Impact of changes in the vaginal microbiome and chronic endometritis on the initiation of hyperplastic processes of the endometrium in women

Dmytro, Khaskhachykh; Valentin Potapov

doi:10.32345/USMYJ.4(134).2022.22-29

Dmytro, Khaskhachykh Dnipro State Medical University, Dnipro, Ukraine https://orcid.org/0000-0001-5097-6667
Valentin Potapov Dnipro State Medical University, Dnipro, Ukraine https://orcid.org/0000-0001-7498-7416

DOI: https://doi.org/10.32345/USMYJ.4(134).2022.22-29

Keywords: chronic endometritis, diagnosis, endometrial hyperplasia, infections, microbiota

Abstract

the article presents a review of the literature, which examines the impact of changes in the vaginal microbiome and chronic endometritis on the development of hyperplastic processes of the endometrium in women. Many studies have proven the undoubted role of these factors in the development of endometrial hyperplastic processes, such as atypical hyperplasia and endometrial polyposis. Chronic endometritis, on the background of which there was a course of endometrial hyperplasia, in 95.1% of women studied was caused by an infection of viral, bacterial or fungal origin. Numerous studies indicate the important role of chronic persistent infection in the development of hyperproliferative processes of the endometrium. The largest role in the pathological process is probably played by bacteria of the genus Gardnerella viridans as well as gram-positive cocci (Streptococcus). Herpes simplex virus, cytomegalovirus, human papilloma virus and pathogenic fungi represented by the genus Candida also influence the occurrence of this process. Further studies of the pathological action of these microorganisms will achieve greater accuracy in the diagnosis of hyperplastic processes of the endometrium.

References

Akhmetova, E. S., Belokrinitskaya, T. E., & Chartorizhskaya, N. N. (2009). The role of infections and chronic inflammation in the pathogenesis of endometrial hyperplastic processes. Problems of reproduction (special issue), 167-168

Gromova, A. M., & Afanasyeva, O. E. (2012). Sexually transmitted infections in women with hyperplastic processes of the endometrium. Actual problems of modern medicine: Bulletin of the Ukrainian Medical Stomatological Academy, 12(3 (39)), 126-129.

Gromova, A. M., Afanasyeva, O. E., Gromova, O. L., Martynenko, V. B., & Nesterenko, L. A. (2014). The role of sexually transmitted infections in the development of endometrial hyperplasia. World of medicine and biology, 10(3 (45)), 29-32.

Saprykina, L. V., Dobrokhotova, Yu. E., & Litvinova, N. A. (2011). Hyperplastic processes of the endometrium: issues of etiopathogenesis, clinic, diagnosis, treatment. Medicine, (3), 4-8.

Chaika, G. V., Yaremchuk, L. V., & Karetna, A. O. (2017). Optimization of treatment and rehabilitation of reproductive function of women with endometrial hyperplasia against the background of pelvic inflammatory disease. Bulletin of the Vinnytsia National Medical University, (21, No. 1 (2)), 302-306.

Khanina, O. I. (2013). Epidemiological and clinical characteristics of endometrial hyperplasia against the background of chronic endometritis in premenopausal women. World of Medicine and Biology, 9(3-2 (40)), 046-048.

Allhorn, S., Böing, C., Koch, A. A., Kimmig, R., & Gashaw, I. (2008). TLR3 and TLR4 expression in healthy and diseased human endometrium. Reproductive biology and endocrinology: RB&E, 6, 40. https://doi.org/10.1186/1477-7827-6-40

Andrews, W. W., Hauth, J. C., Cliver, S. P., Conner, M. G., Goldenberg, R. L., & Goepfert, A. R. (2006). Association of asymptomatic bacterial vaginosis with endometrial microbial colonization and plasma cell endometritis in nonpregnant women. American journal of obstetrics and gynecology, 195(6), 1611–1616. https://doi.org/10.1016/j.ajog.2006.04.010

Armstrong, A. J., Hurd, W. W., Elguero, S., Barker, N. M., & Zanotti, K. M. (2012). Diagnosis and management of endometrial hyperplasia. Journal of minimally invasive gynecology, 19(5), 562–571. https://doi.org/10.1016/j.jmig.2012.05.009

Auclair, M. H., Yong, P. J., Salvador, S., Thurston, J., Colgan, T., & Sebastianelli, A. (2019). Guideline No. 390-Classification and Management of Endometrial Hyperplasia. Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC, 41(12), 1789–1800. https://doi.org/10.1016/j.jogc.2019.03.025

Auclair, M. H., Yong, P. J., Salvador, S., Thurston, J., Colgan, T. T. J., & Sebastianelli, A. (2019). Guideline №390-classification and management of endometrial hyperplasia. Journal of obstetrics and gynaecology Canada, 41(12), 1789-1800.

Bespoiasnaia, V. V. (1998). Korrektsiia immunoéndokrinnykh narusheniĭ u bol'nykh s giperplasticheskimi protsessami v éndometrii [The correction of immunoendocrine disorders in patients with hyperplastic processes in the endometrium]. Likars'ka sprava, (5), 139–142.

Cicinelli, E., Matteo, M., Tinelli, R., Pinto, V., Marinaccio, M., Indraccolo, U., De Ziegler, D., & Resta, L. (2014). Chronic endometritis due to common bacteria is prevalent in women with recurrent miscarriage as confirmed by improved pregnancy outcome after antibiotic treatment. Reproductive sciences (Thousand Oaks, Calif.), 21(5), 640–647. https://doi.org/10.1177/1933719113508817

Chaplin, A.V., Rebrikov, D.V., Boldyreva, M.N. (2017). The human microbiome. Bulletin of Russian State Medical University. NI Pirogov scientific medical journal. 2(5),3.

Eddib, A., Allaf, B., Lee, J., & Yeh, J. (2012). Risk for advanced-stage endometrial cancer in surgical specimens from patients with complex endometrial hyperplasia with atypia. Gynecologic and obstetric investigation, 73(1), 38–42. https://doi.org/10.1159/000329326

Epplein, M., Reed, S. D., Voigt, L. F., Newton, K. M., Holt, V. L., & Weiss, N. S. (2008). Risk of complex and atypical endometrial hyperplasia in relation to anthropometric measures and reproductive history. American journal of epidemiology, 168(6), 563–576. https://doi.org/10.1093/aje/kwn168

Fallahi, P., Ferrari, S. M., Giuggioli, D., Sebastiani, M., Colaci, M., Ferri, C., & Antonelli, A. (2017). Chemokines in the Pathogenesis and as Therapeutical Markers and Targets of HCV Chronic Infection and HCV Extrahepatic Manifestations. Current drug targets, 18(7), 786–793. https://doi.org/10.2174/1389450116666150804105937

Fang, R. L., Chen, L. X., Shu, W. S., Yao, S. Z., Wang, S. W., & Chen, Y. Q. (2016). Barcoded sequencing reveals diverse intrauterine microbiomes in patients suffering with endometrial polyps. American journal of translational research, 8(3), 1581–1592.

Garcia-Grau, I., Simon, C., & Moreno, I. (2019). Uterine microbiome-low biomass and high expectations†. Biology of reproduction, 101(6), 1102–1114. https://doi.org/10.1093/biolre/ioy257

Gromova, O., Potapov, V., Hasachih, D., Haponova, O., & Kukina G. (2020). Analysis of the causes of unsuccessful hormonal treatment of non-atypical endometrial hyperplasia in premenopousal women. Reports of Vinnytsia National Medical University. 24(4),604-610.

Gorban, N. E., Vovk, I. B., Nikitina, I. M., Kondratiuk, V. K., & Yemets, N. O. (2020). Іmmunoglobulin indicators to viruses cytomegal and genital herpes in the blood serum of women with non-atipical endometrial hyperprolifetative pathology. Wiadomosci lekarskie (Warsaw, Poland : 1960), 73(8), 1600–1604.

Goncharenko, V. M., Beniuk, V. A., Kalenska, O. V., Demchenko, O. M., Spivak, M. Y., & Bubnov, R. V. (2013). Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. The EPMA journal, 4(1), 24. https://doi.org/10.1186/1878-5085-4-24

Horban, N. Y., Vovk, I. B., Lysiana, T. O., Ponomariova, I. H., & Zhulkevych, I. V. (2019). Peculiarities of Uterine Cavity Biocenosis in Patients with Different Types of Endometrial Hyperproliferative Pathology. Journal of medicine and life, 12(3), 266–270. https://doi.org/10.25122/jml-2019-0074

Hui, L. S., Chin, S., Goh, C., Hui, L. X., Mathur, M., Kuei, T., & Xian, F. (2021). Non-atypical endometrial hyperplasia: risk factors for occult endometrial atypia and malignancy in patients managed with hysterectomy. Obstetrics & gynecology science, 64(3), 300–308. https://doi.org/10.5468/ogs.20294

Kelly, P., Dobbs, S. P., & Mc Cluggage, W. G. (2007). Endometrial hyperplasia involving endometrial polyps: report of a series and discussion of the significance in an endometrial biopsy specimen. BJOG : an international journal of obstetrics and gynecology, 114(8), 944–950. https://doi.org/10.1111/j.1471-0528.2007.01391.x

Khaskhachih D, Potapov V. (2018). Influence level of expression of sex hormones receptors on the effectiveness of hormonal treatment of endometrial hyperplasia without atypia. Scientific digest of association of obstetricians and gynecologists of Ukraine, 2(42), 203-207.

Khaskhachykh, D. A., Potapov, V. O., & Kukina, H. O. (2019). A differentiated approach to the treatment of endometrial hyperplasia without atypia in women of reproductive age. Current issues of pediatrics, obstetrics and gynecology, (2), 149-155.

Kurman, R. J., Kaminski, P. F., & Norris, H. J. (1985). The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients. Cancer, 56(2), 403–412. https://doi.org/10.1002/1097-0142(19850715)56:2<403:aid-cncr2820560233>3.0.co;2-x

McCluggage, W. G., Singh, N., & Gilks, C. B. (2022). Key changes to the World Health Organization (WHO) classification of female genital tumours introduced in the 5th edition (2020). Histopathology, 80(5), 762–778. https://doi.org/10.1111/his.14609

Nikitina, I. M., Horban, N. Y., Mykytyn, K. V., Kondratiuk, K. O., Smiian, S. A., Kalashnyk, N. V., & Gerevich, N. V. (2021). The state of reproductive health of women with hyperproliferative pathology of the endometrium. Wiadomosci lekarskie (Warsaw, Poland : 1960), 74(9 cz 1), 2076–2081.

Nikitina, I. M., Horban, N. Y., Mykytyn, K. V., Kondratiuk, K. O., Smiian, S. A., Kalashnyk, N. V., & Gerevich, N. V. (2021). The state of reproductive health of women with hyperproliferative pathology of the endometrium. Wiadomosci lekarskie (Warsaw, Poland: 1960), 74(9 cz 1), 2076–2081.

Nicolae, A., Preda, O., & Nogales, F. F. (2011). Endometrial metaplasias and reactive changes: a spectrum of altered differentiation. Journal of clinical pathology, 64(2), 97–106. https://doi.org/10.1136/jcp.2010.085555

Pelzer, E. S., Willner, D., Buttini, M., & Huygens, F. (2018). A role for the endometrial microbiome in dysfunctional menstrual bleeding. Antonie van Leeuwenhoek, 111(6), 933–943. https://doi.org/10.1007/s10482-017-0992-6

Peric, A., Weiss, J., Vulliemoz, N., Baud, D., & Stojanov, M. (2019). Bacterial Colonization of the Female Upper Genital Tract. International journal of molecular sciences, 20(14), 3405. https://doi.org/10.3390/ijms20143405

Podolskyi, V., Lisyana, T., Ponomaryova I. (2015). Microbiocenosis urogenital of women with reproductive disorders and changes in vegetative homeostasis. Health of woman, 2(98), 142–150.

Raglan, O., Kalliala, I., Markozannes, G., Cividini, S., Gunter, M. J., Nautiyal, J., Gabra, H., Paraskevaidis, E., Martin-Hirsch, P., Tsilidis, K. K., & Kyrgiou, M. (2019). Risk factors for endometrial cancer: An umbrella review of the literature. International journal of cancer, 145(7), 1719–1730. https://doi.org/10.1002/ijc.31961

Ricci, E., Moroni, S., Parazzini, F., Surace, M., Benzi, G., Salerio, B., Polverino, G., & La Vecchia, C. (2002). Risk factors for endometrial hyperplasia: results from a case-control study. International journal of gynecological cancer: official journal of the International Gynecological Cancer Society, 12(3), 257–260. https://doi.org/10.1046/j.1525-1438.2002.01105.x

Shalepo, K.V., Mikhaylenko, T.G., Savicheva, A.M. (2016).The role of bacterial films in the formation of chronic pathological processes in the vagina and endometrium. Journal of Obstetrics and Women’s Diseases, 4(65), 75.

Sobczuk, A., Wrona, M., & Pertyński, T. (2007). Nowe poglady na temat klasyfikacji rozrostów błony śluzowej trzonu macicy--endometrialna śródnabłonkowa neoplazja (EIN) [New views on hyperplastic endometrial lesions classification--endometrial intraepithelial neoplasia (EIN)]. Ginekologia polska, 78(12), 986–989.

Sobczuk, K., & Sobczuk, A. (2017). New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Przeglad menopauzalny = Menopause review, 16(3), 107–111. https://doi.org/10.5114/pm.2017.70589

Tatarchuk, T. F., Kvasha, T. I., Zakharenko, N. F., Kosei, N. V., Solskyy, V. S., & Shmulian, I. V. (2021). Therapeutic options for the management of endometrial hyperplasia. Modern recommendations and promising directions of treatment: Review of the literature. Reproductive Endocrinology, (60), 86-90.

The American College of Obstetricians and Gynecologists Committee Opinion no. 631. Endometrial intraepithelial neoplasia. (2015). Obstetrics and gynecology, 125(5), 1272–1278. https://doi.org/10.1097/01.AOG.0000465189.50026.20

Vereshchagina, T. V. (2020). A modern view of the diagnosis of hyperplastic processes of the endometrium: (literature review). Achievements of clinical and experimental medicine, (1), 6-13.

Vitale, S. G., Riemma, G., Carugno, J., Chiofalo, B., Vilos, G. A., Cianci, S., Budak, M. S., Lasmar, B. P., Raffone, A., & Kahramanoglu, I. (2020). Hysteroscopy in the management of endometrial hyperplasia and cancer in reproductive aged women: new developments and current perspectives. Translational cancer research, 9(12), 7767–7777. https://doi.org/10.21037/tcr-20-2092

Walther-António, M. R., Chen, J., Multinu, F., Hokenstad, A., Distad, T. J., Cheek, E. H., Keeney, G. L., Creedon, D. J., Nelson, H., Mariani, A., & Chia, N. (2016). Potential contribution of the uterine microbiome in the development of endometrial cancer. Genome medicine, 8(1), 122. https://doi.org/10.1186/s13073-016-0368-y

Zhang, H., Feng, Q., Zhu, Z., Dai, H., & Hu, H. (2021). The Value of Vaginal Microbiome in Patients with Endometrial Hyperplasia. Journal of healthcare engineering, 2021, 4289931. https://doi.org/10.1155/2021/4289931