masumoto H, Ogawa K, Koshiba A, Mori T, Itoh K, Teramukai S, Matsuda K, Nakashima M, Kitawaki J.
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Journal Title
Eur J Obstet Gynecol Reprod Biol.
Volume: 264
Pages: 103-116
DOI
Related Report
Peer Reviewed
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[Journal Article] An axonemal alteration in apical endometria of human adenomyosis2021
Author(s)
Khan KN, Fujishita A, Suematsu T, Ogawa K, Koshiba A, Mori T, Itoh K, Teramukai S, Matsuda K, Nakashima M, Kitawaki J
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Journal Title
Hum Reprod
Volume: 36(6)
Issue: 6
Pages: 1574-1589
DOI
Related Report
Peer Reviewed
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