肠道菌群与女性生殖疾病的关系研究进展

肠道菌群的形成和增殖始于出生，其组成的改变主要取决于遗传、营养和环境因素。人体肠道内定植着千余种细菌，有高度的多样化。随着高通量测序技术、生物信息学和培养组学的发展，使得研究者能够更深入地探索微生物群的组成及其功能，肠道菌群与人体疾病之间的相关性研究蓬勃开展。肠道菌群在人体的生理、代谢、营养和免疫功能中都起着重要的作用，肠道菌群与宿主之间的微妙平衡影响不同疾病的发展。越来越多的研究聚焦于肠道菌群改变与女性生殖疾病的关联。从动物模型研究到人体研究，目前已有多项研究结果表明肠道菌群整体多样性的改变、特定细菌丰度的变化以及菌群比例的失衡与女性生殖疾病密切相关，如多囊卵巢综合征、子宫内膜异位症、妊娠并发症和不良妊娠结局，但目前对其机制的研究还很有限。以特定肠道菌群或其代谢物为靶点，在女性生殖相关疾病的诊断和治疗的临床研究中已初步展露效果。未来需要进一步地开展机制研究明确肠道菌群与女性生殖相关疾病的因果关系，以及设计更为严谨的临床试验明确有效治疗的标准，为肠道菌群在疾病预防、诊断和治疗中的应用提供更多依据。本文拟对肠道菌群与多囊卵巢综合征、子宫内膜异位症以及复发性流产的关系研究进展进行综述。

Progress on the relationship between gut microbiota and female reproductive diseases

The formation and proliferation of gut microbiota begin at birth, and its composition changes mainly depending on genetic, nutritional and environmental factors. There are more than thousands of bacteria in the human intestines which are highly diversified. With the development of high-throughput sequencing technology, bioinformatics and culturomics, researchers can deeply explore the composition of the microbiota and their functions. At present, the study on the correlation between gut microbiota and human diseases is booming. Gut microbiota plays an important role in human physiology, metabolism, nutrition and immune function. The delicate balance between gut microbiota and host affects the development of different diseases. An increasing number of studies have focused on the relationship between gut microbiota changes and female reproductive diseases. From animal model research to a human study, various results have shown that the diversity of gut microbiota, the change of species of bacteria abundance and the imbalance of some bacteria proportion, are closely related to female reproductive diseases, such as polycystic ovary syndrome, endometriosis, pregnancy complications and adverse pregnancy outcomes, however, the mechanism is still limited. Targeting specific gut microbiota or its metabolites, results have initially shown effects in the clinical study of diagnosis and treatment of female reproductive-related diseases. Therefore, further mechanism research is needed to clarify the causal relationship between gut microbiota and female reproductive diseases and design more rigorous clinical trials to clarify the standards of effective treatment to provide more basis for the application of gut microbiota in disease prevention, diagnosis and treatment. Thus, this article reviews the research progress on the relationship between intestinal flora and polycystic ovary syndrome, endometriosis and recurrent abortion.