Становление микробиоты кишечника доношенных и поздних недоношенных детей, рожденных самопроизвольно и путем операции кесарева сечения

Endometriosis is a chronic inflammatory condition affecting approximately 10% of women of reproductive age, characterized by pelvic pain, dysmenorrhea, and infertility. Emerging evidence suggests a potential link between gut microbiota dysbiosis and endometriosis pathogenesis, mediated through hormonal regulation, immune modulation, and systemic inflammation. Dienogest (DNG) is widely used for endometriosis management, but its effects on gut microbiota remain underexplored. This study investigates the impact of DNG on gut microbial composition in endometriosis patients, aiming to elucidate its therapeutic mechanisms beyond hormonal modulation. DNG therapy led to a significant reduction in the Bacillota/Bacteroidota ratio (p = 0.0421), driven by decreased Staphylococcus spp. (p = 0.0244) and increased commensal bacteria such as Lactobacillus spp. and Collinsella aerofaciens (p = 0.049). Species richness and alpha diversity indices showed a non-significant upward trend. Notably, C. aerofaciens, a butyrate producer linked to gut barrier integrity, was detected twice as frequently during therapy. The study also observed reductions in facultative anaerobes like Enterococcus spp. and a trend toward higher titers of beneficial Bacteroidota. This study provides the first evidence that DNG therapy modulates gut microbiota in endometriosis patients, favoring a composition associated with anti-inflammatory and barrier-protective effects. The observed shifts—reduced opportunistic pathogens and increased symbionts—suggest a novel mechanism for DNG’s efficacy, potentially involving the microbial regulation of estrogen metabolism and immune responses.

This review is aimed to analyse research data on the lower genital tract microbiome and factors effecting its composition, as well as the relationship with HPV-associated cervical diseases. Modern studies show that certain types of lactobacilli can play a protective role by reducing the likelihood of human papillomavirus (HPV) infection and contributing to its elimination. At the same time, dysbiotic changes, including decreased levels of lactobacilli and increased levels of opportunistic pathogens, are associated with the development of bacterial vaginosis and other abnormal vaginal biocenosis. These conditions can contribute to the persistence of HPV, increasing the risk of cervical intraepithelial neoplasia and cervical cancer. Most studies show significant differences in the vaginal microbiome composition in women with cervical intraepithelial neoplasia and malignant cervix neoplasms as compared to healthy patients. Anaerobic bacteria such as Gardnerella vaginalis, Mobiluncus spp., Peptoniphilus spp., Parvimonas micra, Prevotella spp. that can inhibit the growth of lactobacilli and disrupt the normal balance of microflora play an important role in this process. In addition, decreased levels of Lactobacillus crispatus are associated with a higher probability of HPV persistence and dysplasia progression. Studying mechanisms of interaction between vaginal microbiota and HPV is critically important to understand the mechanisms of pathogenesis of precancerous and malignant processes of the cervix. Further study of these aspects will allow the development of new prevention and treatment strategies to modulate vaginal microflora and reduce the risk of disease progression.

Background. Polycystic ovary syndrome (PCOS) is the most common endocrinopathy associated with infertility and metabolic disorders. The ethology and pathogenesis of PCOS are not fully understood. The role of gut microbiota (GM) disorders in the genesis of insulin resistance and in the development of PCOS is ambiguous. Aims to compare the GM of patients with PCOS and healthy women, to evaluate the relationship of various groups of microorganisms with markers of chronic inflammation. Methods. A single-center cross-sectional study was conducted involving 148 women: 118 with PCOS and 30 somatically healthy women aged 1840 years. A comprehensive clinical, laboratory and instrumental examination was performed, as well as an assessment of the composition of the GM using the cultural analysis method. Results. In PCOS, a decrease in the GM diversity Margalef index was revealed compared to healthy women. A statistically significant decrease in the level of colonization of Bacteroides (B. vulgatus, B. eggerthii, B. caccae), Lactobacillus gasseri, Lacticaseibacillus rhamnosus, Escherichia coli (E.coli) and, on the contrary, an increase in the population of gamma-proteobacteria of the family Enterobacteriaceae and beta-proteobacteria of the order Burkholderiales, as well as Erysipelatoclostridium ramosum (E. ramosum), compared with healthy women. Correlation analysis revealed a negative correlation of bacteria of the genera Lactobacillus, Bifidobacterium, Bacteroides with IL-6, as well as E. coli with IL-6 and C-reactive protein in patients with PCOS. A positive correlation was observed between the level of IL-6 and the abundance of bacteria of the species E. ramosum. Conclusions. The GM of PCOS patients is characterized by a decrease in Margalef diversity index, aggravated by the imbalance in microbial communities, accompanied by an increase in the levels of pro-inflammatory markers, compared with healthy women.